…forms of acute tubular necrosis, although the complication remains associated with post procedural morbidity and mortality. Pathophysiology The precise mechanism of contrast induced AKI is…

…acute starvation, and dieting. Clinicians should maintain a high index of suspicion for drug induced arrhythmias in patients receiving agents known to alter the electrical…

…pressure ≥120 mmHg) with concurrent signs of acute organ damage or failure. Any of the drugs listed below may be used to treat hypertensive emergencies…

…pressure ≥120 mmHg) with concurrent signs of acute organ damage or failure. Any of the drugs listed below may be used to treat hypertensive emergencies…

…Management Definition and Clinical Characteristics Torsades de pointes (TdP) represents a multifactorial clinical entity typically associated with drug induced long QT syndrome (DI LQTS) [1]…

…administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for…

…Go through the medication and any herbal preparations carefully — drug induced liver injury is the commonest cause of acute liver failure in the Nordic countries.

…and an ECG all come before complete identification of the substance. Treatment of acute poisoning consists of four parallel components: supportive treatment, a targeted antidote…

…acute Heart failure (HF), chronic Bradycardia (second line alternative) High dose : 10.0 20.0 μg/kg/min. ++++ ++++ ++ +++++ Hig dose dopamine additionally induces α1…

…acute Heart failure (HF), chronic Bradycardia (second line alternative) High dose : 10.0 20.0 μg/kg/min. ++++ ++++ ++ +++++ Hig dose dopamine additionally induces α1…

…acute or chronic. Bradycardia (second line option). 10.0–20.0 μg/kg/min ++++ ++++ ++ +++++ High dose dopamine additionally induces α1 stimulation and thereby vasoconstriction…

…the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to their distinct pharmacodynamic mechanisms. These drugs are broadly utilised…

CPR It is commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being…

…process. A broad spectrum of pharmacologic agents can induce bradycardia or conduction disorders. These include beta blockers, non dihydropyridine calcium channel blockers, antiarrhythmic drugs (amiodarone…

…blood pressure measurement. Resuscitation trolley with defibrillator, oxygen, suction and emergency drugs in the room. Staff with current CPR competence; a physician available. Patient preparation…

…of drugs (notably beta blockers, digitalis, verapamil, diltiazem, amiodarone, clonidine) – These drugs affect the pacemaker cells in the sinoatrial node. They may also induce conduction…

Kardiologi Akutsjukvård Lathundar Overview Acute coronary syndrome comprises STEMI, NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable…

…how long an attack lasts, and whether anything actually triggers it [1,2]. The single most important practical rule is: Continuous acute dizziness with spontaneous…

Myocardial ischemia and infarction Introduction Drug eluting stents (DES) are the predominant device used during percutaneous coronary intervention (PCI). They evolved from balloon angioplasty and…

…etiology for acute severe heart failure. A recent echocardiographic examination should be available or performed urgently to evaluate ventricular and valvular function. Levosimendan drug is…

…alone [2]. A markedly raised blood pressure without acute organ damage should as a rule not be lowered rapidly with intravenous drugs. Restart or optimise…

…per day. Patches have no place in acute, unstable pain: the onset takes 12 to 24 hours and the offset just as long. Breakthrough dose…

Clevidipine Drug Clevidipine Brand names Cleviprex ® Indications Hypertension and hypertensive emergency. Treatment of postoperative hypertension. Mechanism of action Ultra short acting calcium channel blocker…

Esmolol Drug Esmolol Brand names Brevibloc ® Indications Short term control of ventricular rate (including perioperative tachycardia) and hypertension (including hypertensive emergency, perioperative hypertension). Mechanism…

Metoprolol Drug Metoprolol Brand names Dutoprol ®, Kapspargo ®, Lopressor ®, Lopressor Hct ®, Toprol ®, Seloken ® Indications Mycoardial ischemia. Perioperative hypertension. Mechanism of…

Procedurer Oxygen is a drug and must be prescribed as one: with an indication, a route of administration and a target range for the saturation…

…Children in an emergency, where peripheral venous access often takes too long. Intraosseous access accepts all drugs, fluids and blood products that can be given…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiology Atherosclerosis and acute coronary syndromes have important inflammatory components. Inflammation contributes to atherothrombosis through activation of…

…individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute left ventricular failure. Mechanism of action Enalaprilat…

…the stable patient Drug Situation Comment : : : Beta blocker (metoprolol) First choice in most cases The IV dose is titrated slowly. Caution in acute heart failure…

…distress. Delirium is an acute neuropsychiatric syndrome and a clinical diagnosis, often described as acute brain failure. It is precipitated by somatic illness, drugs, poisoning…

…is intensified [1,2]. The evidence that any particular intravenous drug improves mortality or long term functional outcome is limited. A Cochrane review found insufficient…

…of beta blockers in selected patients after acute myocardial infarction (MI), antianginal drugs have not been shown to improve long term cardiovascular outcomes in CCS…

…and Management, Including Acute and Long Term Strategies The initial approach to bradycardia management involves identifying and treating any underlying conditions or reversible causes. The…

…abnormalities. Malignant hypertension may cause acute microangiopathy, with renal, retinal, and cerebral involvement. Catecholamine excess and drug related presentations Severe hypertension may result from phaeochromocytoma…

…frequent cause of PCI failure, despite its substantially lower incidence with drug eluting stents (DES) than with bare metal stents (BMS). Clinical ISR is generally…

…a new drug class, the ARNI (Angiotensin–Neprilysin Inhibitors), a long awaited breakthrough. Heart failure is a serious condition with a poor long term prognosis…

…a new drug class, the ARNI (Angiotensin–Neprilysin Inhibitors), a long awaited breakthrough. Heart failure is a serious condition with a poor long term prognosis…

…a fuller account of two of the commonest acute drug problems, see Warfarin therapy and Opioid therapy in severe pain. Cardiac arrest Drug Adult Child : : …

…circulatory compromise severe gastrointestinal symptoms, particularly after exposure to a drug, insect venom or another non food allergen 2. Acute airway, respiratory or circulatory compromise…

…Intravenous antibiotics Drug eGFR 90 60 89 30 59 15 29 <15 : : : : : : Benzylpenicillin 1 3 g three times daily 1 3 g three times daily…

…the patient on anticoagulants; see the acute stroke quick reference. Stopping the drug and forgetting to restart it after the procedure. Document the restart date…

…and change to an infusion or injections Drugs for type 2 diabetes in inpatients Agent The acutely ill inpatient : : Metformin Stop in acute kidney injury…

…and very large people. Acute kidney injury (KDIGO) Stage Creatinine Urine output : : : 1 A rise ≥ 26 µmol/L in 48 h, or 1.5–1…

…over several days to weeks. More acute endocarditis is often caused by staphylococcus auerus . This usually affects drug users (intravenous addiction), elderly patients with altered…

…Causes of sinoatrial (SA) block The following conditions cause sinoatrial block: Sinus node dysfunction (SND) Perimyocarditis Acute myocardial infarction (or ischemia) Drug side effects (procainamide…

…or when a conversion between drugs is made without reduction for incomplete cross tolerance. Indications Acute severe nociceptive pain where paracetamol and a COX inhibitor…

…after pituitary surgery or radiotherapy, or with suspected suppression of the HPA axis after long term glucocorticoid treatment. A basal morning cortisol in the grey…

…the original article. International guidelines and studies support the same principles, but local choices of drug, formulations and infusion rates may differ. Always follow the…

…transfusion requirement. A normal haemoglobin early on does not exclude major bleeding. In acute blood loss, plasma and red cells are lost simultaneously, which means…

…managed from an anticoagulation clinic with dosing support, but whoever starts the drug is responsible for the first week. Indications A mechanical valve prosthesis — warfarin…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiological basis Secondary prevention after myocardial infarction (MI) encompasses long term interventions intended to reduce recurrent infarction…

…High intensity statin therapy remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease…

…although long term success rates remain modest and repeated intervention is often necessary. Patients with acute coronary syndrome should be offered cessation support during hospitalization…

…or resistance to aspirin or clopidogrel Anatomic Long lesions, small vessels, multivessel disease, bifurcation lesions, treatment of acute myocardial infarction Procedural and mechanical Stent underexpansion…

…This is seen in ischemia, electrolyte disorders (calcium, potassium), tachycardia, increased sympathetic tone, drug side effects etc. Secondary ST T changes occur when abnormal depolarization…

…asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation be entirely inhibited (as seen in acute airway obstructions)…

…in the acute setting, whereas long term management only includes pacemaker therapy. Treatment of AV block in the acute setting Treatment in the acute setting…

…It may arise from pulmonary vascular disease, left sided cardiac disease, chronic lung disease or hypoxia, chronic thromboembolic obstruction, or a range of miscellaneous conditions…

…ancestry Previous muscle disease or a personal or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency Concomitant interacting…