Congestive heart failure, or heart failure, is a chronic condition characterized by the inability of the heart to pump enough blood to the rest of the body. Because blood is needed to supply oxygen to the body, this can become problematic. As the amount of blood pumping decreases, our bodies have a response that, under normal circumstances, can help to maintain a good blood pressure. While these responses are good when the causes are reversible, in heart failure, these responses do more harm than good. The mechanisms usually involve increasing the heart rate or how hard the heart pumps. Similarly, to how lifting weights can make a person’s muscle bigger and stronger, the heart is a muscle that can also get bigger. Unfortunately, when the heart gets bigger, it actually makes it more difficult to pump an adequate amount of blood and the cycle continues.
Medications for Heart Failure
Certain medications for heart failure are given to help with extending a patient’s life. These effects, unfortunately, are seen in long term use over the course of many years. At the end of life, there is likely little benefit. Such medications include ACE-inhibitors (Lisinopril, Enalapril), ARBs (Losartan, Valsartan), neprilysin inhibitors, and beta-blockers (metoprolol). These medications can help to keep blood pressure and heart rate lower but can become problematic towards the end of life due to side effects. These medications can put a patient at risk for falling or becoming hypotensive (low blood pressure) or bradycardic (low heart rate). When making decisions about medications for end of life care, it is a balancing act. Risks and benefits are constantly in conflict with each other. Our job at Hospice of Southern Illinois is to minimize risks to patients, while keeping them as comfortable as possible.
Call Hospice of Southern Illinois to learn more about end-of-life care and hospice services, 800-233-1708. Request a chat,
By: Timothy Cruz, PharmD, PGY-2 Pharmacy Resident in Pain and Palliative Care, Hospice of Southern Illinois
October is American Pharmacists Month and we are proud to present to you an educational blog series throughout the month by, Timothy Cruz, PharmD, PGY-2 Pharmacy Resident in Pain and Palliative Care. Our series will help expand your understanding of the use of medications at the end-of-life.