Study Of Pharmacotherapy For The Congestive Heart Failure

Abstract

Congestive heart failure (CHF)is the inability of cardiac structure or function to deliver inadequate blood to the metabolic tissue, in-spite of normal filling pressure ( only with rate of high filling pressure).Types of heart failureis Left sided heart failure which is the most common types of heart failure, Right sided heart failure , Diastolic heart failure, Systolic heart failure. The main causes of CHF is coronary artery disease (20%), cardio myopathy (15%) Arrhythmia, unhealthy lifestyle habits, such as an unhealthy diet, smoking, heavy alcohol use and lack of physical activity can increase your risk of heart failure. The aim of this study was to promote the role 0f pharmacist in rationalizing drug therapy, to check drug indication, doses, dosage and duration of therapy. Total 20 cases Congestive Heart Failure were collected from cardiology ward at Lady Reading Hospital Peshawar. Congestive heart failure in Peshawar was recorded more than the other cities out of 20 patients 5 patients were from Peshawar (25%).The age of majority of the patient was above 45 years.. In current study the highest ratio of (CHF) were in aged of 45–60 years patients (45%) in aged of 61-75% was (30%) In male patients the congestive heart failure was more than (60 %) and in female more than (40%). Pharmacological treatment of CHF are Angiotensin converting enzymes inhibitor , Angiotensin receptor blocker, Ivabradine , Digoxin and Other digitalis glycoside, Renin inhibitors, Diuretics. Some potential interaction between Aspirin and enoxaparin with a percentage of (35%). Similaris the case with aspirin and clopidogrel35%. Spironolactone and Furosemide (25%), Aspirinand Candesartan (30%) Ceftizoxime and Digoxin (35%) Ceftizoxime and Warfarin (5%), Digoxin and Metformin (5%), Further more, to the majority of the patient practice of poly pharmacy was also noticed including more than three anti hypertensive’s like Angiotensin converting enzyme (ACE) inhibitors, loop diuretics, spironolactone and carvedilol were prescribed to the patient combine so in such situation it is recommended to the physician to thoroughly monitored the B.P and heart rhythm. Some of the drugs like digoxin and warfarin which are Therapeutic drug monitoring (TDM) drugs and leads to potential ADRs if there proper monitoring is not conducted. In these 20cases different parameters were studied which showed that 80 %means 16 out of 20 cases received rational the rapy according to standard pharmaco therapy and to the prescribed therapy . the patients respond well . Irrational therapy was received in 4 cases (20%) out of 20 due to poor response of the patient. The irrational drug therapy was due to improper dosages and frequency . The overall study was based on clinical practice hence it is the responsibility of pharmacist in concerned ward to council and educate the patient about prescribed regimen, dosage .The most serious life threating complications associated with congestive heart failure are kidney damage or failure , irregular heartbeat , sudden cardiac arrest and liver damage . This was concluded that majority of the patient observed in hospital were suffering from heartfailure with major cause of left ventricular failure (80%) as well as diastolic dysfunction (20%).