DRUGS USED IN CONGESTIVE HEART FAILURE

Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your heart muscles, simply called as “heart failure” CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently.

You have four heart chambers.

The upper half of your heart has two atria, and the lower half of your heart has two ventricles.

The ventricles pump blood to your body’s organs and tissues, and the atria receive blood from your body as it circulates back from the rest of your body.

CHF develops when your ventricles can’t pump enough blood volume to the body.

Eventually, blood and other fluids can back up inside of lungs, abdomen, liver, lower body

CLASSIFICTAION

BASED ON MECHANISM

Aldosterone antagonist

- Spironolactone

Beta blockers

- Metoprolol, Bisoprolol, Carvedilol

Diuretics

- Amiloride, Furosemide, Torsemide, Hydrochlorthiazide

Endothelian receptor antagonist

- Bosentan, Tezosentan

Ionotropics

- Digoxin, Digitoxin, Dopamine, Dobutamin

Vasodilators

- Hydralzine, Minoxidil, Nitrate

BASED ON PARENT NUCLEUS

Cyclopenta phenanthrene ring

- Digoxin, Digitoxin, Nesiritide

Sulfonamides

- Bosentan, Tezosentan

MECHANISM OF CONGESTIVE HEART FAILURE

DIGOXIN

CHEMICAL STRUCTURE

IUPAC NAME

4-((3S,5R,8R,9S,10S,12R,13S,14S,17R)-3-((2R,4S,5S,6R)-5-((2S,4S,5S,6R)-5-((2S,4S,5S,6R)-4,5-dihydroxy6-methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6-methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6methyltetrahydro-2H-pyran-2-yloxy)-12,14-dihydroxy-10,13-dimethylhexadecahydro-1Hcyclopenta[a]phenanthren-17-yl)furan-2(5H)-one

USES

1. Digoxin is used to treat heart failure

2. It is also used to treat certain types of irregular heartbeat

3. Digoxin can decrease the risk for blood clots, an effect that may reduce your risk for a heart attack or stroke

DIGITOXIN

CHEMICAL STRUCTURE

IUPAC NAME

4-((3S,5R,8R,9S,10S,13R,14S,17R)-3-((2R,4S,5S,6R)-5-((2S,4S,5S,6R)-5-((2S,4S,5S,6R)-4,5-dihydroxy-6methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6-methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6methyltetrahydro-2H-pyran-2-yloxy)-14-hydroxy-10,13-dimethylhexadecahydro-1H-cyclopenta[a]phenanthren17-yl)furan-2(5H)-one

USES

1. Digitoxin is used to treat irregular heartbeat

2. Digitoxin can decrease the risk for blood clots, an effect that may reduce your risk for a heart attack or stroke

3. Unlike Digoxin (which is eliminated from the body via the kidneys)

NESIRITIDE

CHEMICAL STRUCTURE 

IUPAC NAME

4-((3S,5R,8R,9S,10S,13R,14S,17R)-3-((2R,4S,5S,6R)-5-((2S,4S,5S,6R)-5-((2S,4S,5S,6R)-4,5-dihydroxy-6methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6-methyltetrahydro-2H-pyran-2-yloxy)-4-hydroxy-6methyltetrahydro-2H-pyran-2-yloxy)-14-hydroxy-10,13-dimethylhexadecahydro-1H-cyclopenta[a]phenanthren17-yl)furan-2(5H)-one

USES

1. Nesiritide works to make easy cardiovascular fluid homeostasis from side to side counter regulation of the renin angiotensin aldosterone system

2. Nesiritide is stimulating cyclic guanosine monophosphate, for smooth muscle cell relaxation.

3. Nesiritide used to be treat acute decompensated congestive heart failure

BOSENTAN

CHEMICAL STRUCTURE

IUPAC NAME

4-tert-butyl-N-(6-(2-hydroxyethoxy)-5-(2-methoxyphenoxy)-2,2'bipyrimidin-4-yl)benzenesulfonamide

USES

1. Bosentan blocks the effects of endothelin-1, which helps lower blood pressure in the lungs, because endothelin-1 increased levels blood pressure

2. Bosentan is used to treat high blood pressure in the lungs

TEZOSENTAN

CHEMICAL STRUCTURE

IUPAC NAME

N-(2-(2-(2H-tetrazol-5-yl)pyridin-4-yl)-6-(2-hydroxyethoxy)-5-(2methoxyphenoxy)pyrimidin-4-yl)-5-isopropylpyridine-2sulfonamide

USES

1. Tezosentan is a non-selective ETA and ETB receptor antagonist that to treat acute heart failure

2. It acts as a vasodilator