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Farmacoterapia da insuficiência cardíaca
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A Insuficiência Cardíaca (IC) é uma doença caracterizada pelo anormal funcionamento do coração, ou seja, este não consegue bombear sangue suficiente para atender às necessidades do organismo. A patologia é dividida em quatro estágios, designadamente, A, B, C e D, consoante a gravidade dos sintomas clínicos. Nos países europeus, a incidência média desta doença é de 3,2 casos por cada 1000 pessoas por ano e a prevalência é de 17,2 casos por cada 1000 pessoas. A nível global, estima-se que mais de 37 milhões de pessoas apresentem IC. Em Portugal, a doença afeta cerca de 5,2% da população adulta, o que equivale a mais de 400000 pessoas, e tem tendência a aumentar devido ao envelhecimento acentuado da população. Esta patologia apresenta diversos fatores de risco, tais como hipertensão arterial, diabetes, doença renal crónica, doença arterial coronária, doença da válvula aórtica, fibrilhação auricular, cancro, comprometimento cognitivo e demência, entre outros. No que diz respeito aos sintomas, destacam-se a dispneia e a fadiga, que podem limitar o exercício físico, e a retenção de líquidos que pode originar edema. Com base nas considerações anteriores, os objetivos principais desta Dissertação são os seguintes: i) apresentar a definição e classificação da IC; ii) averiguar a incidência e a prevalência desta doença na população; iii) mencionar os sinais e sintomas, fatores de risco, fisiopatologia e diagnóstico; iv) referir a abordagem farmacológica (isto é, algoritmo de tratamento farmacoterapêutico, fármacos utilizados atualmente e fármacos em desenvolvimento); v) descrever as indicações terapêuticas, efeitos indesejáveis, contraindicações, posologia, modo de administração e propriedades farmacocinéticas e farmacodinâmicas para os principais fármacos; e vi) evidenciar a intervenção do farmacêutico. Em relação à metodologia, recorreu-se à análise documental de várias fontes bibliográficas, nomeadamente, artigos científicos, guidelines e livros técnicos. Concluiu-se que os fármacos mais relevantes para o tratamento da IC são os inibidores da enzima de conversão da angiotensina, antagonistas do recetor da angiotensina II, bloqueadores adrenérgicos β, antagonistas da aldosterona, sacubitril + valsartan e inibidores do cotransportador de sódio-glicose 2. Além disso, salienta-se a importância da intervenção farmacêutica na gestão da patologia e da farmacoterapia instituída.
Heart failure (HF) is a disease characterized by abnormal heart function, meaning it cannot pump enough blood to meet the body's needs. The condition is divided into four stages, namely, A, B, C, and D, depending on the severity of clinical symptoms. In European countries, the average incidence of this disease is 3.2 cases per 1,000 people per year, and the prevalence is 17.2 cases per 1,000. Globally, it is estimated that more than 37 million people have HF. In Portugal, the disease affects approximately 5.2% of the adult population, equivalent to more than 400,000 people, and is expected to increase due to the population's aging. This condition presents several risk factors, such as high blood pressure, diabetes, chronic kidney disease, coronary artery disease, aortic valve disease, atrial fibrillation, cancer, cognitive impairment, and dementia, among others. Regarding symptoms, dyspnoea and fatigue, which can limit physical exercise, and fluid retention, which can lead to oedema, stand out. Symptoms include dyspnoea and fatigue, which can limit physical exercise, and fluid retention, which can lead to oedema. Based on the above considerations, the main objectives of this Dissertation are: i) to present the definition and classification of HF; ii) to assess the incidence and prevalence of this disease in the population; iii) to mention the signs and symptoms, risk factors, pathophysiology, and diagnosis; iv) to refer to the pharmacological approach (i.e., pharmacotherapeutic treatment algorithm, currently used drugs, and drugs in development); v) to describe the therapeutic indications, undesirable effects, contraindications, posology, method of administration, and pharmacokinetic and pharmacodynamic properties for the main drugs; and vi) to highlight the role of the pharmacist. Regarding the methodology, a documentary analysis of various bibliographic sources was used, namely, scientific articles, guidelines, and technical books. It was concluded that the most relevant drugs for the treatment of HF are angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, β-adrenergic blockers, aldosterone antagonists, sacubitril + valsartan, and sodium-glucose cotransporter 2 inhibitors. Furthermore, the importance of pharmaceutical intervention in the management of the pathology and the pharmacotherapy instituted is highlighted.
Heart failure (HF) is a disease characterized by abnormal heart function, meaning it cannot pump enough blood to meet the body's needs. The condition is divided into four stages, namely, A, B, C, and D, depending on the severity of clinical symptoms. In European countries, the average incidence of this disease is 3.2 cases per 1,000 people per year, and the prevalence is 17.2 cases per 1,000. Globally, it is estimated that more than 37 million people have HF. In Portugal, the disease affects approximately 5.2% of the adult population, equivalent to more than 400,000 people, and is expected to increase due to the population's aging. This condition presents several risk factors, such as high blood pressure, diabetes, chronic kidney disease, coronary artery disease, aortic valve disease, atrial fibrillation, cancer, cognitive impairment, and dementia, among others. Regarding symptoms, dyspnoea and fatigue, which can limit physical exercise, and fluid retention, which can lead to oedema, stand out. Symptoms include dyspnoea and fatigue, which can limit physical exercise, and fluid retention, which can lead to oedema. Based on the above considerations, the main objectives of this Dissertation are: i) to present the definition and classification of HF; ii) to assess the incidence and prevalence of this disease in the population; iii) to mention the signs and symptoms, risk factors, pathophysiology, and diagnosis; iv) to refer to the pharmacological approach (i.e., pharmacotherapeutic treatment algorithm, currently used drugs, and drugs in development); v) to describe the therapeutic indications, undesirable effects, contraindications, posology, method of administration, and pharmacokinetic and pharmacodynamic properties for the main drugs; and vi) to highlight the role of the pharmacist. Regarding the methodology, a documentary analysis of various bibliographic sources was used, namely, scientific articles, guidelines, and technical books. It was concluded that the most relevant drugs for the treatment of HF are angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, β-adrenergic blockers, aldosterone antagonists, sacubitril + valsartan, and sodium-glucose cotransporter 2 inhibitors. Furthermore, the importance of pharmaceutical intervention in the management of the pathology and the pharmacotherapy instituted is highlighted.
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Palavras-chave
Insuficiência Cardíaca Fisiopatologia Farmacoterapia Farmacêutico