Mandatory Synthesis Essay

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.

Together ACE inhibitors and ARB’s work to lower heart rate and blood pressure by inhibiting the RAS (renin-angiotensin system) in the sympathetic nervous system. This “fight or flight” system is activated by the heart when it senses the inability of the ventricles to pump blood, in which cardiac output and blood pressure are decreased. These medications act by blocking this system and therefore decreasing blood pressure and heart rate (Markaity, 2012). Commonly used ACE inhibitors include: enalapril (Vasotec), benazepril (Lotensin), lisinopril (Prinivil, Zestril) and captopril (Capoten). Commonly used ARBs include: losartan (Cozaar), Candesartan (Atacand), Valsartan (Diovan) (heart.org).Common side effects of ACE inhibitors and ARBs are: dry cough, dizziness, hypotension and hyperkalemia. Renal function tests and serum potassium levels should be monitored periodically. ACE inhibitors and ARBs have a label of pregnancy category D while in the second and third trimesters

Progressivism expanded across American cities and provided a variety of responses to issues of Americans after the introduction and rapid growth of the urban industrial order. Initially the progressive began as a social movement and grew into a political one. The goals of the movement varied addressing issues such as increasing democracy in the government, the improvement of working and social conditions and identifying and correcting issues of corrupted power.

In Amy Chua’s essay, “The Right Road to America” she argues the point that immigration is a great value of this country and that America was built from immigrants. One thing differs from Chua’s essay than from others because she not only gives highly credible facts on how immigrants have helped our country, but she also provides ways to improve the issues of immigration into America. Amy Chua is a highly credible professor at Yale and states throughout her essay that immigrants who possess American values deserve to be here in America and those who don’t should leave. America had always been a country that accepted immigration and allowed all

Patients who have congestive heart failure and do not respond to diuretics may benefit from a combination of several types of diuretic medication, each with a different system of action. Another medication for someone that has congestive heart failure can take Beta-blockers. Side effects include fatigue, cold hands, headache, upset stomach, constipation, diarrhea, dizziness, and shortness of breath. Data reported from 17 studies, researchers came to the conclusion that the risk of death from all causes was 31 percent lower in patients with heart failure who were treated with beta-blockers than in those not receiving such medications. Aldosterone blockers is a form of medication one may take to help slow down the rate of congestive heart failure.This medication can sometimes affect kidney function and can also increase potassium levels. Aldosterone blockers are prescribed to individuals who develop heart failure after a heart attack. Studies show that these medications can reduce the risk of hospitalization and death from cardiovascular disease. The last form of medication is BiDil (isosorbide

It has recently been brought to my attention that our school is looking to adopt a sustainable menu into our meal program and I would like to give my viewpoint on the matter. As one many students here at Oxford Academy this change will affect me directly. Although people may at first oppose this conversion I think if we are able to overcome the first obstacles, this change would bring a great positive impact to the environment and the health of our students.

As time progresses, foreign languages are being abandoned in English-speaking countries. This is because English is becoming a dominant language in international affairs. A common question has arisen because of this situation as Americans are left wondering what will become of foreign languages in the future. At this present time, monolingual English speakers are at a disadvantage. Being multilingual offers better opportunities in the working field and improves brain flexibility. On the other hand, it is understandable that it can be useless as English is becoming an international language and it is expected that people who live in America should know English already.

Lisinopril and levofloxacin were prescribed for Mr. P. Lisinopril was prescribed to treat Mr. P’s new found hypertension. Lisinopril is considered an angiotensin converting enzyme inhibitor (ACE inhibitor). ACE inhibitors are designed to block the vasoconstrictive properties by angiotensin II (Gutierrez, 2008, p712). By blocking this action, and dilating the arteries, the increased workload of the heart is once again decreased, causing decreased blood pressures again (Gutierrez, 2008, p712). ACE inhibitors also help the kidneys excrete sodium and water, thus decreasing the blood volume and decreasing the workload of the heart (Gutierrez, 2008, p712). ACE inhibitors “are biotransformed in the liver” (Gutierrez, 2008, p713, para 5). Excretion occurs through the urine and stool (Gutierrez, 2008, p713).

Pharmacological treatments with diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers or aldosterone antagonist, and beta-blockers are essential for the treatment of heart failure and are effective in improving symptoms of heart failure and patient well-being. Diuretics are administered to help get rid of the excess fluid that helps improve breathing associated with shortness of breath, at rest or on exertion. Diuretics provide relief from symptoms and signs of pulmonary and venous congestion by promotion of fluid loss through the kidneys. Diuretics, for example, Furosemide helps improve breathing status, but monitoring patients for dehydration and kidney problems is crucial. Patient education is essential to ensuring medication adherence and early identification of adverse effects and potential for drug interactions.

According to National Clearinghouse Guidelines, several classes of drugs should be considered in the treatment of systolic heart failure. Angiotensin-converting Enzyme (ACE) inhibitors and Beta Blockers are the treatment of choice for systolic heart failure. Some beta-blockers have demonstrated the benefit of improving clinical symptoms, increasing ventricular function, and decreasing hospitalizations and mortality in systolic heart failure patients. If Ms. Boehmer has intolerance to ACE inhibitors, she may benefit from the combination of Hydralazine and Isosorbide dinitrate (especially beneficial for African Americans with heart failure) or Angiotensin II receptor blockers (ARB). Digoxin can improve Ms. Boehmer’s symptoms. Digoxin is beneficial

All hypertensive drugs lower blood pressure. However, they’re many forms of the drug, all with differing mechanisms of action. Hypertension refers to the constant lingering of blood pressure above the taken normal range of 120/80 mm Hg. Without the proper treatment, hypertension can lead to extreme difficulties such as kidney failure, coronary heart disease or a stroke. Angiotensin converting enzyme (ACE) inhibitors is an antihypertensive drug, which is among the most widely prescribed drug for lowering blood pressure in the United States (Friedman 2004). Angiotensin causes the narrowing of arteries, predominantly in the kidneys. ACE inhibitors assist in producing less angiotensin throughout the body, subjecting the blood vessels to vasodilation,

ACE inhibitors have an increasing role in the management of cardiovascular risk. Examples of these drugs include enalapril, captopril, fosinopril, perindopril, lisinopril, ramipril and quinapril. The reduction in blood pressure that follows ACE inhibition is greatest after

Congestive Cardiac Failure bring an adverse impact on both people’s life and health care systems. Therefore, medication treatment might play an indispensable part in coping with congestive cardiac failure. There are different types of medication could be used to treat CHF, for example, angiotensin- converting enzyme(ACE) inhibitors, β-blockers and digoxin. What’s more, congestive cardiac failure are less likely to accept aspirin, heparin, oral beta-blockers, however, they are more likely to accept angiotensin-converting enzyme(ACE) inhibitors(Garry, Wilson, & Vlodaver, 2017).

The methods that people use to lose weight have a positive effect on the brain because they fuel the brain by providing energy. According to the article “How Low-Carb and Ketogenic Diets Boost Brain Health” a registered dietitian states, “Low carb diets have a fascinating way of providing your brain with energy via processes called ketogenesis and gluconeogenesis” (Franziska Spritzler). Ketogenesis relates to the production of ketones. Ketones are produced when a person goes without eating for hours. These ketones are used by the brain as fuel when needed. Ketones are more commonly used in places such as the heart, the muscles and the brain. When glucose levels are low, ketones are used by the brain to fulfill energy requirements. Gluconeogenesis is defined as the production of new glucose.

Citizens that live in middle and upper-class communities are apart of the main percentage of people that use vehicles due to vehicles playing a major role in human life. However, many countries are recognizing the detrimental effects that car usage has on society and the environment. Lowering the high percentage of citizens that rely on vehicles can lower environmental concerns, improve living conditions in high populated areas, and developing a more dynamic population. The limitations of car usage would obtain numerous benefits for the environment. The article “In German Suburb, Life Goes On Without Cars” by Elisabeth Rosenthal states that “70 percent of Vauban’s families do not own cars...