When the patient was discharged from hospital, why was she prescribed perindopril, bisoprolol, spironolactone and frusemide? Include in your answer the reason for prescribing these medications and their actions and major side effects

Question

What will be an ideal response?

Answer 1

Suggested response: Perindopril Reason for prescribing: antihypertensive and decrease sodium and water reabsorption. It reduces the workload of the heart. Action: ACEIs block the angiotensin-converting enzyme responsible for the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor. ACEIs also inhibit the release of aldosterone, which is responsible for sodium and water retention. Side effects: hyperkalaemia, hypotension, dry irritating cough, headaches, dizziness, loss of taste, diarrhoea and weakness. Bisoprolol Reason for prescribing: Antihypertensive and reduces pulse rate to reduce the workload of the heart. Action: belongs to the beta-1 cardioselective beta-adrenergic blocking agents. They block the action of beta-receptor sites located on the heart, smooth muscle of bronchi and blood vessels, kidney, pancreas, uterus, brain and liver. This results in a decrease in pulse, conduction, myocardial contractility and cardiac output. Side effects: bronchoconstriction, bradycardia, insomnia, depression, headaches, dizziness, fatigue and hypotension. Spironolactone Reason for prescribing: treatment of oedema associated with heart failure or hepatic cirrhosis. Action: spironolactone is an aldosterone antagonist, also called a potassium-sparing diuretic. It blocks the action of aldosterone resulting in the prevention of the reabsorption of sodium and water. Side effects: hyperkalaemia, hyponatraemia, hypochloraemia, gynaecomastia, dizziness, impotence, decreased libido and constipation. Frusemide Reason for prescribing: treatment of oedema, including peripheral oedema and acute pulmonary oedema, associated with heart failure or hepatic cirrhosis. Action: belongs to the loop diuretic group. It acts on the loop of Henle in the kidneys. Loop diuretics prevent the reabsorption of sodium, calcium, magnesium and chloride resulting in an increase in fluid excretion. Frusemide, in particular, also causes short-lasting venodilation. Side effects: hyponatraemia, hypokalaemia, hypomagnesaemia, hypouricaemia, dizziness and postural hypotension.