Health Sciences - Study Contribution Review - Essay Example

In spite of the interesting theoretical nature of working proposed for these drugs, most of them have not been of significant use in CHF (Van Gilst & Veldhuisen, 2003). Problem The lack of one perfect pharmacological treatment has been partly attributed to the probable effect of having used too many drugs within the extensive research regime that has characterized the search for effective CHF treatment. The too many ‘old’ and too many ‘new’ drugs make the attainment of an effective remedy through combination quite complicated because of the wide array of tries possible.

The large number of researches already carried out has led to the heightening of demands on new researches expected to deliver new options, thus posing even further challenges for any new researches (Van Gilst & Veldhuisen, 2003). Background The earliest pharmacologic treatment for CHF constituted a combination of diuretics and digoxin, but this was altered in the early 80s and the use of vasodilators started due to the hemodynamic concept. In the same decade (1987), ACE (Angiotensin converting enzyme) inhibitor enalapril was found to be more effective on reducing mortality (Blue & Stewart, 2001).

Additionally, it was also found to work well on asymptomatic left ventricular dysfunction. This option seemingly offered a good option of treatment, but prognosis remained poor and patients under its treatment were still asymptomatic. As such, research for new and better add-on drugs continued. The tried and tested included dopamine agonists, phosphodiesterase inhibitors, vasodilators and calcium antagonists (Van Gilst & Veldhuisen, 2003). Despite the short-term promising nature of these drugs, none was found to be of effective use in long-term trials that reviewed mortality.

Further studies proposed beta-blockers as the treatment in reducing mortality, especially when combined with diuretics and ACE inhibitors, with or without the inclusion of digoxin. Current study results show that the beta-blockers are effective in advanced CHF, and they could offer a 30% survival benefit when combined with ACE inhibitors. The next drug to be tested was angiotensin II receptor blockers (ARBs) (Van Gilst & Veldhuisen, 2003). This drug used the alternative path of blocking the receptor of angiotensin II instead of using inhibitor to block its production as an alternative solution.

The comparative use of ARBs and ACE inhibitors showed little difference in the long-run, thus implying none was effective. Other test options such as aldosterone receptor blockade reduced morbidity and mortality, but showed significant side-effects. Currently, numerous drugs such as eplerenone are under testing. Others under current testing include cytokine and endothelin antagonists and neutral endopeptidase inhibitors, but most of their short-term success has already been overshadowed by poor long-term results.

The search still continues, but as more new drugs are tested more confusion arises in the treatment regime (Feldman, 2006). Significance to cardiopulmonary care Given the above scenario practitioners should consider different strategies in CHF treatment, instead of increasing the number of drugs in the present regimen. A probable option may entail tailoring the therapy based on individual characteristics of the patient such