Drugs used in ischemic heart disease and congestive heart failure Essay

Drugs used in ischemic heart disease and congestive heart failure - Essay Example Along with beta blockers, ACE inhibitors can also be used since they retard progression of coronary artery disease. These drugs act by inhibiting the activity of the enzyme which decreases the production of angiotensin II. They must be used in caution while using with other drugs because of their potential to increase potassium levels. Statins are used to control hypercholesterolemia. These include atorvastatin, simvastatin, pravastatin, lovastatin and fluvastatin. Their use leads to significant improvement in endothelium-dependent dilation of coronary and peripheral arteries in patients with hyperlipidemia. They also have the advantage of stabilizing atheromatous plaques in coronary arteries and may even contribute to regression of coronary atherosclerosis (Zevitz, 2006). The cornerstone of medical treatment in both patients with symptomatic and those with asymptomatic myocardial ischemia is antianginal medications. The drugs which fall in to this category include beta blockers, calcium channel blockers such as nifedipine, felodipine, and amlodipine, and nitrates. These drugs act by increasing blood supply into the coronary arteries. Long-acting nitrates are effective in the treatment of myocardial ischemia and are frequently used in combination with both beta-blockers and calcium channel antagonists. Short-acting nitroglycerin is the agent of choice in the treatment of acute symptomatic myocardial ischemia (Zevitz, 2006). The antiplatelet drugs which may be used are aspirin, clopidogrel, ticlopidine, or dipyridamole. Of these, aspirin is most effective in reducing risk for MI. These drugs act by decreasing platelet aggregation and inhibiting thrombus formation. They are effective in the arterial circulation, where anticoagulants have little effect. The goal of pharmacotherapy in CCF is to achieve a PCWP of 15-18 mm Hg and a cardiac index >2.2 L/min/m2, while maintaining adequate blood pressure and perfusion to

Ethical theories Essay Example | Topics and Well Written Essays - 250 words

Ethical theories - Essay Example In this regard, practitioners are not supposed to give up on a patient unless all the treatment fails. There arises a dilemma on what to do when the patient is not responding to treatment. The ethical dilemma arises on whether to terminate treatment or allow the patient to suffer under futile treatment. Relegating treatment may be a sign of condemning the patient to death while treatment might be painful and of no importance. Thus, the most appropriate decision should be made. Bioethics principles can be used to chart a way forward in case of a futile treatment dilemma. The principles include autonomy, non-maleficence, beneficence and justice. The autonomy principle states that conscious patients have a choice to decide termination or continuity of futile treatment. The beneficence principle asserts that medical practitioners must do anything possible to alienate suffering from the patient. The non-maleficence principle explains that nurses should check all procedures to ensure that patients do not suffer from intentional errors and omissions. The justice principle asserts that patients have equal rights to benefit from treatment; new or current. From the principles, the medical practitioners can choose a course of action depending on the