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Farmakološko zdravljenje napredovalega srčnega popuščanja = Pharmacotherapeutic management of advanced heart failureŠebeštjen, MiranHospital admissions for acute decompensated heart failure (ADHF) have increased precipitously during the past few decades and are projected to continue to increase in the future. To optimize patient ... outcomes and reduce the costs associated with this disorder, evidence-based pharmacotherapy is essential. The currently available parenteral vasoactive drugs for decompensated heart failure include: (1) vasodilators such as nesiritide, nitroprusside and nitroglycerin (glyceryl trinitrate); (2) catecholamine inotropes, primarily dobutamine; (3) inodilators such as milrinone, a phosphodiesterase inhibitor; (4) levosimendan. Vasodilators are most appropriate for those patients who are primarily volumeoverloaded, but with adequate peripheral perfusion. In this class of agents, nesiritide (recombinant human B-type natriuretic peptide) offers advantages over currently available drugs. Nesiritide produces rapid and sustained decreases in right atrial and pulmonary capillary wedge pressures, with reduction in pulmonary and systemic vascular resistance and increases in cardiac index. Catecholamine- and phosphodiesterase-based inotropic therapies are efficacious, but the inereased risk of arrhythmogenesis and the potential for negative survival effects limit their use. Levosimendan is a positive inotropic agent but does not increase myocyte calcium concentrations as do catecholamines or phosphodiesterase inhibitors. Clinical trial evidence demonstrates a positive survival benefit for levosimendan versus dobutamine.Source: Interna medicina 2005 - novosti in aktualnosti : zbornik predavanj (Str. 19-24)Type of material - conference contributionPublish date - 2005Language - slovenianCOBISS.SI-ID - 20138457
Author
Šebeštjen, Miran
Topics
Heart Failure, Congestive |
Drug Therapy |
Dobutamine |
Vasodilator Agents |
Phosphodiesterase Inhibitors |
Receptors, Vasopressin |
Antagonists And Inhibitors |
Dobutamin |
Fosfodiesterazni inhibitorji |
Receptorji vazopresinski |
Srce, odpoved kongestivna |
Vazodilatatorji
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Database name | Field | Year |
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Links to authors' personal bibliographies | Links to information on researchers in the SICRIS system |
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Šebeštjen, Miran | 19345 |
Source: Personal bibliographies
and: SICRIS
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