DRUGS USED IN CONGESTIVE HEART FAILURE
Congestive heart failure (CHF)
Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your heart muscles, simply called as “heart failure” CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently.
You have four heart chambers.
The upper half of your heart has two atria, and the lower half of your heart has two ventricles.
The ventricles pump blood to your body’s organs and tissues, and the atria receive blood from your body as it circulates back from the rest of your body.
CHF develops when your ventricles can’t pump enough blood volume to the body.
Eventually, blood and other fluids can back up inside of lungs, abdomen, liver, lower body
CLASSIFICATION of DRUGS USED IN CONGESTIVE HEART FAILURE
BASED ON MECHANISM
Aldosterone antagonist
– Spironolactone
Beta-blockers
– Metoprolol, Bisoprolol, Carvedilol
Diuretics
– Amiloride, Furosemide, Torsemide, Hydrochlorthiazide
Endothelian receptor antagonist
– Bosentan, Tezosentan
Ionotropics
– Digoxin, Digitoxin, Dopamine, Dobutamin
Vasodilators
– Hydralzine, Minoxidil, Nitrate
BASED ON PARENT NUCLEUS
Cyclopenta phenanthrene ring
– Digoxin, Digitoxin, Nesiritide
Sulfonamides
– Bosentan, Tezosentan
MECHANISM OF CONGESTIVE HEART FAILURE
DIGOXIN
CHEMICAL STRUCTURE
IUPAC NAME
4-((3S,5R,8R,9S,10S,12R,13S,14S,17R)-3-((2R,4S,5S,6R)-5-((2S,4S,5S,6R)-5-((2S,4S,5S,6R)-4,5-dihydroxy6-methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6-methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6methyltetrahydro-2H-pyran-2-yloxy)-12,14-dihydroxy-10,13-dimethylhexadecahydro-1Hcyclopenta[a]phenanthren-17-yl)furan-2(5H)-one
USES
1. Digoxin is used to treat heart failure
2. It is also used to treat certain types of irregular heartbeat
3. Digoxin can decrease the risk for blood clots, an effect that may reduce your risk for a heart attack or stroke
DIGITOXIN
CHEMICAL STRUCTURE
IUPAC NAME
4-((3S,5R,8R,9S,10S,13R,14S,17R)-3-((2R,4S,5S,6R)-5-((2S,4S,5S,6R)-5-((2S,4S,5S,6R)-4,5-dihydroxy-6methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6-methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6methyltetrahydro-2H-pyran-2-yloxy)-14-hydroxy-10,13-dimethylhexadecahydro-1H-cyclopenta[a]phenanthren17-yl)furan-2(5H)-one
USES
1. Digitoxin is used to treat irregular heartbeat
2. Digitoxin can decrease the risk for blood clots, an effect that may reduce your risk for a heart attack or stroke
3. Unlike Digoxin (which is eliminated from the body via the kidneys)
NESIRITIDE
CHEMICAL STRUCTURE
IUPAC NAME
4-((3S,5R,8R,9S,10S,13R,14S,17R)-3-((2R,4S,5S,6R)-5-((2S,4S,5S,6R)-5-((2S,4S,5S,6R)-4,5-dihydroxy-6methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6-methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6methyltetrahydro-2H-pyran-2-yloxy)-14-hydroxy-10,13-dimethylhexadecahydro-1H-cyclopenta[a]phenanthren17-yl)furan-2(5H)-one
USES
1. Nesiritide works to make easy cardiovascular fluid homeostasis from side to side counter regulation of the renin angiotensin aldosterone system
2. Nesiritide is stimulating cyclic guanosine monophosphate, for smooth muscle cell relaxation.
3. Nesiritide used to be treat acute decompensated congestive heart failure
BOSENTAN
CHEMICAL STRUCTURE
IUPAC NAME
4-tert-butyl-N-(6-(2-hydroxyethoxy)-5-(2-methoxyphenoxy)-2,2’bipyrimidin-4-yl)benzenesulfonamide
USES
1. Bosentan blocks the effects of endothelin-1, which helps lower blood pressure in the lungs, because endothelin-1 increased levels blood pressure
2. Bosentan is used to treat high blood pressure in the lungs
TEZOSENTAN
CHEMICAL STRUCTURE
IUPAC NAME
N-(2-(2-(2H-tetrazol-5-yl)pyridin-4-yl)-6-(2-hydroxyethoxy)-5-(2methoxyphenoxy)pyrimidin-4-yl)-5-isopropylpyridine-2sulfonamide
USES
1. Tezosentan is a non-selective ETA and ETB receptor antagonist that to treat acute heart failure
2. It acts as a vasodilator
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