Discussion: What would pharmacologically management of a new diagnosis of congestive heart failure with supportive sources

Discussion: What would pharmacologically management of a new diagnosis of congestive heart failure with supportive sources

Discussion: What would pharmacologically management of a new diagnosis of congestive heart failure with supportive sources

What would pharmacologically management of a new diagnosis of congestive heart failure with supportive sources. Document uploaded has patient history and physical exam findings. I forgot to addd losartan 25 mg po daily please explain rationale for medication in CHF thank you

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What would pharmacologically management of a new diagnosis of congestive heart failure with supportive sources.

I forgot to add losartan 20 mg po daily need rationale–PLEASE WRITE RATIONALE FOR LOSARTAN THANKYOU

Patient has a history of hypertension is on lisinopril PO daily, hyperlipidemia is on Atorvastatin 20 mg PO daily, takes omega 3 fish oil 1200mg PO BID.

Physical exam findings:

PHYSICAL EXAM

Vital Signs: 

Temp 36.7^o C, BP Right Arm 146/90 BP Left Arm 146/88, Pulse 104, Respiratory Rate 19, O2 98%, Height 5’11, 180 cm, Weight 197 lbs,89.5 kg, BMI 27.48

EKG Sinus Rhythm with no ST elevation

General: Mr. Foster is a pleasant, 58-year-old Caucasian. He is alert and oriented and answers questions appropriately. Patient is cooperative and follows commands appropriately. Appears hydrated and well-nourished. Affect is good.

Neurological:Alert and cooperative. A&O x 4.

HEENT:The skull isnormocephalic noted.

Lymph Nodes:Deferred.

Respiratory:Breath sounds are clear to auscultation in upper lobes. Fine crackles noted to right posterior lobe and left posterior lobe.

Cardiovascular:S1, S2 without murmurs noted. S3 with gallops noted at the apex of the heart. No venous distention, JVD 3 cm above the sternal angle. Left carotid no bruit or thrill, 2+ noted. Right carotid bruit with thrill, 3+ noted. Brachial, radial, femoral pulses without thrill, 2+noted. Popliteal, tibial, and dorsalis pedis pulses without thrill, 1+noted. Capillary refill > 3 seconds in all bilateral hands and feet.

GI:Abdomen symmetric, round, soft, non-tender with normoactive bowl sounds in all four quadrants noted. No abdominal bruits. No tenderness to light or deep palpitation. Tympanic throughout. Liver is 7 cm at the MCL and 1 cm below the right costal margin. Spleen not palpable. Bilaterally kidneys not palpable.

Musculoskeletal: No joint pain noted.

Skin:Warm and dry to touch. No tenting noted. Capillary refill > 3 seconds noted in bilaterally fingers and toes.

Psychiatric: Mood and affect appropriate.

Pharmacological management:

Losartan 25 mg PO once daily. Losartan acts by hindering the binding of angiotensin II to type 1 angiotensin II receptors. It also opposes the vasoconstrictor and aldosterone-secreting effects of angiotensin II (Mulla & Siddiqui, 2022). It is approved by the FDA for treating hypertension and is indicated as a first-line therapy in stage 1 hypertension. In addition, it lowers the risk of stroke in hypertensive patients by hindering angiotensin II-induced cardiac remodeling. Losartan alleviates symptoms of congestive heart failure by increasing urinary flow and the excretion of sodium, chloride, magnesium, potassium, uric acid, calcium, and phosphate (Mulla & Siddiqui, 2022). Thus, Losartan is an ideal drug for this patient to lower hypertension, improve symptoms of CHF, and lower the risk of stroke.

References

Mulla, S., & Siddiqui, W. J. (2022). Losartan. In StatPearls. StatPearls Publishing.