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CHF 4TH UNIT.pptx
1. Introduction
⚫ Congestive heart failure (CHF) is defined as the inefficiency of the
heart to pump sufficient amounts of oxygenated blood to the organs
of the body to meet their normal metabolic demands.
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2. Classification
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Based on inotropic effects:
1. with positive inotropic effects:
Levoimendan,
a. Cardiac Glycosides: Digitoxin, Digoxin, Ouabain
b.Phosphodiesterase Inhibtors: Inamrinone, Milrinone
c. β-adrenergic agonist: Dobutamine, Dopamine, Dopexamine
3. 2. without positive inotropic effects:
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a. Angiotension converting enzyme (ACE)inhibitor: Captopril,
Enalapril, Ramipril, Lisinopril
b. β-adrenergic receptor antagonist: Bisoprolol, Carvedilol,
Metorolol
c. Diuretics: Acetazolamide, Bumetanide, Hydrochlorothiazine,
Metolazone, Spironolactone
d. Vasodilators: Hydralazine, Isosorbide dinitrate, sodium
nitropruside, Nesiritide
4. Cardiac Glycosides
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⚫ Cardiac Glycosides are naturally occurring drugs with positive
inotropic action.
⚫ They are also termed cardiotonics. Cardiac glycosides are obtained
from various sources.
5. ⚫ Digitalis gets reversibly bound to the sodium or potassium ATPase
pump and inhibits its activity. This results in progressive
accumulation of intracellular sodium ions and loss of potassium
ions. Due to the deposition of intercellular sodium ions, sodium or
calcium exchange pump gets activated.
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7. Adverse Drug Reactions:
⚫ Dizziness, Depression, Confusion,Anxiety
⚫ Nausea, Vomiting, Diarrhea
⚫ Head ache
⚫ Rashes, weakness
⚫ Irregular Heart rate
⚫ Blurred vision
Therapeutic Uses:
⚫ Used in the treatment of heart failure, used to relieve symptoms of
heart failure when the patient does not responding to ACE inhibitor
and diuretics.
⚫ It reduces the heart rate and increase the cardiac output.
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9. Adverse Drug Reactions:
⚫ Dizziness,Anxiety
⚫ Nausea, Vomiting
⚫ Diarrhea
⚫ Head ache
⚫ Rashes, weakness
⚫ Irregular Heart rate
⚫ Visual problems
⚫ Low platelet count
Therapeutic Uses:
⚫ Used in the treatment of heart failure
⚫ Used to treat certain types of irregular heart beat can decrease the
risk for blood clots that may reduce the risk for heart attacks
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12. Adverse Drug Reactions:
⚫ Head ache, Nausea, Vomiting
⚫ Rashes, Itching
⚫ Hypotension, Sweating
⚫ Anemia, Confusion
⚫ Cough
⚫ Increase creatinine
⚫ Injection side reactions
Therapeutic Uses:
⚫ It will relax and dilutes blood pressure, lowering blood pressure
improve the breathing in people with CHF.
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14. Pharmacokinetics:
⚫ Intravenous route of administration, metabolized in liver,
eliminated through urine
Adverse Drug Reactions:
⚫ Nausea
⚫ Head ache
⚫ Hypotension
Therapeutic Uses:
⚫ Used in the treatment of heart failure
⚫ Used to improve cardiac output
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16. 16
Adverse Drug Reactions:
⚫ Dizziness
⚫ Allergic reaction
⚫ Swelling
Therapeutic Uses:
⚫ It is used treat high blood pressure, It acts as a vasodilator and was
designed as a therapy for patients with acute heart failure.
