…usually within 30 seconds. Doses higher than 18 mg are unlikely to revert a tachycardia and should not be used. Specific dosing adjustments are required…

…mg with prednisolone 0.75 mg. A tenfold difference in effect. Giving the morning dose late in the day , which causes sleep disturbance and more…

…controversial. Epidemiological studies have often described a J shaped association between consumption and cardiovascular outcomes, with apparently lower overall cardiovascular risk around one drink daily…

…with the patient's usual glasses and then through a pinhole. This is done before any drops. 2. Inspect the eyelids, conjunctiva, cornea and anterior…

…evident and is therefore often done wrongly. The two commonest errors are that an intramuscular injection in fact ends up subcutaneously in a patient with…

…correlates best with total cumulative dose—may be a better predictor of long term tolerability. Hemodynamic Effects Amiodarone acts as a peripheral and coronary vasodilator…

…fibrinogen and creatinine. With DOACs, drug concentration measurement is available at some laboratories. Red flags and pitfalls Failing to ask when the last dose was…

…inotropes and vasopressors Drug Indications Dose α1 effect β1 effect β2 effect D1/D2 effect Result Side Effects Dopamine low dose Rarely used Low dose…

…inotropes and vasopressors Drug Indications Dose α1 effect β1 effect β2 effect D1/D2 effect Result Side Effects Dopamine low dose Rarely used Low dose…

…particularly in patients with marked tolerance. The most important measures in severe or complicated withdrawal are: 1. A benzodiazepine in a sufficient and repeated dose …

…10.0 μg/kg/min + ++++ + +++++ Intermediate dose dopamine activates β1, releases noradrenaline and thereby increases contractility and chronotropy, with a slight rise in SVR…

…Older people, the immunosuppressed and patients with renal or hepatic failure can have subtle symptoms. Findings that suggest acute organ dysfunction Organ or system Finding…

…biomarkers without affecting lipids or other major coronary risk factors. In patients with previous myocardial infarction and residual inflammation, defined by hsCRP ≥2 mg/L…

…Inclisiran produces a dose dependent reduction in PCSK9 and LDL C. Across clinical studies, LDL C reductions have generally been approximately 50%, with reported reductions…

…this risk. Synchronized cardioversion is used for organized tachyarrhythmias such as atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, and hemodynamically compromising ventricular tachycardia, while defibrillation…

…and progress in our understanding of the pathophysiology of cardiac disease. Ultrasound systems have become cheaper, more portable, more powerful, equipped with an increasing number…

…time. Opioids in abdominal pain of unclear cause do not delay the diagnosis and should be given, but document the examination findings before the dose…

…to clopidogrel; reducing the dose of prasugrel; extending DAPT beyond 12 months in carefully selected patients with high ischemic risk and low bleeding risk. These…

…DWI FLAIR mismatch can be used for selection with an unknown time of onset when MRI is immediately available and does not delay treatment Saturation…

…on the anterior septum and stop with correctly performed compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient…

…reaches hospital early. The benefit of both methods falls steeply with the time since ingestion, and both can harm the patient through aspiration. Contact your…

…be done without delay. 5. Start active warming and use a blood warmer. 6. Take a blood gas with lactate, pH, base excess, haemoglobin and…

…propofol is used in units with airway expertise. Procedure 1. Dry the skin and shave where necessary. Do not clip the hair — small cuts cause…

…blockers may also be used, although hypotension may limit dosing and evidence for their efficacy is limited. Ivabradine alone or combined with a beta blocker…

…proarrhythmia, and severe bradycardia. Patients should be monitored for arrhythmias and QT prolongation with each dose adjustment, typically waiting 2 to 3 days to attain…

…thrombogenic responses and immune activity. Statin intolerance refers to adverse effects attributed to statin treatment that improve or resolve after reducing the dose or stopping…

…an abnormal and rapid heart rate, whereas tachycardia is defined as the subjective perception of a rapid heart rate. These terms are often used interchangeably…

…drug. • Effective in sinus bradycardia or AV node block. • Dose <0.5 mg may worsen bradycardia and should not be given. • Relative contraindications are ileus…

…can be used to estimate pressure gradients (pressure differences) between the atria, ventricles, and connecting vessels. The estimation of pressure gradients is done using the…

…therapy Increase diuretic dose and/or combine diuretic classes Diuretic resistance or end stage renal failure Consider renal replacement therapy Hypoperfusion with persistent organ injury…

…be treated immediately with DKA dose insulin, while the osmolality is corrected cautiously [1,3]. Euglycaemic DKA Euglycaemic DKA means ketosis and metabolic acidosis despite…

…the tourniquet 10–15 cm proximal to the intended puncture site, let the arm hang, ask the patient to pump with the hand, and pa

…compromise. Diagnostics The diagnosis of ACE inhibitor induced cough is primarily clinical and relies on the temporal association of the cough with the medication. Specific…

…and Management Heart Failure with Reduced Ejection Fraction (HFrEF) There is overwhelming evidence that ACE inhibitors should be used in symptomatic and asymptomatic patients with…

…to take statins. Approximately 70% were in secondary prevention and 30% in primary prevention; 23% were taking a small dose of a statin, defined as…

…superior to upfront monotherapy for every patient with isolated hypertension. Single Pill Combinations Fixed dose, single pill combinations are preferred whenever combination treatment is used…

…including dose related increases. In people living with HIV, antiretroviral therapy may contribute to HTG. Reducing alcohol and carbohydrate intake, and considering a switch to…

…of these agents. Continuous blood pressure and rhythm monitoring are mandatory, particularly when utilising dobutamine, to ensure the lowest effective dose is used. When titrating…

…programmed algorithms and settings, which can be tailored to the patient's needs. Programming is done through an external device that communicates wirelessly with the…

…molecular weight heparin. Consider the bleeding risk with gastrointestinal and urogenital tumours Marked renal failure Low molecular weight heparin with dose adjustment, or warfarin Subsegmental…

…are no absolute contraindications. Refrain or adapt in atrial fibrillation with a rapid and irregular ventricular rate (oscillometric measurement becomes unreliable), lymphoedema or a dialysis…

…induction is used when intubation is required [1]. In salicylate poisoning, intubation with an inadequate minute ventilation can rapidly worsen the acidaemia and increase the…

…Sjögren syndrome, gout and antiphospholipid syndrome (APS). Collectively, these disorders are associated with excess cardiovascular disease (CVD), although the cardiovascular phenotype varies substantially between diseases…

…including NSAIDs; and repeated or high volume contrast exposure. Patients with multiple myeloma and renal disease are particularly susceptible. The risk is also greater when…

…the protocol and scanner; CAC scanning is associated with a particularly low dose, approximately 1–2 mSv, while contemporary combined coronary, pulmonary, and aortic angiography…

…uptake. Expected LDL C reduction Ezetimibe produces a modest LDL C reduction when used alone and a further reduction when added to statin therapy. Treatment…

…when the target remains unmet despite maximally tolerated statin therapy and ezetimibe. For patients with a recurrent atherothrombotic event while receiving maximally tolerated statin therapy…

…24 hour urine collection for electrolytes can be used to quantify sodium and potassium intake, preferably while the patient is receiving a stable diuretic dose…

…is used to denote the occluded coronary artery. In the majority of cases, it is only possible to determine the ischemic/infarct area (and thus…

…This is routinely done to measure the velocity of the mitral annulus, which during systole travels towards the apex, and then recoils to its starting…

…total time taken to depolarize and repolarize the ventricles ( Figure 1 ). The length of the QT interval correlates strongly with the risk of potentially life…

…as large artery atherosclerosis and small vessel disease may also contribute to stroke in patients with AF. Stroke risk is heterogeneous and is determined principally…

…loading dose followed by maintenance treatment. The source material does not specify the loading dose. Efficacy and harms In secondary prevention trials involving patients with…

…manually. Naloxone 0.4 mg/mL out and checked before the first intravenous dose is given. Oxygen with a mask and a bag available. The…

…Calcium iv High dose insulin with glucose IV Carbamates Atropine Pralidoxime chloride Cyanide hydroxocobalamin Cyanide antidote kit (includes amyl nitrate, sodium nitrite, and sodium thiosulfate…

… doubling the dose produces an additional reduction of approximately 6%. Clinical indications and treatment goals Established atherosclerotic cardiovascular disease Patients with established ASCVD are at…

…fluid. The aspiration is technically simple — what determines the outcome is that it is done early and sterilely and that the samples are sent correctly…

…with the drug treatment Resuscitation, investigation and drug treatment must proceed simultaneously. Do not wait for laboratory results, CT or EEG before the first dose…

…A2 promotes vasoconstriction and platelet aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that…

…is done. With echocardiography, good conditions are obtained for visualizing the pericardium, its surroundings, the myocardium and valves. ECG is recorded in all patients with…