The book presents core drug knowledge using prototypes of different drug classes and emphasizes core patient variables that influence the patient's response to therapy. [books.google.com]

Nesiritide should be considered for patients presenting with acutely typical or useful decompensated heart failure, especially those with dyspnea at rest or with minimal activity. [ncbi.nlm.nih.gov]

MHS, Associate Professor, Duke Clinical Research Institute, presented the results during a late-breaking clinical trial presentation during the Scientific Sessions of the American Heart Association. [cardiobrief.org]

The author presents a point of view in his telling, but the writing is clear-eyed and straightforward. [blueinkreview.com]

• Congestive Heart Failure

  Natriuretic peptides in the pathophysiology of congestive heart failure. Curr Cardiol Rep 2000;2:198–205. Google Scholar 4. Zellner C, Protter AA, Ko E, et al. [link.springer.com]

  Treatment Congestive Heart Failure (CHF) 2 3 Completed Treatment Congestive Heart Failure (CHF) / Dyspnea, Paroxysma / Prophylaxis of cardiomyopathy 1 3 Completed Treatment Congestive Heart Failure (CHF) / Heart Decompensation 3 3 Completed Treatment [drugbank.ca]

  Congestive heart failure is caused by a reduction in the heart's pumping strength, producing a reduced outflow of blood from the left side of the heart. [centerwatch.com]

  But when nesiritide was approved by the Food and Drug Administration (FDA) in 2001, it was designated for the treatment of acute, decompensated congestive heart failure. [nejm.org]

  Intravenous nesiritide, a natriuretic peptide, in the treatment of decompensated congestive heart failure. N Engl J Med 2000;343:246–53. [cardio-debate.com]

• Asymptomatic

  Cardiovascular adverse events were hypotension (asymptomatic and symptomatic), ventricular extrasystole, ventricular tachycardia (sustained and non-sustained), cardiac arrest, bradycardia and angina pectoris. [bmjopen.bmj.com]

  1.08) Death: 3.6% vs 4.0% (p>0.05) Secondary outcomes Persistent/worsening HF or death prior to discharge: Nesiritide 4.2%, placebo 4.8% (p=0.30) Adverse effects Symptomatic hypotension: Nesiritide 7.2%, placebo 4.0%, number needed to harm (NNH) 32 (p Asymptomatic [nerdcat.org]

  In addition, there was no benefit in renal function but a significant increase in the rate of asymptomatic and symptomatic hypotension effecting about one quarter of patients. [cardio-debate.com]

  Hyperinsulinemia 1 1 Completed Basic Science BMI >30 kg/m2 / Cardiovascular Disease (CVD) / Diabetes Mellitus (DM) / High Blood Pressure (Hypertension) 1 1 Terminated Basic Science Congestive Heart Failure (CHF) / Renal Dysfunction 1 1, 2 Completed Basic Science Asymptomatic [drugbank.ca]

  Of the 11 infusions that were stopped, 10 were discontinued following a single reported adverse event (4 because of asymptomatic hypotension, 2 because of symptomatic hypotension, 1 because of angina, 1 because of myocardial infarction, 1 because of nausea [ajhp.org]

• Intravenous Administration

  As a peptide, nesiritide has poor bioavailability and therefore is only available for intravenous administration. With a short half-life of less than 20 minutes, it is administered as a continuous infusion following a bolus injection. [cvpharmacology.com]

  A meta-analysis of five randomized studies with 1269 ADHF patients has demonstrated that intravenous administration of nesiritide significantly increase the risk of WRF and may cause renal toxicity [ 6 ]. [journals.plos.org]

• Intravenous Drugs

  Here is the AHA press rel ease: Large study of patients with severe heart failure confirms nesiritide safe, but shows no significant benefit on symptoms or mortality In a large clinical trial of the intravenous drug nesiritide in severe heart failure, [cardiobrief.org]

• Dyspnea at Rest

  It is effective in managing dyspnea at rest in patients with acute congestive heart failure (CHF). Acute treatment of decompensated CHF in patients who have dyspnea at rest or with minimal activity. [robholland.com]

  CHF and arrhythmias: Indications for NATRECOR: Acutely decompensated CHF with dyspnea at rest or with minimal activity. Adult: 2mcg/kg IV bolus once, then 0.01mcg/kg per minute by continuous IV infusion; limited experience with therapy >96 hours. [empr.com]

  […] at rest or with minimal activity. [cms.gov]

  Nesiritide should be considered for patients presenting with acutely typical or useful decompensated heart failure, especially those with dyspnea at rest or with minimal activity. [ncbi.nlm.nih.gov]

  Availability Injection: 1.5 mg in single-use vials Indications and dosages ➣ Acutely decompensated heart failure in patients who have dyspnea at rest or with minimal activity Adults: 2 mcg/kg I.V. bolus, followed by continuous I.V. infusion of 0.01 mcg [medical-dictionary.thefreedictionary.com]

• Abdominal Pain

  abdominal pain catheter-related pain headache nausea does not interact with enalapril interactions with IV vasodilators (including IV ACE inhibitors) and other cardiovascular drugs have not been formally studied bolus of 2 mcg/kg followed by infusion [aic.cuhk.edu.hk]

  • Body as a Whole : Headache, abdominal pain and back pain. • Heart : Low blood pressure, fast/slow heart rate and chest pain. • Central Nervous System : Sleeplessness, dizziness, drowsiness and anxiety. • Gastrointestinal : Nausea and vomiting. [medindia.net]

  Adverse reactions CNS: dizziness, headache, insomnia, anxiety CV: hypotension, angina pectoris, bradycardia, ventricular extrasystole, ventricular tachycardia GI: nausea, vomiting, abdominal pain Musculoskeletal: leg cramps, back pain Respiratory: cough [medical-dictionary.thefreedictionary.com]

  (abnormally slow heart rate) Headache Abdominal pain Back pain Insomnia Dizziness Anxiety Nausea Vomiting Mechanism of Action Human BNP binds to the particulate guanylate cyclase receptor of vascular smooth muscle and endothelial cells, leading to increased [centerwatch.com]

  GI: Abdominal pain, nausea, vomiting. Respiratory: Cough, hemoptysis, apnea. Skin: Sweating, pruritus, rash. Special Senses: Amblyopia. Renal: Renal failure in acutely decompensated heart failure patients. Drug: No interaction trials conducted. [robholland.com]

• Hypotension

  Notify physician immediately if systolic BP Establish hypotension parameters prior to initiating therapy. Reduce the dose or withhold the drug if hypotension occurs during administration. [robholland.com]

  Interactions: Hypotension potentiated by ARBs and/or ACE inhibitors. Adverse Reactions: Hypotension, headache, nausea, back pain, dizziness; hypersensitivity. How Supplied: Single-use vials—1 [empr.com]

  While there was no increase in 30-day mortality or renal failure with nesiritide, the incidence of hypotension, including symptomatic hypotension, was higher with nesiritide. [acc.org]

  Adverse effects Hypotension, ventricular tachycardia, headache, nausea, back pain, decreased renal function. [medical-dictionary.thefreedictionary.com]

  […] usually resolves spontaneously or responds to fluid challenge of 250 ml or less duration of episode longer than hypotensive episodes associated with glyceryl trinitrate not proarrhythmic Non-cardiovascular Less common than with glyceryl trinitrate general [aic.cuhk.edu.hk]

• Heart Disease

  Pediatric patients with critical congenital heart disease, pulmonary congestion, and inadequate urinary output despite diuretic therapy. Nesiritide infusion. [journals.lww.com]

  Disease 502 The Heart and Pregnancy 537 Chapter32 Women and Heart Disease 553 The Elderly and Aging 561 Chapter34 EndofLife Care 587 The Heart and Other Organ Systems 595 Chapter 35B Hematologic Disorders and the Heart 604 Chapter35C The Heart and the [books.google.com]

  Failure (CHF) / Diastolic Heart Failure / Heart Diseases / Heart Failure 1 4 Terminated Treatment Cardiorenal Syndrome / Congestive Heart Failure (CHF) 1 4 Terminated Treatment Cardiothoracic Surgery / Chronic Lung Diseases / Malignancies / Pulmonary [drugbank.ca]

  Patients with chronic RI are known to have a high prevalence of ischaemic heart disease. [ndt.oxfordjournals.org]

• Hypertension

  1 1, 2 Terminated Treatment Cardiopulmonary Bypass / Heart Defects,Congenital 1 1, 2 Terminated Treatment Cardiorenal Syndrome 1 1, 2 Terminated Treatment High Blood Pressure (Hypertension) 1 2 Completed Prevention Acute Myocardial Infarction (AMI) [drugbank.ca]

  These properties together suggest that nesiritide would be a particularly good therapeutic choice for the patient with decompensated CHF, diastolic dysfunction and hypertension, a common presenting triad in patients with chronic RI. [ndt.oxfordjournals.org]

  Mitral valve (MV) surgery in patients with severe mitralregurgitation (MR), impaired left ventricular function, and pulmonary hypertension is associated with a high operative mortality. [mitralvalverepair.org]

  Effect of nesiritide in isolated right ventricular failure secondary to pulmonary hypertension. Congest Heart Fail 2012 ; 18 : 18 – 24. 11. Gottlieb, S, Stebbins, A, Voors, AA, et al. [cambridge.org]

  Tell your doctor about all other medicines you use, especially medication to treat high blood pressure ( hypertension ). Other drugs may interact with nesiritide, including prescription and over-the-counter medicines, vitamins, and herbal products. [emedicinehealth.com]

• Tachycardia

  Adverse effects Hypotension, ventricular tachycardia, headache, nausea, back pain, decreased renal function. [medical-dictionary.thefreedictionary.com]

  CV: Hypotension, ventricular tachycardia, ventricular extrasystoles, angina, bradycardia, tachycardia, atrial fibrillation, AV node conduction abnormalities. GI: Abdominal pain, nausea, vomiting. Respiratory: Cough, hemoptysis, apnea. [robholland.com]

  […] enalapril, fosinopril, quinapril, captopril, ramipril, trandolapril, and perindopril Side effects: dry, hacky cough, fatigue, hyperkalemia from long term use and kidosis digoxin (Lanoxin) (cont'd) Cardiovascular Dysrhythmias, including bradycardia or tachycardia [quizlet.com]

  However, levosimendan therapy showed higher risks of hypotension, ventricular tachycardia, cardiac arrest, bradycardia, headache and abdominal pain than control therapy did. [bmjopen.bmj.com]

  Side Effects Adverse events that occurred during the first 24 hours of Natrecor infusion in clinical trials include (but are not limited to) the following: Hypotension Ventricular tachycardia (abnormally fast heart rate) Angina pectoris (chest pain) Bradycardia [centerwatch.com]

• Orthostatic Hypotension

  hypotensive activities of Nesiritide. [drugbank.ca]

• Pruritus

  Skin: Sweating, pruritus, rash. Special Senses: Amblyopia. Renal: Renal failure in acutely decompensated heart failure patients. Drug: No interaction trials conducted. No clinically significant interactions reported. Onset: 15 min. [robholland.com]

• Renal Injury

  On the other hand, the investigators found no evidence for an increase in mortality or renal injury, according to the investigators. [cardiobrief.org]

[…] of nesiritide and was continued during nesiritide treatment. [ndt.oxfordjournals.org]

Intravenous nesiritide, a natriuretic peptide, in the treatment of decompensated congestive heart failure. Nesiritide Study Group. N Engl J Med 2000;343:246–253. Google Scholar 10. VMAC Investigators. [link.springer.com]

Acute Heart Failure (AHF) 1 2 Completed Treatment Congestive Heart Failure (CHF) 2 2 Completed Treatment Congestive Heart Failure (CHF) / Impaired Renal Function 1 2 Completed Treatment Heart Failure 1 2 Recruiting Treatment Diastolic Dysfunction / Type [drugbank.ca]

[…] with standard care. 1, 2, 5 However, nesiritide may cause renal function to worsen and may increase the risk of death within 30 days. 3 Patients should be notified about the potential risks of treatment; nesiritide is not indicated for serial treatments [aafp.org]

Currently ACEI and BB represent the cornerstone of HF treatment. [cardio-debate.com]

[…] predicts outcome in patients with heart failure 13–17 and in those after infarction. 10,18,19 In parallel with the prognostic importance of the presence of renal dysfunction, worsening renal function immediately after coronary bypass portends a worse prognosis [circ.ahajournals.org]

All in all there has been no convincing beneficial effect on prognosis, and the use of this agent is mainly limited to the relief of dyspnea in the hospitalized HF patient with normal blood pressure. [cardio-debate.com]

B-Type natriuretic peptide (BNP) 1 and N-terminal proBNP (NT-proBNP) are now being used to confirm the diagnosis and, in some studies, to aid in the assessment of prognosis in patients with heart failure. [clinchem.aaccjnls.org]

There were no clinical characteristic differences between infusion responders and nonresponder patients in etiology of heart failure, left ventricular ejection fraction, presence of biventricular failure, estimated GFR, serum potassium and sodium, body [clinchem.aaccjnls.org]

VMAC would accept patients who required hospitalization and had heart failure with shortness of breath regardless of etiology or ventricular function. [clinicalleader.com]

Renal dysfunction in patients with heart failure with preserved versus reduced ejection fraction impact of the new chronic kidney disease-epidemiology collaboration group formula. [journals.plos.org]

Monash University, and Department of Epidemiology and Preventive Medicine, Alfred Hospital, Prahan, VIC, Australia (H.K.); Vilnius University Hospital, Santariskiu Klinikos, Department of Cardiology and Angiology, Vilnius, Lithuania (A.L.); University [nejm.org]

This thoroughly updated Third Edition covers newly approved drugs, has separate chapters on drugs affecting fungal and viral infections, and includes more pathophysiology information. [books.google.com]

Natriuretic peptides in the pathophysiology of congestive heart failure. Curr Cardiol Rep 2000;2:198–205. Google Scholar 4. Zellner C, Protter AA, Ko E, et al. [link.springer.com]

Renal insufficiency may increase risk of heart failure progression, and the pathophysiology of renal dysfunction during the process of heart failure is complex. [bmjopen.bmj.com]

Pathophysiologically, nesiritide not only could directly influence the glomerular arterioles, mesangial cells and renal tubules to improve renal function, but also could indirectly regulate the systemic hemodynamics, renin-angiotensin-aldosterone axis [journals.plos.org]

Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. ‏ [books.google.com]

Acute Myocardial Infarction (AMI) 1 2 Completed Prevention Cardiopulmonary Bypass / Congestive Heart Failure (CHF) / Coronary Artery Bypass Graft Surgery Patients / Coronary Heart Disease (CHD) / Ischaemic Heart Diseases 1 2 Completed Prevention Renal [drugbank.ca]

Prevent sodium and water resorption by inhibiting aldosterone secretion Diuresis results, which decreases preload, or the left ventricular end-volume, and the work of the heart Examples: lisinopril, enalapril, fosinopril, quinapril, captopril, ramipril [quizlet.com]