Rational Therapeutic Approaches for the Management of Congestive Cardiac Failure

المؤلفون

  • Shah Hamayun Department of Cardiology, Pakistan Institute of Medical Sciences (PIMS) Islamabad, Punjab, Pakistan
  • Muneeb Ullah College of Pharmacy, Pusan Nation University, Busan 609-735, South Korea
  • Mahboob Ur Rehman Department of Cardiology, Pakistan Institute of Medical Sciences (PIMS) Islamabad, Punjab, Pakistan
  • Maheer Hussain Department of biological Sciences, National University of Medical Science, Islamabad, Punjab, Pakistan
  • Aroosa Imtiaz Khan Department of Pharmacy, Riphah International University, Islamabad, Punjab, Pakistan
  • Syed Nasir Ali Shah Department of Cardiology, Pakistan Institute of Medical Sciences (PIMS) Islamabad, Punjab, Pakistan
  • Afraa Waleed Department of biological Sciences, National University of Medical Science, Islamabad, Punjab, Pakistan
  • Tayyaba Muneeb Department of Pharmacy, Kohat University of Science and Technology, Kohat, Khyber Pakhtunkhwa, Pakistan
  • Tasweer Khan Department of Pharmacy, Kohat University of Science and Technology, Kohat, Khyber Pakhtunkhwa, Pakistan

DOI:

https://doi.org/10.53576/bashir.004.01.0114

الكلمات المفتاحية:

Heart diseases، Cardiac failure، Congestive heart diseases

الملخص

Background: Heart failure is a serious and progressive condition where the heart's ventricle fails to pump sufficient blood to the body's tissues. Flaws in the rationality of medication use, particularly with narrow therapeutic index drugs like digoxin, have been observed. These include multiple drug-drug interactions, polypharmacy, and therapeutic duplication. Pharmacists play a crucial role in minimizing medication errors through dose adjustments, patient counseling, and ensuring proper administration. Aims and Objectives: The objective of this project was to assess the appropriateness of recommended pharmacotherapies and their implementation in a clinical setting, focusing on drug-drug interactions, polypharmacy, contraindications, and untreated conditions. Study Design: For this study, a specialized questionnaire-based approach was used to gather data on congestive heart failure (CHF) patients. The collected information included patient demographics (name, gender, and age), chief complaints, co-morbidities, past medical and medication history, biochemical tests, diagnosis, social history, allergies, family history, and past surgeries. Materials and Methods: From a collection of 20 patient histories, it was observed that the majority of cases involved congestive heart failure (43.57%), followed by left ventricular dysfunction (30.35%), myocardial infarction (17.23%), and atrial fibrillation (8.71%) as the primary causes of hospitalization. Among the patients, co-morbidities such as diabetes mellitus (31.71%) and hypertension (25.23%) were prevalent. The collected data was regularly examined and analyzed. Results were evaluated based on ±SD (Standard). Results and Conclusion: In this study, 60 drugs were identified as contraindicated for patients, and some drugs required monitoring due to their profiles. Among the identified drug-related errors, 56.66% were attributed to drug interactions, often resulting from the simultaneous prescription of two interacting drugs. The incidence of polypharmacy was found to be 8.88%. Narrow therapeutic index drugs accounted for 5.55% of the medications, which were not adequately monitored. The analysis revealed that 33.35% and 25.80% of patients had diabetes and hypertension, respectively, in addition to heart failure. Heart failure was most commonly observed in individuals aged 51-60 years. The study highlighted several irrationalities in prescription practices, including inadequate dose adjustment for patients with chronic renal failure, polypharmacy, drug duplication, adverse drug reactions, cost-related issues, unavailability of therapeutic alternatives, and lack of monitoring for narrow therapeutic index medications.

التنزيلات

منشور

2023-06-25