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Related Concept Videos

Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

38
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
38
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

161
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
161
Mitral Regurgitation IV: Nursing Management01:28

Mitral Regurgitation IV: Nursing Management

113
Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
113
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

47
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
47
Angina V: Nursing Management01:20

Angina V: Nursing Management

79
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
79
Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

778
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
778

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SGLT-2 Inhibitor Use in Heart Failure: A Review for Nurses.

Katherine L March1, Jack G Lukas, Theodore J Berei

  • 1Clinical Pharmacy Department, Methodist University Hospital, Memphis, Tennessee (Drs March, Lukas, and Cave); University of Tennessee Health Science Center, College of Pharmacy, Memphis (Drs March, Lukas, and Cave); and University of Wisconsin Hospitals and Clinics, Madison (Drs Berei and Shah).

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Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are now key heart failure treatments, showing reduced mortality and hospitalizations. This review explores their benefits, mechanisms, and clinical use in heart failure patients.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Metabolic Diseases

Background:

  • Sodium-glucose cotransporter-2 (SGLT-2) inhibitors, initially for type 2 diabetes mellitus (T2DM), demonstrated significant benefits in heart failure (HF) outcomes in clinical trials.
  • Landmark studies in T2DM patients revealed reduced mortality and HF hospitalizations, prompting further investigation into SGLT-2 inhibitors for HF management.
  • Empagliflozin and dapagliflozin have been specifically evaluated in heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction.

Purpose of the Study:

  • To review current literature on SGLT-2 inhibitors as adjunctive therapy for heart failure.
  • To evaluate the proposed metabolic and hemodynamic mechanisms underlying SGLT-2 inhibitor efficacy in heart failure.
  • To assess adverse effects and practical considerations for clinical implementation of SGLT-2 inhibitors in heart failure.

Main Methods:

  • Literature review of clinical trials and studies on SGLT-2 inhibitors in heart failure.
  • Analysis of data regarding cardiovascular outcomes, mortality, and hospitalization rates.
  • Synthesis of proposed mechanisms of action and safety profiles.

Main Results:

  • SGLT-2 inhibitors are now recognized as foundational therapy in heart failure guidelines (American and European).
  • Empirical evidence supports their use in both heart failure with reduced and preserved ejection fraction.
  • Ongoing research aims to elucidate the precise mechanisms of benefit, including metabolic and hemodynamic pathways.

Conclusions:

  • SGLT-2 inhibitors represent a significant advancement in heart failure pharmacotherapy.
  • Further research is needed to fully understand the mechanisms of action and optimize clinical application.
  • These agents are increasingly integrated into standard heart failure treatment protocols.