Heart failure has a high global burden of morbidity and mortality. Despite significant advances in medical management of heart failure, the prognosis remains poor. This justifies the search for newer therapeutic agents. Recently, soluble guanylate stimulators have demonstrated favorable results in clinical trials. This article aims to summarize the guanylate cyclase signaling pathway, the role of soluble guanylate cyclase stimulators in heart failure, and data from recent clinical trials of these drugs. We concluded that soluble guanylate cyclase stimulators have significant benefits in reducing hospitalizations in patients with heart failure with reduced ejection fraction that are at high risk of cardiovascular events. There appears to be no benefit of these drugs in patients with heart failure with preserved ejection fraction.

Mycophenolate mofetil (MMF) is an immunosuppressant drug widely used in post-transplant patients and the treatment of various inflammatory conditions. It is considered a relatively safe drug with minimal adverse effects. We managed an acute overdose of 19 grams (g) of MMF with a suicidal intention in a 17-year-old female with no significant past medical history. Apart from episodes of mild headaches, she did not develop other symptoms, laboratory abnormalities, or complications.

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed drugs to treat pain, and are easily available over the counter in lower dosages. NSAID use is associated with various side effects and elevated blood pressure is one of them. NSAIDs vary considerably in their effect on blood pressure with indomethacin being one of the NSAIDs associated with a significant increase in blood pressure. We present a case of a 58-year-old woman who developed a hypertensive crisis after a single dose of prescription indomethacin.