Agiotensin Beta Blocker

Situation: Two patients in their 70s present to the office at different times today, each with documented heart failure: one diastolic and the other systolic, and both are hypertensive. First, discuss the difference between systolic and diastolic heart failure, providing appropriate pathophysiology. ACEI/ARBs are the only medications prescribed for CHF that have been found to prolong life and improve the quality of that life. EXPLAIN the mechanism of action of ACEI/ARBs and how they affect morbidity and mortality in CHF. Be specific. Diuretics must be used very carefully in diastolic ventricular dysfunction. EXPLAIN this statement using appropriate physiology. Now considering all of the above, describe an appropriate comprehensive plan of

Congestive heart failure patients may need multiple medications. Each medication option treats a different symptom or contributing factor and comes

Varying patients may present to their clinician or the emergency department for treatment with heart failure. It is important to understand that there is more than one type of heart failure; primarily the focus is placed on diastolic heart failure and systolic heart failure. Depending upon the cause of heart failure and what areas are affected dictates the treatment plan needed. While there are similarities with both kinds of heart failure, there are also differences that can help the clinician distinguish the diagnosis needed to fit the patient. Once a diagnosis is made the clinician can move forward in determining if the patient is at risk for use of diuretics and then look towards prescribing ACEIs, ARBs, and beta-blockers.

daily. She is also on metoprolol tartrate 25 mg half tablet b.i.d. She cannot tolerate ACE inhibitors or ARB secondary to angioedema in the past. The patient was started on metoprolol after an episode of ventricular tachycardia with ectopy for which she was hospitalized. She does see David Cunningham

Patient Sallie Mae Fisher was released from the hospital last Saturday. This patient is eighty two years old and lives alone as her daughter lives too far away to be helpful. Her medical history includes chronic congestive heart failure (CHF), atrial fibrillation (AF), and hypertension (HTN). She has been hospitalized four times for CHF exacerbation in the last six months. She was discharged from the hospital after being there three day to treat increased dyspnea, an eight pound weight gain, and chest pain. This paper will identify, prioritize, and describe at least four problems with evidence for each problem and identify at least four medical or nursing interventions with rationale for the interventions included.

Alpha-blockers or alpha-adrenergic antagonist drugs help to decrease blood pressure and dilate blood vessels, allowing for blood to move more freely.Alpha-blockers accomplish this by either limiting or inhibiting the affects of norepinephrine, a stimulant hormone of the sympathetic nervous system. The term norepinephrine or noradrenaline works to constrict the muscles that line the interior of small veins and arteries in the body (Mayo Clinic, 2014). There are two types of alpha-receptors that are affected by norepinephrine, alpha-1 and alpha-2 receptors.Alpha-1 receptors are found throughout the body in: male reproductive organs, eyes, bladder, prostatic capsule, and more importantly blood vessels.Alpha-2 receptors exist in presynaptic nerve terminals. By blocking noradrenaline affects on alpha-1 receptors coronary arteries and veins will remain open, allowing for increased blood flow and in turn lowering blood pressure (Aschenbrenner & Venable, 2012).

Patient A.S. is 87-year-old female with a diagnosis of Acute onset chronic systolic heart failure, Afib, CHF, and hypothyroidism. She has a past medical history of Hypertension, diabetes mellitus, CAD (Stent 2001). The patient was admitted to Lutheran Augustana Center on January 4, 2016 and was evaluated for therapy on January 5, 2016. Her current medications include Albuterol and Ipratropium via nebulizer to address shortness of breath. A combination of drugs to treat the symptoms of congestive heart failure and other comorbid diagnosis include: Eliquis, Furosemide, hydralazine, and metoprolol. Other medications include Synthroid to treat hypothyroidism, Tradjenta for hyperglycemia, and Zocor for hyperlipidemia. The patient also presented with skin problems. She has bilateral ecchymosis in her lower extremities and abdomen. Lotrisone lotion was prescribed for atopic dermatitis. Edema was also present in her lower extremities.

The study shows that disease-modifying medications were prescribed significantly more often in 2000 than in 1995, particularly in patients younger than 65 and in those aged 75 to 84 (Saczynski et al., 2009, p. 3). The study indicates that Beta-blockers and ACE inhibitors have been shown to improve survival and reduce hospitalizations in patients with Heart Failure. The second article mentioned about the elderly patients who have CHF not on or under dosage of Angiotensin Converting Enzyme (ACE) inhibitors. According to this article ACE inhibitors should be given for patients diagnosed asymptomatic left ventricular systolic dysfunction (LVSD) (EF<40%) and symptomatic heart failure with systolic dysfunction associated with other heart problems such as myocardial infarction, pulmonary hypertension. The suggested dosage for the CHF patients mentioned in the article and due to age-related changes in pharmacokinetic drugs, it also recommended the initial dosage must be half the standard dose and gradual increase after assessing renal function. After studying a group of elderly CHF patients revealed that higher or standard dose of ACE inhibitors reduce the risks of major clinical events. Results from the research display a decrease of hospitalizations due to cardiovascular reason, heart failure, and ischemic events in the standard-dose group. The study also found out that the adverse effects of high doses can be managed by reducing the dosage or by changing

Mineralocorticoid/aldosterone receptor antagoists are the useally recommended in all heart failure patient with reduce left ventricular ejection fraction <35%. Precution should be taken before giving MRAs to the patient with reduce renal function (24). ACEi supress the secretion of adlosterone transiently. So, the treatment

Beta-2 Adrenergic Agonists Are Substrates and Inhibitors; Albuterol is a beta-adrenergic agonist called also sympathomimetic. It mimics the effect of sympathetic nervous systems.

Therapeutic measures for a patient with congestive heart failure would be daily weights, dietary sodium restrictions, positioning in high or semi-Fowler’s position, frequent vital signs, oxygen by cannula or mask, medical devices: pacemakers, internal cardiac defibrillator, biventricular cardiac pacemaker, ventricular assist device, medications: digoxin, diuretics, inotropes, nesiritide, beta blockers, surgery: heart valve repair or replacement, coronary

Experiment one tested the concentration of experimental beta blockers, and its relationship with the percent decrease in of the heart rate of the Daphnia. Our goal, was to prove that, an increased concentration of beta blockers would decrease the overall heart rate of the Daphnia being tested. Our results, established, that as the beta blocker concentration increased, so did the decrease in the heart rate of the Daphnia. Experiment two tested two unknown concentrations (A and D) and its effect on the Daphnia to see if it contained any concentration of beta blockers. The results, for concentration A showed very little effect, and concentration D seemed to have no effect on the Daphnia at all. Experiment one shows, that

Beta Blockers are known as a medicine that used to treat a person who has a blood pressure. By blocking the effect of adrenaline and noradrenaline, this drug can lower blood pressure, slow down the heart rate and lessen the force of the blood impelled in the body. While taking this drug, it requires to check the pulse daily and when it is slower than it was supposed to be, ask the doctor if the medication needs to take that day. Sometimes, the beta blocker doesn’t work right while the person is also using another drug. The person who is taking this medication should avoid caffeine and alcohol and for those whom this drug may not work with them are older people and people with asthma, for those who has a low blood pressure, and person who has

For years health care providers have been using drugs like beta blockers or ACE inhibitors to treat patients with heart failure, but with cardiovascular disease still being a leading cause of death, it is evident that current treatments have been lacking the ability to produce adequate results. However, with the newest heart failure drug on the market a positive change has finally come for heart failure patients. The new heart failure drug reigns far more superior when compared to the treatments healthcare professionals already use and can potentially alter the foundation of heart failure treatments altogether.

There are a plethora of treatments available for patients with heart failure including but not limited to diuretics, ACE inhibitors, angiotensin receptor blockers, and oral nitrates. The Vasodilator heart failure (V-HEFT) studies show that enalapril has less cumulative mortality among study participants when compared to patients taking a combination of isosorbide dinitrate and hydralazine. (MGMT) This is not to say that the combination of isosorbide dinitrate and hydralazine is not efficacious because when compared to placebo, mortality rates improved with the combination treatment.