Use of Ramipril and Carvedilol Combination Therapy in Heart Failure

2386 Words Dec 12th, 2013 10 Pages
Assignment:

Treatment

of

Heart

Failure:

The severity of HF is determined by The New York

Carvedilol and Ramipril

Heart Association classification (NYHA), which is

Keywords: Heart failure, beta-blockers, carvedilol,

summarized in the table 15.

angiotensin-converting enzyme inhibitors, ramipril.
INTRODUCTION
Heart failure (HF) is the disease of the elderly. Over
70% of the patients are older than 65 years. The risk of having the condition rises with age. HF can be defined as a clinical syndrome. The ability of the heart to pump blood is impaired and it can no longer meet the body’s metabolic requirements

Table 1. New York Heart Association Classification of Heart
Failure. Remme WJ, Swedberg K. Guidelines for the diagnosis
and
…show more content…
It was

al., 2006) suggests that the drug blocks ATP-

proven that these therapies significantly reduce the

sensitive (KATP) and G-protein-activated (KG)

risk of mortality and improve the symptoms.

potassium

However,

by

hyperinsulinemia and hypoglycemia. It is believed

implementing multi drug therapy. ACE inhibitors

that the KG channel is opened by G protein in

can cause hypotension, cough, and worsen the renal

response to stimulation of G-protein-coupled

function. Cough can cause patient noncompliance,

muscarinic acetylcholine receptors in atria and sino-

which in turn may result in the need of different

atrial node cells. Therefore, the inhibition of this

drug therapy. Beta-blockers can cause bradycardia,

channel would result in anti-cholinergic effects in

hypotension, fatigue and fluid retention. Also, in

the heart12.

Study

patients

there

with

and

Australian-New

are

risks

diabetes,

associated

beta-blockers

ion

channels.

This

results

in

could

potentially mask the symptoms of hypoglycemia7.

Pharmacodynamics
Carvedilol is a racemic mixture of R and S

Carvedilol

enantiomers. Both enantiomers show α1 receptor

Carvedilol is a non-selective beta-blocker (ß1 and

inhibition. However, only S enantiomer inhibits ß

ß2)

has

adrenoreceptors. It competitively blocks both ß1 and

vasodilatation and antioxidant effects. Previously it

ß2 receptors. The drug reduces high blood pressure

was

be

mainly due to the α1 and ß blockage. The

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