Home' Australian Pharmacist : Australian Pharmacist May 2012 Contents 400 Australian Pharmacist May 2012 I © Pharmaceutical Society of Australia Ltd.
The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.
Key learning points
Patients who are prescribed a
thiazolidinedione should be monitored
for signs of congestive heart failure
such as dyspnoea, oedema, exercise
intolerance, fatigue and lethargy.
If heart failure is suspected, patients
should be referred to a medical
practitioner to be assessed for heart
An alternative hypoglycaemic medicine
should also be prescribed. It is important
that pharmacists are aware of the
symptoms of heart failure and understand
the best course of action for patients with
suspected heart failure.
1. Chronic hypertension can cause
heart failure due to:
a) impaired blood flow through the
b) changes in myocardial structure and
c) a direct effect on the left ventricle to
reduce ejection fraction.
d) None of the above.
2. Choose the CORRECT statement
about heart failure.
a) Common symptoms include fatigue,
dyspnoea, oedema and exercise
b) Common causes include hypertension
and coronary artery disease.
c) It can be exacerbated by medicines
that cause fluid retention and oedema.
3. Which of the following drugs can
cause new onset or worsening heart
4. Beta-blockers are indicated in heart
a) patients with fluid-overload.
b) patients with severe symptoms
despite treatment with aldosterone
c) patients who cannot tolerate ACEIs.
d) patients who remain symptomatic
despite treatment with an ACEI.
5. In Australia, most cases of anaemia
are due to kidney disease.
A score of 4 out of 5 attracts 1 CPD credit.
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of Australia and New Zealand (Chronic Heart Failure Guidelines
Expert Writing Panel). Guidelines for the prevention, detection
and management of chronic heart failure in Australia. Updated
Updating your knowledge
– enhancing your skills
Annual Consultant Pharmacy Seminar
Hyatt Regency Coolum
1–3 June 2012
ConPharm2012 strip ad-AJP-43x235mm.indd 1
5/02/2012 11:22:38 PM
10. Hopper I. Cardiac effects of non-cardiac drugs [online]. Aust
Prescr. 2011;34(2):52–4 . At: www.nps.org.au/__data/assets/
11. Graham DJ, Ouellet-Hellstrom R, MaCurdy T, et al. Risk of acute
myocardial infarction, stroke, heart failure, and death in elderly
medicare patients treated with rosiglitazone or pioglitazone.
JAMA. 2010; 304(4):411–8 .
12. NPS Better choices, Better health. Pioglitazone (Actos) for type
2 diabetes mellitus. NPS Radar Mar 2008 [online]. At: www.nps.
13. Nesto RW, Bell D, Bonow RO, et al. Thiazolidinedione use, fluid
retention, and congestive heart failure: a consensus statement
from the American Heart Association and American Diabetes
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thiazolidinedione therapy: the impact of increased risk of heart
failure. Eur Heart J. 2008: 29(1):12–20.
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