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Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

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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...
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Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

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β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

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The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
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Related Experiment Video

Updated: Jun 21, 2025

Author Spotlight: Workflow for Integrating POCUS Data into EHR for Managing Heart Failure Patients
03:47

Author Spotlight: Workflow for Integrating POCUS Data into EHR for Managing Heart Failure Patients

Published on: July 12, 2024

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Challenges to heart failure medication prescribing post-hospitalization.

Jiaqi Li1, Visopiano Sanyu2, Elise Coia1

  • 1Department of Pharmacy, Cabrini Hospital, Malvern, Melbourne, VIC 3144, Australia.

The International Journal of Pharmacy Practice
|July 16, 2024
PubMed
Summary

Prescribing of heart failure (HF) medications, including renin-angiotensin-aldosterone system inhibitors and HF-specific beta-blockers, remains low upon hospital discharge. This study highlights a gap in guideline-recommended HF pharmacotherapy.

Keywords:
cardiovascular pharmacologyevidence-based therapiesheart failureheart failure treatmentmedication managementpost-hospitalizationprescribing challenges

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Area of Science:

  • Cardiology
  • Pharmacology
  • Health Services Research

Background:

  • Heart failure (HF) is a significant cause of morbidity and mortality.
  • Evidence-based guidelines recommend specific pharmacotherapies for HF management.
  • Optimizing medication prescribing at discharge is crucial for patient outcomes.

Purpose of the Study:

  • To assess the current prevalence of guideline-directed medical therapy (GDMT) prescribing upon discharge for patients admitted with heart failure.
  • To identify prescribing rates for key HF medication classes.

Main Methods:

  • A retrospective audit of 216 heart failure admissions over six months.
  • Analysis of electronic health records to extract medication data at discharge.

Main Results:

  • Prescribing rates for key HF medications at discharge were: renin-angiotensin-aldosterone system inhibitors (32.9%), HF-specific beta-blockers (31.5%), aldosterone receptor antagonists (42.6%), sodium-glucose cotransporter-2 inhibitors (11.6%), and angiotensin receptor-neprilysin inhibitors (10.6%).
  • Overall prescribing of guideline-recommended HF medications remains low.

Conclusions:

  • Despite established benefits and guideline recommendations, the prescription of heart failure medications at discharge is suboptimal.
  • Further interventions are needed to improve adherence to evidence-based pharmacotherapy for heart failure patients.