TITLE

Pharmacotherapy for acute heart failure syndromes

AUTHOR(S)
Coons, James C.; McGraw, Molly; Murali, Srinivas
PUB. DATE
January 2011
SOURCE
American Journal of Health-System Pharmacy;1/1/2011, Vol. 68 Issue 1, p21
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose. Drug therapies for patients with acute heart failure syndromes (AHFS) are reviewed, including clinical practice guideline recommendations for the treatment of hospitalized patients with heart failure (HF). Summary. AHFS may be defined as new-onset, gradual, or rapidly worsening HF signs and symptoms that require urgent therapy. Clinical practice guidelines from the American College of Cardiology Foundation-American Heart Association, Heart Failure Society of America, and European Society of Cardiology offer recommendations for the management of AHFS, addressing the role of diuretics, vasodilators, and inotropes. The guidelines emphasize the utility of vasodilators for patients with signs and symptoms of pulmonary congestion, including pulmonary edema or severe hypertension or both, who have not responded to diuretics. The early initiation of vasoactive medications, including diuretics and vasodilators, has been linked to improved outcomes in some reports. Conversely, the use of inotropes is deemphasized, particularly as part of the routine management of these patients. Newer agents, including vasopressin antagonists, have also been approved recently but are not addressed by the clinical practice guidelines. The guidelines address the importance of initiating and optimizing evidence-based oral medications for long-term use, including angiotensin-converting-enzyme (ACE) inhibitors, angiotensin-receptor blockers, b-blockers, and aldosterone antagonists, during the patient's hospital stay in an effort to address long-term outcomes. Conclusion. Drug therapy of AHFS may include diuretics, vasodilators, morphine, ACE inhibitors, digoxin, inotropes, and vasopressin antagonists. Clinical practice guidelines for patients with AHFS provide a useful mechanism to incorporate available evidence and standards of practice into patient care.
ACCESSION #
56943535

 

Related Articles

  • Milrinone therapy in adults with heart failure. O'Donovan, Kate // British Journal of Cardiac Nursing;Sep2013, Vol. 8 Issue 9, p426 

    Heart failure is a chronic progressive condition where the myocardial pump fails to maintain peripheral perfusion. Treatment aims to alleviate signs and symptoms, reduce hospitalizations and mortality. Heart failure patients may experience episodes of acute decompensation where cardiac output...

  • Chronic heart failure: pathophysiology, diagnosis and treatment. Nicholson, Christopher // Nursing Older People;Sep2014, Vol. 26 Issue 7, p29 

    Heart failure has significant prevalence in older people: the mean average age of patients with the condition is 77. It has serious prognostic and quality of life implications for patients, as well as health service costs. Diagnosis requires confirmatory investigations and consideration of...

  • Perindopril/Indapamide 2/0.625 mg/day: A Review of its Place in the Management of Hypertension. Matheson, A.J.; Cheer, S.M.; Goa, K.L. // Drugs;Jun2001, Vol. 61 Issue 8, p1211 

    The fixed low-dose combination of the ACE inhibitor perindopril and the non-thiazide diuretic indapamide has been evaluated in the management of patients with mild to moderate hypertension. Combination therapy aims to improve overall therapeutic efficacy while minimising adverse effects. In...

  • Heart Failure in a Breast Cancer Survivor. Moore, Susan // Oncology Nursing Forum;Mar2012, Vol. 39 Issue 2, p147 

    A 64-year-old woman named J.G. was diagnosed with a right side, node-negative, HER2-positive, hormone-negative (stage I) breast cancer about eight years ago. Following lumpectomy and sentinel node biopsy, she was referred to a medical oncologist at a National Cancer Institute-designated...

  • Underuse of ACE inhibitors in treatment of heart failure. Apgar, Barbara // American Family Physician;9/15/1997, Vol. 56 Issue 4, p1170 

    Presents a summary of the work `Heart Failure Treatment With Angiotensin-Converting Enzyme Inhibitors in Hospitalized Medicare Patients,' by the Large State Peer Review Organization Consortium from the `Archives of Internal Medicine' dated 1997.

  • Therapeutic Options for the Management of the Cardiorenal Syndrome. Koniari, Katerina; Nikolaou, Marinos; Paraskevaidis, Ioannis; Parissis, John // International Journal of Nephrology;2011, p1 

    Patients with heart failure often present with impaired renal function, which is a predictor of poor outcome. The cardiorenal syndrome is the worsening of renal function, which is accelerated by worsening of heart failure or acute decompensated heart failure. Although it is a frequent clinical...

  • Managing Hypertension in the Elderly: A Common Chronic Disease with Increasing Age. Nguyen, Quang t.; Anderson, Scott R.; Sanders, Lindsay; Nguyen, Loida D. // American Health & Drug Benefits;May/Jun2012, Vol. 5 Issue 3, p146 

    The article presents a study which examines hypertension in elderly and existing strategies to improve its management. The study investigates over 4600 elderly patients with isolated systolic hypertension (ISH) who were randomized to receive dihydropyridine nitrendipine or placebo. The study...

  • Lack of adherence to hypertension treatment guidelines among GPs in southern Sweden-A case report-based survey. Ekesbo, Rickard; Midlöv, Patrik; Gerward, Sofia; Persson, Kristin; Nerbrand, Christina; Johansson, Lennart // BMC Family Practice;2012, Vol. 13 Issue 1, p34 

    Background: General practitioners (GPs) often fail to correctly adhere to guidelines for the treatment of hypertension. The reasons for this are unclear, but could be related to lack of knowledge in assessing individual patients' cardiovascular disease risk. Our aim was to investigate how GPs in...

  • BNP thresholds should be adjusted by patient age.  // Pulse;6/16/2010, Vol. 70 Issue 21, p8 

    The article reports on the result of a study regarding the implementation of the age-related cut-off points for B-type natriuretic peptide (BNP) for patients with heart failures in Great Britain.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics