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A Review of the Mechanism of Action of Drugs Used in Congestive Heart Failure in Pediatrics

Congestive heart failure (CHF) is a complex, heterogeneous medically ill condition that can occur due to diverse primary (cardiomyopathies, coronary artery diseases, and hypertension) and secondary causes (high salt intake and noncompliance toward treatment) and leads to significant morbidity and mo...

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Autores principales: Singh, Rakshit K, Meshram, Revat J, Tiwari, Aakriti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931378/
https://www.ncbi.nlm.nih.gov/pubmed/36819391
http://dx.doi.org/10.7759/cureus.33811
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author Singh, Rakshit K
Meshram, Revat J
Tiwari, Aakriti
author_facet Singh, Rakshit K
Meshram, Revat J
Tiwari, Aakriti
author_sort Singh, Rakshit K
collection PubMed
description Congestive heart failure (CHF) is a complex, heterogeneous medically ill condition that can occur due to diverse primary (cardiomyopathies, coronary artery diseases, and hypertension) and secondary causes (high salt intake and noncompliance toward treatment) and leads to significant morbidity and mortality. The approach toward managing the patient of CHF in the pediatric age group is more complex than in the adult population. Currently, in the adult group of the population of CHF, there are well-established guidelines for managing these patients, but in the case of children, there are no well-established guidelines; therefore, this systematic review gives more ideas for managing the pediatric population undergoing CHF. Treatment of the underlying cause, rectification of any advancing event, and management of pulmonary or systemic obstruction are the principles for management. The most widely used drugs are diuretics and angiotensin-converting enzyme (ACE) inhibitors, whereas beta-blockers are less commonly used in children than in adults. ACE inhibitors such as captopril, enalapril, and cilazapril are widely used in the pediatric age group. ACE inhibitors act on the renin-angiotensin-aldosterone system (RAAS) similar to those in the adult population. In children with heart failure (HF), ACE inhibitors reduce the pressure in the aorta, resistance in the systemic blood vessels, and upper left and right chamber pressures but do not appreciably influence pulmonary vascular resistance. We use a patient's initial perfusion and volume status assessment to decide further action for the supervision of acute HF. This paradigm was adopted from adult studies that showed higher rates of morbidity and mortality in patients with HF whose hemodynamic or volume status assessment results were stable with a pulmonary capillary wedge pressure >18 mmHg and a combined index (CI) of 2.2 L/minute/m(2). ACE inhibitors, beta-blockers, and spironolactone are the most widely prescribed drugs for the chronic condition of CHF. This study shows the current status of medical therapy for critical as well as persistent pediatric HF.
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spelling pubmed-99313782023-02-16 A Review of the Mechanism of Action of Drugs Used in Congestive Heart Failure in Pediatrics Singh, Rakshit K Meshram, Revat J Tiwari, Aakriti Cureus Pediatrics Congestive heart failure (CHF) is a complex, heterogeneous medically ill condition that can occur due to diverse primary (cardiomyopathies, coronary artery diseases, and hypertension) and secondary causes (high salt intake and noncompliance toward treatment) and leads to significant morbidity and mortality. The approach toward managing the patient of CHF in the pediatric age group is more complex than in the adult population. Currently, in the adult group of the population of CHF, there are well-established guidelines for managing these patients, but in the case of children, there are no well-established guidelines; therefore, this systematic review gives more ideas for managing the pediatric population undergoing CHF. Treatment of the underlying cause, rectification of any advancing event, and management of pulmonary or systemic obstruction are the principles for management. The most widely used drugs are diuretics and angiotensin-converting enzyme (ACE) inhibitors, whereas beta-blockers are less commonly used in children than in adults. ACE inhibitors such as captopril, enalapril, and cilazapril are widely used in the pediatric age group. ACE inhibitors act on the renin-angiotensin-aldosterone system (RAAS) similar to those in the adult population. In children with heart failure (HF), ACE inhibitors reduce the pressure in the aorta, resistance in the systemic blood vessels, and upper left and right chamber pressures but do not appreciably influence pulmonary vascular resistance. We use a patient's initial perfusion and volume status assessment to decide further action for the supervision of acute HF. This paradigm was adopted from adult studies that showed higher rates of morbidity and mortality in patients with HF whose hemodynamic or volume status assessment results were stable with a pulmonary capillary wedge pressure >18 mmHg and a combined index (CI) of 2.2 L/minute/m(2). ACE inhibitors, beta-blockers, and spironolactone are the most widely prescribed drugs for the chronic condition of CHF. This study shows the current status of medical therapy for critical as well as persistent pediatric HF. Cureus 2023-01-16 /pmc/articles/PMC9931378/ /pubmed/36819391 http://dx.doi.org/10.7759/cureus.33811 Text en Copyright © 2023, Singh et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pediatrics
Singh, Rakshit K
Meshram, Revat J
Tiwari, Aakriti
A Review of the Mechanism of Action of Drugs Used in Congestive Heart Failure in Pediatrics
title A Review of the Mechanism of Action of Drugs Used in Congestive Heart Failure in Pediatrics
title_full A Review of the Mechanism of Action of Drugs Used in Congestive Heart Failure in Pediatrics
title_fullStr A Review of the Mechanism of Action of Drugs Used in Congestive Heart Failure in Pediatrics
title_full_unstemmed A Review of the Mechanism of Action of Drugs Used in Congestive Heart Failure in Pediatrics
title_short A Review of the Mechanism of Action of Drugs Used in Congestive Heart Failure in Pediatrics
title_sort review of the mechanism of action of drugs used in congestive heart failure in pediatrics
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931378/
https://www.ncbi.nlm.nih.gov/pubmed/36819391
http://dx.doi.org/10.7759/cureus.33811
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