…a stable pulmonary embolism is a diagnostic pathway. The unstable patient Hypotension (systolic < 90 mmHg for 15 minutes, or a need for a vasopressor)…

…SIRS), disseminated intravascular coagulation (DIC), and hypoperfusion manifesting as hypotension. The high mortality associated with sepsis underscores the critical importance of timely and appropriate interventions…

…increased work of breathing, exhaustion and, in the most severe cases, hypotension, pneumothorax and respiratory arrest [1]. The first few minutes 1. Sit the patient…

…abnormal 24 hour rhythm should prompt investigation for sleep apnoea, renal disease and secondary hypertension, and lead to one dose being moved to the evening…

…swelling of the tongue or throat dyspnoea, hypoxia, bronchospasm or severe cough hypotension, collapse, impaired consciousness or new onset marked weakness rapidly progressive symptoms from…

…contraindicated, for example in asthma Contraindicated in impaired left ventricular function and together with an intravenous beta blocker Digoxin In heart failure or hypotension, or…

…and ACTH first only if this does not delay treatment. Plus fluid and glucose Adrenal crisis: hypotension that does not respond to fluid, abdominal pain…

…at all is then delivered while the patient deteriorates. Indications Emergency, irrespective of duration and anticoagulation status: Tachyarrhythmia with haemodynamic compromise: hypotension, shock, pulmonary oedema…

…not normally be lowered rapidly with intravenous drugs. Such treatment has not been shown to improve the prognosis and can cause hypotension, acute kidney injury…

…diagnostic, not therapeutic. An unstable patient should be cardioverted, not investigated. Contraindications Haemodynamic instability — hypotension, shock, impaired consciousness or pulmonary oedema. Treat the arrhythmia first…

…in suspected purulent pericarditis, tuberculosis or malignancy. Tamponade is a clinical diagnosis supported by echocardiography: Finding Comment : : Hypotension, distended neck veins, muffled heart sounds Beck…

…predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous) pacing in bradycardia with haemodynamic compromise — hypotension, shock…

…with acute heart failure. • Clevidipine can cause reflex tachycardia. • Contraindicated in severe aortic stenosis due to risk of hypotension. Clevidipine doses and administration in hypertension.

…®, Duraclon ®, Kapvay ® Indications • Agitated delirium • Analgesia • Hypertension, hypertensive crisis/emergency Mechanism of action Clonidine is primarily a centrally acting alpha 2 agonist…

…no no AQUASOL A VITAMIN A PALMITATE VITAMIN A PALMITATE NA sp ambiguous hypotension(Pediatric Use) mild BAL DIMERCAPROL Dimercaprol Mixed ar less tachycardia/blood…

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

…Dizziness. Nausea. Atrioventricular blocks (AV blocks). Orthostatic hypotension. Paresthesias (scalp tingling). Bronchospasm. Caution • Avoided in hypertensive emergencies with left ventricular failure (due to negative inotropic…

…Lopressor Hct ®, Toprol ®, Seloken ® Indications Mycoardial ischemia. Perioperative hypertension. Mechanism of action Beta 1 adrenergic blocker. Effects Lowers blood pressure, reduces heart…

…Effective in pulmonary edema. Can produce severe hypotension. Time to onset of action 30 seconds to 1 minute Duration of action 1 to 10 minutes…

…if the patient reverts to sinus rhythm. Th e infusion must be aborted if hypotension or bradycardia occurs. A defibrillator should be immediately available as…

…of systemic arterial pressure. This renoprotective effect involves a reduction in intraglomerular hyperfiltration and hypertension by disproportionately reducing glomerular efferent arteriolar vasoconstriction. Clinical Presentation and…

…depends on the adequacy of cardiac output. Isolated sinus bradycardia that is unaccompanied by hypotension or ventricular ectopy is generally asymptomatic and hemodynamically stable. However…

…Consequently, isolated systolic hypertension and widening pulse pressure are common in later life. These changes contribute to the complexity of defining an appropriate treatment target…

…by manifestations of severe right ventricular failure. Typical findings include: Jugular venous distension Kussmaul’s sign Hepatomegaly Hypotension, which may or may not be present…

…severe anaemia, and hypotension or shock. Conversely, mechanisms that increase myocardial oxygen demand include sustained tachyarrhythmia and severe hypertension, with or without left ventricular hypertrophy…

…and finally a reduction in heart rate. This sequence is characteristic of neurally mediated hypotension. Clinical Presentation and Symptoms Vasovagal syncope is frequently preceded by…

…tongue, and uvula causing airway obstruction Cardiovascular: Hypotension Circulatory collapse culminating in cardiac arrest Anaphylaxis can develop without dermatological or upper airway manifestations. Anaphylactic cardiac…

…Clinically, patients may present with: Absent breath sounds on the affected side Crepitus Subcutaneous emphysema Hypotension Hypoxia Mediastinal shift, with potential tracheal deviation to the…

…Heat stroke ( 40°C) Neurological symptoms, confusion, convulsion, tachycardia, hypotension, coma. As above but with lower temperatures. Electrolyte replacement. Large infusions of fluids are typically needed…

…contraindications: Adenosine, Dipyridamole, Regadenoson : Should be avoided in patients with active bronchospasm, severe hypotension, or high degree AV block. Caffeine and other methylxanthines, which antagonize…

…The drugs can also be given sequentially. Hypotension can be counteracted with simultaneous administration of norepinephrine. All patients with severe acute heart failure who receive…

…failure New drowsiness, confusion or agitation Suspect hypoxaemia or hypercapnia Cyanosis or saturation below target despite oxygen Severe impairment of gas exchange Hypotension, cool peripheries…

…usually lasting seconds, reproducibly triggered by a particular change in position Benign positional vertigo, orthostatic hypotension Dix Hallpike, supine roll test, orthostatic blood pressure Episodic…

…obstructive airways disease — relative; the risk of bronchospasm is real. Hypotension and haemodynamic instability. Respiratory compromise during an ongoing crisis. Distinguish the conditions instead by…

…marked rise in SVR. As for the intermediate dose, together with marked hypertension (caution during non selective beta blockade). Dobutamine Cardiogenic shock. Bradycardia (second line…

…bleeding, or a smaller measured blood loss if there is physiological compromise. Do not wait for hypotension in young, pregnant or previously athletic patients. Beta…

…obligatory Hypothermia, new confusion, tachypnoea, hypotension, rigors, abdominal pain or a rapid deterioration in general condition may be the only signs of infection. Corticosteroids and…

…sets of blood cultures, and a culture from the likely focus 0 to 15 min Ringer's acetate for hypotension or hypoperfusion, usually 500 mL…

…lactate, acidosis, hypertension and tachycardia are common during a generalised seizure. In prolonged status the initial sympathetic response can give way to hypotension, hypoxia, hypoglycaemia…

… 2. Is there cirrhosis, or another strong suspicion of portal hypertension? Variceal and ulcer bleeding are managed differently from the first minute. Peptic ulcer remains…

Info This drug manual is provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is…

…As medium dose, and additionally severe hypertension (caution if patient on nonselective beta blockers). Dobutamine Cardiogenic shock Bradycardia (second line therapy) Stress testing (due to…

…symptoms. Typical acute manifestations include severe pain, hypotension and abdominal tenderness. Leakage or rupture is life threatening and requires emergency operation or endovascular repair. AAA…

…Physical examination should therefore focus on: Blood pressure and evidence of hypotension Heart rate and tachycardia Respiratory rate and oxygenation Evidence of systemic congestion or…

…must be administered cautiously to patients with marginal cardiac compensation, as it may induce hypotension. Loading Dosing Strategies There is no standard dosing schedule applicable…

Cardiology Definition and pathophysiology Blood pressure is a continuous cardiovascular exposure rather than a binary distinction between normotension and hypertension. Its long term relationship with…

…Whether heart failure is present and whether left ventricular systolic function is depressed or preserved Whether hypotension is present Whether an accessory pathway is suspected…

…Presyncope or syncope Exercise intolerance Symptoms of shock in advanced cases The presentation may be abrupt or subacute. Acute haemopericardium may cause sudden hypotension, syncope…

Cardiology Pharmacology & dosing Definition and Therapeutic Rationale Hypertension is a major risk factor for atherosclerotic cardiovascular disease and contributes to microvascular and macrovascular complications. It…

…paraplegia or paraparesis, rapid aortic expansion, refractory pain and hypertension despite treatment. A related entity is non A non B dissection , which involves the arch…

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

…coronary embolism, coronary dissection, hypotension, shock, respiratory failure, severe anaemia, sustained bradyarrhythmia Increased myocardial oxygen demand Sustained tachyarrhythmia, severe hypertension, hypertensive crisis, critical aortic stenosis…

…these patients exhibit hypotension—often with a systolic blood pressure less than 90 mmHg—accompanied by signs of poor vital organ perfusion or frank shock…

…Predisposing features Risk features vary by lesion but include: Older age. Female sex. Hypertension. Absence of an adequate collateral circulation. A first or anterior infarction…

…dissection, hypotension or shock, respiratory failure, severe anaemia, sustained bradyarrhythmia, tachyarrhythmia, or severe hypertension with or without left ventricular hypertrophy. Among patients with NSTE ACS…

…seconds due to the short half life of adenosine. Anxiety Chestpain. Palpitations. Headache Hypotension. Facial flushing. Sweating. Bronchospasm Dyspnea Nausea Metallic taste Tightness in throat…

…ventricular fibrillation (VF). Clinical presentation Confusion Abdominal pain Hypotension Arrhythmias and ECG changes Cardiac arrest Treatment Furosemide 1 mg/kg IV. Hydrocortisone 300 mg IV…

…arrest. Within the context of pregnancy, hypovolemia and other etiologies of hypotension remain the predominant causes of cardiac arrest. Should cardiac arrest occur postpartum, hemorrhage…

…systemic response to reperfusion and ischemia causes a state similar to SIRS (systemic inflammatory response syndrome) with risk of disseminated intravascular coagulation, hypotension, impaired vasoregulation…

…15% of cases). Clinically, patients present with severe chest pain, diaphoresis, hypotension, pulmonary edema, malignant arrhythmias, and rapid progression to cardiogenic shock. Ventricular fibrillation or…