NATS 1540 Lecture Notes - Lecture 3: Angiotensin Ii Receptor Blocker, Bisoprolol, Ramipril
31 May 2020
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Goals of therapy (should generally include a parameter, value and timeframe) Reduce risk of cardiovascular mortality, hospitalizations and progression to symptomatic heart failure in next 1 year. List interventions to resolve the drug therapy problem (interventions can include initiation or modification of pharmacologic and non-pharmacologic therapy, as well as specific patient instructions or education) Increase bisoprolol dose to 7. 5 mg daily for 2 weeks then titrate up to 10mg once daily if patient can tolerate and after md assessment. Increases ramipril dose to 5mg bid once daily for 1 month. Justify your recommendations considering efficacy, safety, convenience & cost (include reasons why you excluded other reasonable alternatives) The medications usually initiated for heart failure with reduced ejection fraction (hfref) i. e. lvef<40% include an ace inhibitor, a beta-blocker and an aldosterone antagonist. Patients should be titrated to the target doses for them to have full benefit. Only if patients are symptomatic, a loop-diuretic can be added.
