Heart failure Flashcards
(48 cards)
some things to tell patients about NHPs
can interact with meds could have detremental effects on the body need to be looked at seriously tell HCP about your use include on medication lists educate on reliable sources of info
what are patients with heart failure at an increased risk of
polypharmacy
have multiple comorbid conditions and prescribers and pharmacies
delicate fluid electrolyte balance
elderly have renal/hepatic impairment
are NHP taken seriously
patients dont think theyre medicine
dont tel HCP
often left out of med histories
CV benefit with which PUFA
DHA EPA
found in fish oil, flax seed, canola oil, soybeans
PUFA adverse effects
fish burp halitosis heartburn dyspnea nausea loose stools rash
omega 3 MOA
lower triglyceride levels at higher doses prevent serious arrthymias decrease platelet aggregation lower blood pressure lower resting HR
american heart association recommends daily use of omega 3 in the form of DHA and EPA for what
secondary prevention of CV disease
updated to patients with HFrEF
what cant be garunteed for omega 3
not standardized so may not be reliable
get from a reliable source
what is coenzyme q
vit compound found in the body high concentrations in mitochondria of the heart liver and kidney
coenzyme q MOA
important role in production of ATP
patients with HF have reduced levels
inhibition of ATP production can cause cell death and tissue dmaage
replacing the coenzyme q might improve cellular energy production and prevent cell death in people with HF
sources of coenzyme q
some in meats and seafood
side effects of coenzyme q
just GI no toxicity
coenzyme q drug interactions
warfarin - decreased effect becuase structurally similar to vitamin k so warfarin binds to this instead
increase the antihypertensive effects of some BP lowering drugs
bottom line for vit D supplementation in HF
seen loewr vit D levels at increased risk of CVD but supplementation does nothing
can recommend for general health doesnt cause any harm but wont dhave any benefit
vit E role in HF
advise against
increase risk of hospitalization, mortality, HF
what drug is hawthorn like
digoxin
pharmacological effects of the flavonoids in hawthorn
reduce BP and HR
positive inotroph
vasodilatory
reduce afterload
potential benefits of hawthorn
may help with symptoms but no decrease in mortality
hawthorn drug interactions
enhances digoxins activity
inhibits synthesis of thromboxane 2, increase risk of bleeding in patients on antiplatelets or anticoagulants
examples of herbal diuretics
dandelion
stinging nettle
corn silk
herbal diuretuics recommendation
advise not to use as no evidence that they reduce edema in patients with HF
what is l carnitine
amino acid cofactor in skeletal muscles and the heart
lcarnitine proposed mechanism
genereates energy within the cells causing a positive inotropic effect
HF patients have lower levels in their heart tissue
what is l-arginine do
amino acid for protein synthesis
substrate for NOS enzyme which forms nitric oxide causing vasodilation
