在患有急性心力衰竭的患者中,Carperitide的良好利尿反应和施用方法的预测因素
Mayumi Inamoto1, Noriko Kohyama2, Hiroshi Suzuki3
1Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, Tokyo, Japan; Department of Pharmacy, Showa University Fujigaoka Hospital, Kanagawa, Japan.
Clinical therapeutics
|November 9, 2023
概括
预测因素如年龄较小,以前没有使用循环利尿剂,血液尿素/白细胞数量较低,表明急性心力衰竭中对卡佩里的利尿反应良好. 在furosemide的2小时内给出carperitide可以改善结果.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 急性心力衰竭 (AHF) 经常导致肺堵塞.
- 在日本,Carperitide是对AHF的推治疗方法.
- 优化carperitide的使用需要识别反应的预测因素和理想的管理时间.
研究的目的:
- 确定与AHF患者对卡佩里提德的良好利尿反应相关的因素.
- 为了确定与furosemide有关的carperitide的最佳时间.
主要方法:
- 对293名住院的AHF患者进行了回顾性队列研究,这些患者接受了卡佩里提德治疗.
- 定义好的利尿反应是尿液输出≥100毫升/小时在6小时内.
- 使用多变量分析来识别预测因素,并分析了罗塞米德和卡佩里提德的时间.
主要成果:
- 53.6%的患者表现出良好的利尿反应.
- 良好反应的预测因素包括年龄<75岁,以前没有使用循环利尿剂,BUN<20 mg/dL,WBC<8.6 × 109/L.
- 在furosemide的2小时内给予卡佩里提德,与>6小时间隔相比,导致尿量显著增加.
结论:
- 年龄,先前的利尿剂使用,BUN和白细胞计数是对卡佩里提德施用决策的有用指标.
- 在静脉注射弗洛塞米德后2小时内服用卡佩里提德可能会增加肺堵塞的改善.
更多相关视频
相关概念视频
Heart Failure Drugs: Diuretics
400
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...
400
Heart Failure V: Medical Management
9
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...
9
Heart Failure VI: Adjunct Therapies
15
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.
15
Heart Failure Drugs: Inotropic Agents
598
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...
598
Acute Kidney Injury V: Interprofessional Care
11
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
11
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
438
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...
438


