Medicines are nothing in themselves, if not properly used, but the very hands of the GODS if employe

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.

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What is the pathology?

• www.mc.uky.edu/.../pha824hf/PHA824hf.html

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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 gt
  than 65 years will increase from approx 11 to 20
  million

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What are the symptoms?

• The triad of classic symptoms are
• Shortness of breath
• Fluid accumulation
• Overwhelming fatigue

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What is the pharmaceutical treatment?

• ACE inhibitors
• ARBs
• Diuretics
• B-Blockers
• Digoxin

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How was the drug discovered?

• Captopril. The first ACE inhibitor developed in
  1975. Approved by FDA 1981

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How does the drug work
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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

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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

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How is the drug administered?

• Mainly orally as tablets and extended release
  tablets, but can also be administered
  intravenously

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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

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How are the side effects treated?

• Substitution of ACE by ARBs
• Reduction of dosage
• Shift to another therapeutic agent