HFrEF Treatment
Starting ENTRESTO for heart failure
As a cardiovascular pharmacist, you will hear lots of buzz about Entresto , a new drug for systolic heart failure. It's the first "angiotensin receptor neprilysin inhibitor" (ARNI) and combines valsartan with sacubitril. Sacubitril works by inhibiting the enzyme neprilysin. This increases sodium loss and vasodilation and enhances ARB efficacy (see figur…
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HFrEF Treatment
Keep NEW heart failure guidelines in mind
As a clinical pharmacist, you should put NEW heart failure guidelines in perspective . Big changes in guidelines will lead to debate about managing heart failure with reduced ejection fraction (HFrEF). We’re used to “triple therapy” for HFrEF; an ACEI or ARB , evidence-based beta-blocker (carvedilol, etc), and aldosterone antagonist (spironolac…
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Spironolactone
Managing diastolic or preserved ejection fraction heart failure (HFpEF)
How to treat "DIASTOLIC" heart failure or heart failure with a PRESERVED ejection fraction (HFpEF)? Over HALF of heart failure patients have this type, which is due to a stiff left ventricle that can't adequately fill. This is different from "SYSTOLIC" heart failure or heart failure with a REDUCED ejection fraction (HFrEF). These patients have…
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