Draft Assignment Pharma

Diuretics
Diuretics are known for their ability to increase the formation and excretion of urine. The
increase in excretion allows for more water + sodium to be removed and ultimately
affects the vascular system by leading to a decrease in fluid volume. The decrease in
fluid volume affects blood pressure directly, which is why they are effective in reducing
high blood pressure. Sometimes a combination of two diuretics is given because this can be
significantly more effective than either compound alone (synergistic effect). There are three
different groups of diuretics, these include thiazide diuretics, loop diuretics, and
potassium-sparing diuretics. Potassium diuretics are used in congestive heart failure.
Thiazides cause initial volume depletion associated with decreased cardiac output, which
recovers within 6 to 8 weeks of starting the treatment in a reverse autoregulation mechanism
while the blood pressure remains controlled; thiazide diuretics can acutely activate the renin-
angiotensin system and cause systemic vascular resistance, which prevents a good
response to the diuretic treatment, this increase in renin-angiotensin activity may resolve
with chronic thiazide treatment, the addition of an ACE inhibitor or ARB can enhance the
blood pressure control. Also, the thiazide-type diuretics have a modest vasodilation effect,
although the mechanism is still unclear.
Angiotensin II constricts arteries and veins by binding to AT1 receptors on the smooth muscle,
which are coupled to a Gq-protein and the IP3 signal transduction pathway. Angiotensin II also
facilitates the release of norepinephrine from sympathetic adrenergic nerves and inhibits
norepinephrine reuptake by these nerves. This action of angiotensin II augments sympathetic
activity on the heart and blood vessels, promoting cardiac stimulation and vasoconstriction.
Angiotensin II stimulates the adrenal cortex to release aldosterone, which acts on the kidneys to
increase sodium and water reabsorption, leading to increased blood volume and arterial
pressure. By stimulating pituitary release of antidiuretic hormone (ADH; vasopressin), water renal
reabsorption is increased, which increases blood volume and arterial pressure. ADH can also
directly constrict blood vessels.
i. Heart failure
Known as congestive heart failure. Occur when the heart inability to pump an adequate
supply of blood to the body. Without sufficient blood flow, all major body functions are
disrupted. Heart failure is a condition or a collection of symptoms that weaken or stiffen the
heart.
ii. Heart attack
A life-threatening medical emergency that requires immediate treatment. Known as a

myocardial infarction, happens when the flow of blood that brings oxygen to a part of the
heart muscle suddenly becomes blocked and the heart can’t get enough oxygen. Cause
severe chest pain; an irregular heartbeat. If, blood flow is not restored quickly, the heart
muscle will begin to die.
iii. Cardiac arrest
Also known as sudden cardiac arrest. A condition is when suddenly, the heart stops beating.
When that happens, blood stops flowing to the brain and other vital organs. It can cause a
person to lose consciousness, become disabled or die if not treated immediately.
iv. Ischemic heart disease

It's heart problem caused by narrowed heart arteries. When arteries are narrowed, less
blood and oxygen reach the heart muscle. This is also called coronary artery disease and
coronary heart disease. This can lead to heart attack.
SUGGESTION DRUG FOR HEART FAILURE AND CARDIAC ARREST
1. Heart failure
 The heart has difficulty pumping enough blood to support other organs in the
body. Other people may have a hardening and stiffening of the heart muscle
itself, which blocks or reduces blood flow to the heart. Heart failure can affect
the right or left side of your heart or both at the same time. It can be either
an acute (short-term) or chronic (ongoing) condition.
 With acute heart failure, the symptoms appear suddenly but go away fairly quickly.
This condition can occur after a heart attack. It may also be a result of a problem with
the heart valves that control the flow of blood in the heart.
 With chronic heart failure, symptoms are continuous and don’t improve over time.
Most heart failure cases are chronic.
increase your risk of developing heart failure include:
 cardiomyopathy, a disorder of the heart muscle that causes the heart to become
weak
 heart valve disease
 certain types of arrhythmias, or irregular heart rhythms
 high blood pressure
 emphysema, a disease of the lung

 diabetes
 severe forms of anemia
 certain cancer treatments, such as chemotherapy
DRUGS
2. Cardiac arrest
v. Angina pectoris
3. MOA
4. Side effect
5. Justification
6. Others - Epidemiology
Heart failure
A common term for the build-up of plaque in the heart’s arteries that could lead to heart
attack. Occur when the heart inability to pump an adequate supply of blood to the body.
Without sufficient blood flow, all major body functions are disrupted. Heart failure is a
condition or a collection of symptoms that weaken or stiffen the heart.
Causes
Heart failure can be defined as the inability of the heart to provide adequate cardiac output and
oxygen delivery to meet the metabolic demands of the body, or can do so only under conditions
of increased cardiac preload. Heart failure can be caused by factors originating from within the
heart (intrinsic disease or pathology) or from external factors that place excessive demands upon
the heart.
The number one cause of heart failure is coronary artery disease (CAD). CAD reduces coronary
blood flow and oxygen delivery to the myocardium. This leads
to myocardial hypoxia and impaired function. Another common cause of heart failure
is myocardial infarction, which is the final and often fatal culmination of CAD. Infarcted tissue
does not contribute to the generation of mechanical activity, so overall cardiac performance is
diminished. Furthermore, non-infarcted regions must compensate for the loss of function and this
extra burden can precipitate changes that lead to failure of the non-infarcted
myocardium. Valvular disease and congenital defects place increased demands upon the heart
that can precipitate failure. Cardiomyopathies of known origin (e.g., bacterial or viral) or idiopathic
(unknown origin) can lead to failure. Myocarditis damages the heart and can lead to abnormal
function. Arrhythmias, such as severe bradycardia or tachycardia, can also precipitate failure.
https://pharmaceutical-journal.com/article/ld/angina-management-options-overview
https://www.hopkinsmedicine.org/health/conditions-and-diseases/heart-attack
https://www.healthline.com/health/heart-failure
https://www.medicinenet.com/vasodilators_drug_class_side_effects_list_of_names/article.htm

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Diuretics

ii. Heart attack

A life-threatening medical emergency that requires immediate treatment. Known as a

muscle will begin to die.

iii. Cardiac arrest

iv. Ischemic heart disease

SUGGESTION DRUG FOR HEART FAILURE AND CARDIAC ARREST

increase your risk of developing heart failure include:

 heart valve disease

 certain types of arrhythmias, or irregular heart rhythms

 high blood pressure

 emphysema, a disease of the lung

 severe forms of anemia

 certain cancer treatments, such as chemotherapy

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