Subject(s)
Blood Pressure/drug effects , Cardiotonic Agents/therapeutic use , Dopamine/therapeutic use , Natriuretic Agents/therapeutic use , Natriuretic Peptide, Brain/therapeutic use , Shock/physiopathology , Adult , Cardiography, Impedance/methods , Diphenhydramine/poisoning , Drug Therapy, Combination , Female , Follow-Up Studies , Humans , Hypnotics and Sedatives/poisoning , Shock/chemically induced , Shock/drug therapyABSTRACT
Little information exists regarding the use of nesiritide for treatment of right-sided heart failure. Similarly, little information is available regarding routine use of combination nesiritide and diuretics as initial therapy to relieve edema due to heart failure. Nesiritide may be beneficial in combination with diuretics because it reduces activity of the renin-angiotensin-aldosterone system. It is unclear how potent nesiritide is as a diuretic. Patients exhibit wide variability in clinical response from the diuretic effects of the drug. Two patients were given a combination of nesiritide and diuretics as initial treatment of right-sided heart failure; both experienced significant diuresis and weight loss. Further literature is needed to clarify the role of nesiritide in the treatment of right-sided heart failure.