POTASSIUM MONITORING IN HEART FAILURE PATIENTS RECEIVING COMBINED THERAPY OF CAPTOPRIL AND FUROSEMIDE

Hubby Hubby, Suharjono Suharjono, Zaenab Djafar

= http://dx.doi.org/10.20473/fmi.v52i4.5477
Abstract views = 1733 times | downloads = 1079 times

Abstract


In the treatment of heart failure is recommended the use of a combination of ACEI (captopril) with diuretics (furosemide), ACEI has the side effect of hyperkalemia 10-38% in hospitalized patients and 10% in outpatients, is increased in patients with renal failure and diabetes mellitus, the use diuretics occur hypokalemia 5-20% in outpatients. Hyperkalemia and hypokalemia both should be avoided in heart failure patients, because it can cause cardiac conduction disorders such as cardiac arrhythmias This study aims to monitor levels of potassium in the use of combination therapy with furosemide captopril in heart failure patients. The study was conducted using the method Prospective Observational Cross Sectional Analysis, conducted in January-May 2015 in heart failure patients male and female NYHA II-III receiving combination therapy with furosemide Captopril met the inclusion criteria were treated in the department CVCU Dr. Wahidin Sudirohusodo Makassar. Potassium levels were measured pre and post administration of the combination therapy. A total of 37 patients met the inclusion and exclusion criteria in this study, 31 male patients (83.8%) and 6 female patients (16.2%) aged between 35-80 years, during this study after administration of the combination therapy, 5 patients (13.5%) had hypokalemia (<3.5 mmol/L) and 2 patients (5.4%) experienced hyperkalemia (> 5 mmol/L) and 30 patients (81.1%) of normal potassium levels (3,5 to 5.0 mmol/L). The test results paired t test p = 0.432 (p> α;α = 0.05) showed no significant differences between potassium levels pre and post potassium levels. In conclusion, the use of a combination of captopril and furosemide therapy, the risk of hyperkalemia and hypokalemia not significant but need to be monitored levels of potassium and ECG patient.

Keywords


heart failure; a combination of captopril therapy with furosemide; hyperkalemia; hypokalemia; ACEI; diuretic

Full Text:

PDF

References


Dursun I and Sahin M (2006). Difficulties in maintaining potassium homeostasis in patients with heart failure. Clin Cardiol 29, 388-392

Felker G, Lee K, Bull D, Redfield MM, Stevenson LW, Goldsmith SR, LeWinter MM, Deswal A, Rouleau JL, Ofili EO, Anstrom KJ, Hernandez AF, McNulty SE, Velazquez EJ, Kfoury AG, Chen HH, Givertz MM, Semigran MJ, Bart BA, Mascette AM, Braunwald E, O'Connor CM, for the NHLBI Heart Failure Clinical Research Network (2011). Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med 364, 797–805

Harvey RA and Champe PC (2009). Lippincott's Illustrated Reviews Pharmacology, 4th ed, Philadelphia, Lippincott Williams & Wilkins, p215 -230

Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW (2009). 2009 focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119, e391-479

Jentzer JC, DeWald TA, Hernandez AF (2010). Combination of loop diuretics with thiazide-type diuretics in heart failure. J Am Coll Cardiol 56, 1527-1534

Kabo P (2010). Bagaimana Menggunakan Obat-obat Kardiovaskular secara Rasional, Jakarta, Balai Penerbit Fakultas Kedokteran Universitas Indonesia, p 63-75

Lim H (2013). Farmakologi Kardiovaskuler, Mekanisme dan Aplikasi Klinis, edisi ketiga, Jakarta, PT Sofmedia, p 118-135

McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Køber L, Lip GY, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rønnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A; ESC Committee for Practice Guidelines (2012). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 33, 1787-1847

Panggabean MM (2014). Buku Ajar Ilmu Penyakit Dalam, Jilid II, Edisi VI, Jakarta Pusat, Interna Publishing, p 1132–1136.

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL (2013). 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 128, 1810-1852


Refbacks

  • There are currently no refbacks.


Copyright (c) 2017 Hubby Hubby, Suharjono Suharjono, Zaenab Djafar

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Indexed By

View My Stats

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.