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1.
Int J Pharm Pract ; 32(5): 423-425, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39011608

RESUMO

OBJECTIVES: To determine the prevalence of heart failure (HF) medication prescribing on discharge post-HF-related admission. METHODS: A retrospective audit was conducted for 216 HF admissions over a period of 6 months; medication data from electronic records were collected for analysis. KEY FINDINGS: The prevalence of HF medication prescribing on discharge was: 32.9% (95% confidence interval: 26.6-39.6) renin-angiotensin-aldosterone system inhibitors, 10.6% (6.9-15.6) angiotensin receptor-neprilysin inhibitors, 31.5% (25.4-38.1) HF-specific beta-blockers, 42.6% (35.9-49.5) aldosterone receptor antagonists, and 11.6% (7.6-16.6) sodium-glucose cotransporter-2 inhibitors. CONCLUSION: HF medication prescribing remains relatively low despite the known benefits and recommendations listed in the guidelines.


Assuntos
Insuficiência Cardíaca , Humanos , Insuficiência Cardíaca/tratamento farmacológico , Estudos Retrospectivos , Masculino , Feminino , Idoso , Alta do Paciente/estatística & dados numéricos , Pessoa de Meia-Idade , Padrões de Prática Médica/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Idoso de 80 Anos ou mais , Prescrições de Medicamentos/estatística & dados numéricos , Antagonistas Adrenérgicos beta/uso terapêutico
2.
Pediatr Res ; 80(4): 538-46, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27356081

RESUMO

BACKGROUND: Cardiovascular dysfunction at birth may underlie poor outcomes after fetal growth restriction (FGR) in neonates. We compared the cardiovascular transition between FGR and appropriately grown (AG) preterm lambs and examined possible mechanisms underlying any cardiovascular dysfunction in FGR lambs. METHODS: FGR was induced in ewes bearing twins at 0.7 gestation; the twin was used as an internal control (AG). At 0.8 gestation, lambs were delivered and either euthanized with their arteries isolated for in vitro wire myography, or ventilated for 2 h. At 60 min, inhaled nitric oxide (iNO) was administered in a subgroup for 30 min. Molecular assessment of the nitric oxide (NO) pathway within lung tissue was conducted. RESULTS: FGR lambs had lower left ventricular output and cerebral blood flow (CBF) and higher systemic vascular resistance compared with AG lambs. INO administration to FGR lambs rapidly improved cardiovascular and systemic hemodynamics but resulted in decreased CBF in AG lambs. Isolated arteries from FGR lambs showed impaired sensitivity to NO donors, but enhanced vasodilation to Sildenafil and Sodium nitroprusside, and altered expression of components of the NO pathway. CONCLUSION: Cardiovascular dysfunction at birth may underlie the increased morbidity and mortality observed in preterm FGR newborns. Impaired NO signaling likely underlies the abnormal vascular reactivity.


Assuntos
Retardo do Crescimento Fetal/fisiopatologia , Resistência Vascular/efeitos dos fármacos , Administração por Inalação , Animais , Animais Recém-Nascidos , Circulação Cerebrovascular , Modelos Animais de Doenças , Ecocardiografia Doppler , Feminino , Hemodinâmica/efeitos dos fármacos , Tamanho da Ninhada de Vivíparos , Pulmão/efeitos dos fármacos , Óxido Nítrico/administração & dosagem , Óxido Nítrico Sintase Tipo III/metabolismo , Nitroprussiato/uso terapêutico , Oxigênio/metabolismo , Ovinos , Carneiro Doméstico , Citrato de Sildenafila/uso terapêutico , Fatores de Tempo
3.
Am J Physiol Lung Cell Mol Physiol ; 310(3): L213-23, 2016 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-26608532

RESUMO

Intrauterine growth restriction (IUGR) and preterm birth are frequent comorbidities and, combined, increase the risk of adverse respiratory outcomes compared with that in appropriately grown (AG) infants. Potential underlying reasons for this increased respiratory morbidity in IUGR infants compared with AG infants include altered fetal lung development, fetal lung inflammation, increased respiratory requirements, and/or increased ventilation-induced lung injury. IUGR was surgically induced in preterm fetal sheep (0.7 gestation) by ligation of a single umbilical artery. Four weeks later, preterm lambs were euthanized at delivery or delivered and ventilated for 2 h before euthanasia. Ventilator requirements, lung inflammation, early markers of lung injury, and morphological changes in lung parenchymal and vascular structure and surfactant composition were analyzed. IUGR preterm lambs weighed 30% less than AG preterm lambs, with increased brain-to-body weight ratio, indicating brain sparing. IUGR did not induce lung inflammation or injury or alter lung parenchymal and vascular structure compared with AG fetuses. IUGR and AG lambs had similar oxygenation and respiratory requirements after birth and had significant, but similar, increases in proinflammatory cytokine expression, lung injury markers, gene expression, and surfactant phosphatidylcholine species compared with unventilated controls. IUGR does not induce pulmonary structural changes in our model. Furthermore, IUGR and AG preterm lambs have similar ventilator requirements in the immediate postnatal period. This study suggests that increased morbidity and mortality in IUGR infants is not due to altered lung tissue or vascular structure, or to an altered response to early ventilation.


Assuntos
Retardo do Crescimento Fetal/metabolismo , Pulmão/metabolismo , Pneumonia/metabolismo , Surfactantes Pulmonares/metabolismo , Lesão Pulmonar Induzida por Ventilação Mecânica/metabolismo , Animais , Animais Recém-Nascidos , Feminino , Idade Gestacional , Gravidez , Respiração Artificial/efeitos adversos , Ovinos
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