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

…Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial loading dose: 300–500 mg as soon…

…Heart failure with NYHA class III–IV. Prolonged QT at baseline (uncorrected 440 ms), or severe bradycardia, sinus node dysfunction or second degree and third…

…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…

…SGB) or cardiac surgical sympathetic denervation can be performed to mechanically reduce sympathetic output [4]. Evaluation of Treatment and Alternatives for Drug Failure The provided…

…12 or 16 mg. Renal failure or renal replacement therapy No dosage adjustment is required in renal failure or renal replacement therapy. Pediatric patients Body…

…BSA is utilized in various medical applications: Calculation of drug dosages, particularly in chemotherapy Determination of fluid administration Assessment of various hemodynamic and echocardiographic parameters…

…dominant presenting symptom in acute decompensated heart failure and occurs in more than 90% of patients presenting with the syndrome. Its severity and temporal pattern…

…angiography in patients with unknown etiology for acute severe heart failure. A recent echocardiographic examination should be available or performed urgently to evaluate ventricular and…

Cardiology Definition and classification Heart failure (HF) is a clinical syndrome in which the heart cannot deliver blood at a rate appropriate to tissue requirements…

…HFrEF. Advanced or refractory heart failure should be considered when there is recurrent clinical deterioration despite careful follow up and appropriate therapy. In this setting…

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

…use drugs only in severe agitation or marked distress. Delirium is an acute neuropsychiatric syndrome and a clinical diagnosis, often described as acute brain failure…

…valvular disease or congenital heart disease. Cardiomyopathy leads to impaired cardiac function and heart failure. There are six main types of cardiomyopathy: Hypertrophic cardiomyopathy (HCM…

…failure progressed rapidly during the 1970s and 1980s. Beta blockers, ACE (angiotensin converting enzyme) inhibitors, and angiotensin receptor blockers (ARB) were introduced and improved survival…

…failure progressed rapidly during the 1970s and 1980s. Beta blockers, ACE (angiotensin converting enzyme) inhibitors, and angiotensin receptor blockers (ARB) were introduced and improved survival…

…in decompensated heart failure (DHF). In the critically ill patient, AF may be pre existing, newly detected for the first time, or newly developed during…

…Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome characterized by the cardinal symptoms and signs of heart failure (HF) in the…

…prevalent in women than men after approximately 65 years of age. Hypertension related left ventricular hypertrophy, concentric remodelling, reduced longitudinal strain and heart failure with…

Myocardial ischemia and infarction Definition and Clinical Significance In stent restenosis (ISR) is recurrent narrowing within a previously implanted coronary stent. It represents a form…

…offering profound benefits in major adverse cardiovascular events (MACE), heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD), and peripheral artery disease (PAD…

…indicated in the following scenarios: Inability to exercise due to physical limitations. Contraindications to exercise, such as unstable angina, severe aortic stenosis, decompensated heart failure…

…IV, repeated to a maximum of 15 mg 0.1 mg/kg slowly Avoid in decompensated heart failure Digoxin 0.25–0.5 mg IV…

…pain Practical points during titration: Give the injection slowly over at least a minute; a rapid injection causes nausea and a fall in blood pressure…

…Isolated sinus bradycardia in the early hours following infarction may be associated with hemodynamic compromise. More broadly, bradyarrhythmic arrest and asystole represent severe manifestations of…

…Heart failure with preserved ejection fraction becomes particularly common among the very old. Hypertension, diabetes, atrial fibrillation, and age related changes in left ventricular filling…

…one in five strokes. Thrombus formation is most commonly related to the left atrial appendage, although competing mechanisms such as large artery atherosclerosis and small…

…low flow velocities during the loss of organized atrial systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF…

…LVEF normalization. Epidemiology and risk factors The global burden of heart failure is staggering, affecting an estimated 64 million individuals worldwide. In developed nations, the…

… in the absence of cardiac dysfunction, these conditions do not fulfil the definition of heart failure. They may, however, coexist with heart failure and aggravate…

…comparable to BNP and NT proBNP in heart failure (HF). The biologically active natriuretic peptides promote vasodilation, renal sodium and water excretion, and reduction of…

…failure and ischaemic heart disease. Ageing is associated with progressive increases in systolic blood pressure (SBP), while diastolic blood pressure (DBP) rises less steeply and…

…persistent failure to reach goal. For statin intolerant patients, ezetimibe may be used initially. If LDL C remains above target, bempedoic acid is recommended in…

…a lubricant that prevents friction during ventricular contraction and relaxation. Pericardial effusion is the presence of an abnormal amount of fluid in the pericardial space…

…10. Call anaesthetics and intensive care early with life threatening features or an inadequate response. First line treatment is oxygen in hypoxaemia, repeated doses of…

…an initial medical strategy. In haemodynamically unstable patients, evaluation must also consider acute severe mitral regurgitation, mechanical complications, and ischaemia related ventricular failure as potential…

…ECG, and normal initial troponin may be observed in a chest pain unit or another non intensive care setting while serial testing is completed. Diagnostic…

…the troponin level and the longer the duration of elevated troponin levels. Differences in absolute concentrations of troponin I and T during acute myocardial infarction…

…failure, structural heart disease, fibrosis of the conduction system and acute myocardial infarction (particularly anterior STEMI). Hence, an acute myocardial infarction may actually result in…

…heart failure or cardiogenic shock. In chronic coronary disease, the principal symptomatic indication for revascularization is angina that remains refractory despite medical therapy when significant…

…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…

Cardiology Critical care Pharmacology & dosing Definition and Pathophysiology In the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to…

…peritonism and instead presents as encephalopathy, renal failure or simply deterioration. The procedure itself is straightforward: ultrasound to find the fluid, an insertion site in…

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

…picture Moderate 6.0 to 6.4 mmol/L ECG and cardiac monitoring. Emergency treatment is often warranted, particularly in an acute rise, renal failure…

…Dizziness. Caution Should be used cautiously in patients with myocardial ischemia and/or heart failure. Nicardipine doses and administration in hypertension (hypertensive crisis/emergency). ACE…

…catheter interventions, and medical therapies. Adults with congenital heart disease are mostly managed in GUCH clinics (Grown Up Congenital Heart disease). Prevalence of congenital heart…

…Dizziness. Caution Should be used cautiously in patients with myocardial ischemia and/or heart failure. Nicardipine doses and administration in hypertension (hypertensive crisis/emergency). ACE…

…and efficacy of an approach based on starting and titrating oral medical therapy for heart failure within 2 days before anticipated hospital discharge and in…

…for medical reasons: the cuff is in the wrong place, the electrodes come off, the patient has not kept a diary. The set up and…

…AV block is defined by the intermittent failure of atrial impulses to conduct to the ventricles, resulting in some P waves not being followed by…

…plasma renin levels, and potentially aldosterone levels. Clinical Presentation and Symptoms In the management of heart failure, digoxin improves hemodynamics without increasing heart rate or…

…is the commonest cause of vertigo in primary care and one of the few diagnoses that can be cured on the spot, in three minutes…

… note it in the report. Shaving and careful skin preparation at the electrode sites — movement artefact ruins an exercise test more often than anything else…

…drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The…

…marrow failure and certain targeted cancer treatments. Fever is not obligatory Hypothermia, new confusion, tachypnoea, hypotension, rigors, abdominal pain or a rapid deterioration in general…

…TIA, systemic thromboembolism) in the next 12 months and the calculations apply to untreated patients with non valvular atrial fibrillation ( Table 1 ). CHADS VASc Score…

…a risk factor for heart failure and arrhythmias. Family History of Sudden Cardiac Death (FHSCD) : A history of SCD in close relatives suggests a genetic…

…not be given to pregnant women. • Should not be given to patients with Leber optic atrophy. Nitroprusside doses and administration in hypertension (hypertensive crisis/emergency).