…antihypertensive drugs used in a hypertensive emergency. It summarises the mechanism of action, the onset, the duration of effect, the dosing, the adverse effects and…

…and thus the selection between them may be guided by individual patient needs rather than by a distinct advantage of one drug over the other…

…not surprising given the adverse effects of long periods of tachycardia and desynchronized atrial and ventricular activity. Fortunately, the treatment of atrial fibrillation has come…

…or verapamil, although this is not an established drug interaction. The half life of adenosine is 8 seconds. Adverse effects are therefore very brief. Indications…

…component major adverse cardiovascular events. The reported hazard ratio was 0.83, with a 95% confidence interval of 0.72–0.95 and an absolute…

…other circumstances that may affect cessation or treatment monitoring. Single question screening can identify unhealthy drug use requiring counselling regarding cardiovascular effects and potential drug…

…ischaemic events and possible infectious or other non cardiovascular adverse outcomes. Mechanisms of action Colchicine Colchicine appears to exert several anti inflammatory effects relevant to…

…obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked…

…this reflects true biological protection. Potentially favourable associations with myocardial infarction may coexist with adverse effects on stroke, heart failure, cardiovascular mortality and atrial fibrillation…

…through diabetic neuropathy and adverse metabolic effects, independently of coexisting CAD, previous myocardial infarction or HF. Nevertheless, the risk of arrhythmia and sudden cardiac death…

…effects. Most of these adverse events are related to the suppression of the renin angiotensin aldosterone system (RAAS), such as decreases in blood pressure and…

…causes adverse hemodynamic effects, and the condition is classified as cardiac tamponade. The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular…

…of revascularization Expected effects on death, myocardial infarction and stroke Likelihood of repeat revascularization Symptom burden and treatment goals Diabetes, left ventricular function and other…

…adverse cardiovascular outcome, the potential benefit for an individual patient may remain substantial. At the same time, adverse effects such as hypotension, syncope, falls, and…

…shoulder dislocation, with an effect equivalent to sedation and fewer adverse effects Digital nerve block The standard in finger dislocation Procedural sedation Propofol, ketamine or…

…onset, prolonged duration of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute…

…egg), of which the maximum dose per 24 hours is 1000 mL. Adverse effects Headache. Nausea. Fever. Atrial fibrillation. Worsening of heart failure. Caution • Used…

…min. Maximum infusion dose: 300 μg/kg/min. Bolus doses of 300 μg/kg can be repeated during infusion. Adverse effects Flushing. Nausea…

…hour. Adverse effects Tachycardia. Flushing. Headache. Angina pectoris. Caution Heart failure. Angina pectoris (ischemic heart disease). Hydralazine doses and administration in hypertension (hypertensive crisis/emergency).

…patients with asthma (due to risk of bronchospasm). • Used cautiously in bradycardia due to negative chronotropic effect. Metoprolol doses and administration in hypertension (hypertensive crisis…

…nitroglycerin regularly may have developed tolerance and require higher doses, alternatively nitroprusside to achieve desirable blood pressure lowring effect. Drug Nitroglycerin Brand names Gonitro ®…

…with increased risk of major adverse cardiovascular events (MACE) and stent thrombosis. Premature DAPT interruption is described as the strongest predictor of stent thrombosis in…

…than either drug alone. Long term efficacy data remain limited, and the possibility that chronic If channel blockade could increase sympathetic activity, with adverse remodelling…

…Catapress TTS 3 (0.3 mg/24hrs) Dosage in renal failure and renal replacement therapy: Dose as in normal renal function Adverse effects Excessive sedation…

…minutes to a total dose of 300 mg. Infusion regime : • 0.5–2 mg/minute IV infusion. Higher doses are sometimes required. Adverse effects Vomiting…

…Any of the drugs listed below may be used to treat hypertensive emergencies. The desired time to action, contraindications and risk of adverse effects should…

…synthesis and very low density lipoprotein production. Cyclosporine raises LDL cholesterol, partly by reducing LDL receptor availability. Tacrolimus appears to have less adverse effect on…

…Any of the drugs listed below may be used to treat hypertensive emergencies. The desired time to action, contraindications and risk of adverse effects should…

…and effect on activities of daily living. Workload or exertion required to provoke symptoms. Response to current antianginal therapy. Adverse effects that restrict further drug…

…for mor than 10 minutes. Administer sodium thiosulfate (cyanide into thiocyanate) and terminate infusion of nitroprusside if cyanide toxicity is suspected. Adverse effects • Nausea. Vomiting…

…including modulation of inflammation, oxidative stress, endothelial function, plaque stability, thrombogenic responses and immune activity. Statin intolerance refers to adverse effects attributed to statin treatment…

…statins further reduces major adverse cardiovascular events (MACE) and major adverse limb events (MALE), and improves walking distance. The role of PCSK9 inhibition in thoracic…

…digoxin treatment. Adverse effects of digoxin The incidence of adverse drug reactions is high, owing to the narrow therapeutic index of the drug. Digoxin is…

…coronary vasodilation. This selectivity minimizes activation of A1, A2B, and A3 receptors, which are associated with adverse effects such as bronchoconstriction and atrioventricular block. Adenosine…

…Nitroprusside Figure 1. The approximate position of each drug according to its vasoconstrictor effect (vertical axis) and its positive inotropic effect (horizontal axis). Grey =…

…must be individualized based on the clinical situation and arrhythmia severity. Because of the drug's unusual pharmacokinetics, serious arrhythmia indications, and potential adverse effects…

…are the strongest predictors of adverse outcomes. Non acute or asymptomatic bradycardia Non acute bradycardia is a common finding in both healthy and diseased individuals…

…DICT = Drug induced cardiotoxicity Trade Name Generic/Proper Name(s) Active Ingredient(s) Cardiotoxicity Label Section DICT Concern Cardiac side effects Severity of cardiotoxicity…

…70–79 Avoid a systolic pressure < 120 mmHg and a diastolic pressure < 70 mmHg on treatment — the benefit plateaus and adverse effects increase…

…Effects Dopamine 1 receptor agonists lower systemic blood pressure and increase renal perfusion. Time to onset of action 50 to 10 minutes Duration of action…

…and increase in increments of 0.1 mg. Adverse effects Tachycardia. Flushing. Headache. Nausea. Vomiting. Caution Rarely used unless patient has a confirmed diagnosis of…

…and favourably modifies inflammatory and collagen related components of atherosclerotic plaque. These effects help explain why reductions in cardiovascular events are substantially greater than the…

…administration of adrenaline is associated with more severe and more protracted reactions, biphasic courses and fatal outcome. At the same time, serious adverse effects are…

…contraction of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and…

…CKD), and peripheral artery disease (PAD). Figure 1 (below) shows weight loss effects of novel multi agonists in recent clinical trials (Rawshani et al). Recommended…

…atrial fibrillation and peripheral artery disease. Prognosis is generally worse when diabetes coexists with these conditions. However, the cardiovascular effects of SGLT2 inhibitors are not…

…apnoea). Suspected hypotension: dizziness, syncope, autonomic dysfunction, adverse drug effects. Wide variability between measurements. Hypertension in pregnancy. Contraindications There are no absolute contraindications. Refrain or…

…than simply increasing the dose of a single drug. They may also permit lower doses of each component, potentially limiting adverse effects and facilitating adherence…

…and death. The clinical consequences are particularly important when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of…

…result, pupils often dilate widely within 30–120 seconds of cardiac arrest and light reactivity is lost when cerebral blood flow ceases. In other words…

…linked to adverse outcomes. Left Ventricular Outflow Tract Gradient (LVOTG) : LVOT obstruction is a risk factor for heart failure and arrhythmias. Family History of Sudden…

…heart team. Predict Outcomes : The score has been validated to predict major adverse cardiac events (MACE) , including mortality, myocardial infarction, and repeat revascularization. For example…

…designed to improve the prediction of long term outcomes after revascularization. It incorporates both anatomical (from the original SYNTAX Score) and clinical variables (e.g…

…The principal determinant of adverse outcome is aneurysm size. Larger aneurysms and more rapid expansion are associated with increasing likelihood of symptoms, complications and rupture…

…antithrombotic surface, and control the adhesion and migration of inflammatory cells. Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The…

…or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular dysfunction and/or MVD…

…dominant manifestation of CAD. As LV dysfunction and HF become more prominent, angina may diminish or disappear. Others have no recognized history of angina or…

…Detect and characterize myocardial scar. Estimate the risk of major adverse cardiovascular events. Assess left ventricular volumes, regional wall motion, and ejection fraction using ECG…

…intensity of the physical activity. It is based on the subjective physical sensations experienced during exercise, including increased heart rate, increased respiratory rate and depth…

…ventricular function The amount of residual viable myocardium exposed to ischaemic risk Susceptibility to serious ventricular arrhythmias Cardiac rehabilitation addresses these determinants indirectly and comprehensively…