June 21, 2021
📖 Angiotensin receptor-neprilysin inhibitors (ARNI) is a new class of heart failure medications.
☝🏻 The first drug in this class is Entresto® (sacubitril/valsartan). It is a combination medication comprised of a neprilysin inhibitor (sacubitril) and an angiotensin II receptor blocker (valsartan).
💊 Sacubitril is a prodrug that inhibits neprilysin thus preventing it from breaking down natriuretic peptides. This mechanism leads to an increase in vasodilation and diuresis as levels of natriuretic peptides rise.
💊 Valsartan directly blocks angiotensin II receptors inhibiting angiotensin II from binding onto the receptors and causing vasoconstriction and aldosterone release.
🤰🏻 Choosing an effective yet safe antibiotic during pregnancy requires you to weigh the risks and benefits. It can often be a gray area based on limited clinical studies in pregnant patients. ⠀
Some tips include:⠀
👉🏻 Only using antibiotics when no other treatment options are available ⠀
👉🏻 Avoid prescribing antibiotics during the first trimester if possible. ⠀
👉🏻 Chose a safe medication with available clinical studies that have been tested in pregnancy⠀
👉🏻 Dose at the lowest possible amount proven effective.⠀