Welcome to Helix Talk, a podcast presented by the Rosalind Franklin University College of Pharmacy.

We're hoping that our real-life clinical pearls and discussions will help you stay up to date

and improve your pharmacy knowledge. This podcast contains general information for educational purposes only. This is

not professional advice and should not be used in lieu of obtaining advice from a qualified health

care provider. And now on to the show. Welcome to episode 32 of Helix Talk. I'm your co-host, Dr.

Kaine. I'm Dr. Schumann. And I'm Dr. Patel. Today we're talking about a newly

approved drug for heart failure. And this new drug class is called an arni, or an angiotensin

receptor, neprilicin inhibitor. And before we get there, I think we should cover a little bit

of kind of the background of heart failure to better understand where this new drug class kind of

fits in with heart failure management.

So we all know that AIDS inhibitors and antigen receptor blockers, the ARBs, they reduce mortality

in systolic heart failure where the left ventricular ejection fraction is less than 40%.

And so the idea here is to

inhibit the the RAS system which is the renin and Jutensin aldosterone system and

block the compensatory mechanisms that actually are aiding into the whole

process of heart failure.

So basically, if we do not block the Ross system, eventually it increases the sodium and water retention causes the raise of restriction, and this all leads to increase preload.

That's why a patient usually present with symptoms of pulmonary congestion or peripheral edema,

and this eventually increases the myocardial oxygen demand.

And then furthermore, the system can also cause cardiac remodeling, mostly hypertrophy or excess growth of the cardiac myocytes,

and that ends up making the heart's contraction

less efficient. So because of that, there's an additional risk of fatal arrhythmias.

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