…the initial dose should be reduced. Dosage and Dose Escalation To terminate tachycardia, adenosine is rapidly injected intravenously at initial doses of 6 to 12…

…Maximum infusion rate 25 mg/hour. Adverse effects Tachycardia. Flushing. Headache. Angina pectoris. Caution Heart failure. Angina pectoris (ischemic heart disease). Hydralazine doses and administration…

…and a longer interval for all opioids Obesity Dose according to effect, not according to total body weight Concomitant benzodiazepine A markedly increased risk of…

…in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells with insulin and glucose. Add high dose salbutamol in marked…

…level exceeding 4 mmol/l, commence an intravenous fluid resuscitation using a crystalloid solution at a dose of 30 ml/kg. Should fluid resuscitation fail…

…Overview of vasopressors and inotropes Vasoconstriction Vasodilatation Positive inotropy Phenylephrine Vasopressin Midodrine Noradrenaline Adrenaline, high dose Dopamine, high dose Adrenaline, low dose Dopamine, intermediate dose…

…is the first line treatment in high risk embolism, unless there is an absolute contraindication. The agent and dose are according to the local protocol…

…the recommended dose for extended treatment for patients who had a heart attack at least a year ago and are at high risk of a…

…Methotrexate: NSAIDs inhibit tubular secretion of methotrexate, increasing plasma levels and risk of toxicity. Avoid combination with high dose methotrexate. Digoxin and lithium: Acetylsalicylic acid…

…Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual for inotropes and vasopressors Drug Indications Dose α1 effect β1 effect β2 effect…

…Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual for inotropes and vasopressors Drug Indications Dose α1 effect β1 effect β2 effect…

…fell asleep and got up. Holter ECG and longer rhythm monitoring Indications Palpitations, presyncope or syncope of suspected arrhythmic origin. Assessment of rate control in…

…and does the patient need an anticoagulant? The unstable patient Immediate electrical cardioversion, without delay, in any of the following: A systolic blood pressure <…

…often done wrongly. The two commonest errors are that an intramuscular injection in fact ends up subcutaneously in a patient with a high BMI, and…

…a MAP of at least 65 mmHg and at the same time has a lactate above 2 mmol/L. This combination carries a high mortality…

…a marked risk of aspiration, or failure that is not rapidly reversed by an antidote B Respiratory rate, saturation, chest movement and a blood gas…

…effects of contrast exposure and other ischaemic or nephrotoxic stresses. The kidney is particularly vulnerable to toxic injury because of its high blood flow and…

…inconclusive. The principal diagnostic strength of CCTA is its ability to exclude significant anatomical CAD with high sensitivity and a high negative predictive value, particularly…

…drugs predisposing to bleeding and alcohol use. A high bleeding risk score should prompt correction of modifiable risk factors and closer surveillance; it does not…

…arches and the lowest complication rate. The femoral artery is the second choice and is often the best in marked shock or during high dose…

…95% of healthy individuals, whereas sensitive, but not high sensitivity, assays detect troponin in approximately 20–50%. Their greater analytical sensitivity improves diagnostic accuracy and…

…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…

…repeated cycles of gradually increasing PR interval until an atrial impulse (P wave) is blocked in the atrioventricular node and the QRS complex does not…

…underestimate the ketosis early on and remain positive after the clinically relevant ketosis has resolved. Capillary measurement of beta hydroxybutyrate has high diagnostic accuracy [2…

…myocardial oxygen demand through increases in heart rate, myocardial contractility and blood pressure. When coronary blood flow cannot increase adequately because of flow limiting disease…

…and salvage the rhythm. Adam Stokes attack Syncope due to sinus arrest is referred to as Adam Stokes attack . Causes of sinoatrial arrest/pause High…

…thiocyanate) and terminate infusion of nitroprusside if cyanide toxicity is suspected. Adverse effects • Nausea. Vomiting. Agitation. Muscle spasm. Sweating. Flushing. • Prolonged high dose use may…

…the lowest heart rate allowed, which triggers the pacemaker), the behavior of the pacemaker at low and high heart rate, the behavior of the pacemaker…

…is done using high frequency waves. The frequency of the ultrasound wave must generally be reduced in order to visualize objects located far away from…

…this that does the work of ventilation — raising IPAP and EPAP by the same amount does not increase ventilation at all . The backup rate is…

…abnormalities of renal structure or function that persist for more than 3 months and have health implications. Diagnostic criteria include an estimated glomerular filtration rate…

…evaluation of patients receiving digoxin reveals specific electrophysiologic profiles. Digoxin's autonomic actions largely slow the sinus node discharge rate, shorten atrial refractoriness, and prolong…

…A prothrombotic state Albuminuria and declining estimated glomerular filtration rate Development of type 2 diabetes mellitus Atherosclerotic cardiovascular events HF and atrial fibrillation Obesity therefore…

…seconds. Case reports have indicated that the risk of high degree AV block and ventricular arrhythmias is greater in patients on digoxin or verapamil, although…

…Regardless of etiology and ECG, ventricular tachycardia is always a potentially life threatening arrhythmia that requires immediate attention. The ventricular rate is typically very high…

…syndrome The period immediately following ACS is associated with particularly high risk of recurrent cardiovascular events. Intensive LDL C lowering should therefore begin early rathe

…at particularly high risk of developing life threatening arrhythmias. Antiarrhythmic drugs Disopyramide Indications Prophylaxis and treatment of symptomatic ventricular tachyarrhythmias. Prophylaxis and treatment of atrial…

…Basic knowledge of arrhythmias and cardiac automaticity will facilitate understanding of this article. As discussed in Chapter 1 the atrioventricular node does not exhibit automaticity…

…conduction. Clinical Presentation and Symptoms Patients with atrial flutter typically present with symptoms related to high ventricular rates and the loss of the atrial kick…

…high CAC score indicates substantial atherosclerotic burden but does not, by itself, establish the presence or haemodynamic significance of a specific stenosis. Clinical Role and…

…airway by tilting the head backward and lifting the chin up. Does the person breathe? Look for respiratory signs for 10 seconds. Palpation of pulses :…

…material does not specify symptom patterns in detail. Physical manifestations Tendinous xanthomas, particularly over extensor tendons, are characteristic clinical manifestations of untreated FH and may…

…a high capacity, low affinity transporter situated in the S1 and S2 segments of the renal proximal tubule. It accounts for approximately 90% of renal…

…construct images with high spatial and temporal resolution. PET offers higher spatiotemporal quality, as compared with SPECT. Quantification of blood flow using PET Quantitative PET…

…avoids ionizing radiation and contrast agents, and accurately identifies abdominal aortic enlargement. Screening reduces aneurysm related mortality in populations with a high prevalence of AAA…

…Evaluation of Treatment and Alternatives for Drug Failure The provided context does not contain specific information regarding the formal criteria for evaluating the success of…

…consequence of this triad is severe: cardioembolic strokes associated with AF are typically larger, present with more severe neurological deficits, and carry higher rates of…

…and more marked HPA suppression. Inhaled and topical steroids in high doses can also cause systemic suppression. Corticosteroids mask fever and peritonitis. The abdomen of…

…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…

…Class I recommendation). • On highest tolerated dose statin and ezetimibe: • If LDL C < 1.4 mmol/L (55 mg/dL): No change. • If LDL…

…atrial fibrillation Drug Standard dose Reduced dose and criterion : : : Apixaban 5 mg twice daily 2.5 mg twice daily if at least two of: age …

…occurs after an abrupt reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood alcohol concentration…

…A high risk of hypoglycaemia in a patient who is eating poorly. Consider stopping it GLP 1 receptor agonist It can cause nausea and delayed…

…level of consciousness, and repeated assessment of the circulation and breathing 2 Assess whether the patient has sepsis, septic shock, or a need for high…

…and high dose corticosteroids. The time limit and the choice of closure strategy The classical limit of 6–8 hours for primary closure rests on…

…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…

…provided proof of concept but was not developed for routine coronary prevention because of fatal infections and high cost. Low dose methotrexate did not reduce…

…concentrations and formulations differ between units, and most serious dosing errors arise at the dilution step, not in the choice of dose. Paediatric doses are…

…effect of enalaprilat depends on plasma volume and plasma renin activity. Volume depletion and high plasma renin activity increase the effect of enalaprilat, and may…

…synthesis and may affect epigenetic regulation through changes in DNA acetylation. Lipid lowering efficacy Bempedoic acid is available as a single daily dose of 180…