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Jung Soo Case Study, Lauren Van Rassel, Justin Gillespie, Robyn Harris,…
Jung Soo Case Study
Background
82 year old male
presented with dyspnea, audible adventitia
+2 pitting edema to legs bilaterally
medical history: MI 5 years ago, diagnosed with heart failure
ran out of his medications a week ago
widowed, no children, lives alone
weight gain of 9kg in one month
given IV furosemide and restarted on Ca2+ channel blocker medication in hospital
Lungs
Furosemide
decreased circulating fluid overall may allow for a decrease in dyspnea
CCB
relaxed pulmonary arteries and decreased systemic vascular resistance, leads to decreased oxygen needs from the heart
digoxin
decreased exertional and paroxysmal evening dyspnea, cough, and cyanosis
Heart
Furosemide
Preload
Decreased
causes a decrease in cardiac output, peripheral resistance, and workload on heart
due to decrease in volumes of plasma and extracellular fluid
CCB
vasodilation of coronary and peripheral arteries
decreased vascular resistance
decreased oxygen demands from heart
decreases the afterload
digoxin
enhanced myocardial contractility
caused by increase in cellular sodium and calcium concentration due to the closing of sodium-potassium ATP pumps
HR
decreases rate of electrical conduction
prolongs refractory period
increases cardiac efficiency
Lauren Van Rassel, Justin Gillespie, Robyn Harris
References
Sealock, K., Lilley, L. L., Snyder, J. S., Collins, S. R., Seneviratne, C., & Lilley, L. L. (2021). Lilley's pharmacology for Canadian Health Care Practice. Elsevier.