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What is the disease? What causes it . Heart Failure is a clinical syndrome with characteristics signs and symptoms which results of damage to the heart that impairs its ability to pump blood to the rest of the body in a normal fashion. Hypertension, Myocardial infarction and other cardiomyopathies,
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1. “Medicines are nothing in themselves, if not properly used, but the very hands of the GODS if employed with reason and prudence.”- Herophilus (Floruit 300B.C.)
2. What is the disease? What causes it Heart Failure is a clinical syndrome with characteristics signs and symptoms which results of damage to the heart that impairs its ability to pump blood to the rest of the body in a normal fashion. Hypertension, Myocardial infarction and other cardiomyopathies, as well as chronic uncontrolled anemia can cause heart failure.
3. What is the pathology? www.mc.uky.edu/.../pha824hf/PHA824hf.html
4. Who is at risk? 5.000.000 Americans are affected by Heart Failure
It is the most common cause of hospitalizations in seniors = 65 years or older
It is a cardiovascular condition increasing in prevalence
Over the next decade the number of Americans > than 65 years will increase from approx 11 to 20 million
5. What are the symptoms? The triad of classic symptoms are:
Shortness of breath
Fluid accumulation
Overwhelming fatigue
6. What is the pharmaceutical treatment? ACE inhibitors
ARBs
Diuretics
B-Blockers
Digoxin
7. How was the drug discovered? Captopril. The first ACE inhibitor developed in 1975. Approved by FDA 1981
8. How does the drug work
9. How much does the drug cost? According to their medical plan, patients on Medicare or Medicaid can pay up to 20% of the cost of the generic drug at their local pharmacies
Wal-Mart $4.00 plan includes: Benazepril,Captopril, Enalapril and Lisinopril. ARBs are not included in the $4.00 plan. Digoxin is included in the plan, as well as, traditional B-blockers and diuretics
10. What is the dosage? How long is the treatment administered? The dosages vary according to the drug.
Benazepril presentations: Lotensin (Novartis) 5mg,10mg,20mg,40mg
Captopril presentations: Capoten (Mylan)
12.5mg,25mg,50mg,100mg
Enalapril: Vaseretic (Merck) 5/12.5mg and 10/25mg
11. How is the drug administered? Mainly orally as tablets and extended release tablets, but can also be administered intravenously
12. What are the side effects? Why do they occur? Side effects of ACE inhibitors
Persistent cough
Decrease renal function in certain patients
Angioedema
Loss of taste
13. How are the side effects treated? Substitution of ACE by ARBs
Reduction of dosage
Shift to another therapeutic agent