Cardiac Drug Therapy Khan by M. Gabriel Khan
By M. Gabriel Khan
Cardiac Drug remedy: seventh variation updates and revises the 6th version in numerous respects. the hot variation comprises six new chapters that care for ongoing controversies in regards to the use of a number of universal medications. those chapters comprise the betablocker controversies, ACE inhibitor controversies, calcium antagonist controversies, high blood pressure controversies, middle failure controversies, and Statin controversies.
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Esmolol IV can be used to predict the outcome of oral beta-blocker therapy. Although a small trial has shown no beneficial effect for some beta-blockers, a noncardioselective agent with greater vasoconstrictive properties such as timolol should be tested in RCTs. Diabetic Patients Diabetic patients at risk are a new indication for beta-blockers. The UKPDS results (19) confirm that in type 2 diabetes, beta-blockers significantly reduced all-cause mortality, risk for MI, stroke, PVD, and microvascular disease (Fig.
The drug is given only under continuous monitoring of cardiac rhythm and blood pressure under close supervision. Hypotension is the major adverse effect, and in one study this occurred more often with esmolol than with IV propranolol (77), but, with careful titration, esmolol is superior, given that adverse effects dissipate rapidly. Contraindications include • Severe hypotension or cardiogenic shock. • Asthma or severe COPD. • Other contraindications to the use of beta-blocking agents. Drug name: Labetalol Trade names: Normodyne, Trandate Supplied: 50, 100, 200, 400 mg Dosage: 50–100 mg twice daily; titrate over weeks to 200–400 mg twice daily; see text for IV dosage 28 Cardiac Drug Therapy A combined alpha- and beta-blocker, this drug is useful in the management of hypertension of all grades including hypertensive emergencies.
MERIT-HF Study Group. Dose of metoprolol CR/XL and clinical outcomes in patients with heart failure. Analysis of the experience in metoprolol CR/XL randomized intervention trial in chronic heart failure (MERIT-HF). J Am Coll Cardiol 2002;40:491–498. 57. Chan AW, Quinn MJ, Bhatt DL, et al. Mortality benefit of beta-blockade after successful elective percutaneous coronary intervention. J Am Coll Cardiol 2002;40:669–675. 58. Wheat MW Jr. Treatment of dissecting aneurysms of the aorta: Current status.