…The differences increase in severe circulatory failure and marked respiratory failure [3,4]. Question Appropriate sample : : Metabolic acidosis or alkalosis in a haemodynamically stable patient…

…Increased urinary albumin/creatinine ratio reflects altered endothelial and renal pathophysiology in insulin resistance. Metabolic Dysfunction Associated Fatty Liver Disease Insulin resistance increases free fatty…

…often used in clinical settings because it is considered a more accurate indicator of metabolic mass than body weight alone. BSA is utilized in various…

…ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements to exceed available blood flow…

…3. Rapid identification of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring at the appropriate level of care , with readiness for respiratory support…

…example during mechanical ventilation or severe metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients in whom non invasive measurement is…

…ketosis and metabolic acidosis despite a normal or only moderately raised glucose, often below 13.9 mmol/L. The condition occurs above all in: treatment…

…Nielsen syndrome Romano Ward syndrome Idiopathic congenital long QT syndrome (LQTS) Metabolic disorders Hypokalemia Hypomagnesemia Hypocalcemia Starvation Anorexia nervosa Liquid protein diets Hypothyroidism Bradyarrhythmia Sinus…

…used. Risk in these circumstances appears to track more closely with apoB. Discordantly high apoB is especially associated with metabolic syndrome and mildly elevated triglycerides…

…glucose metabolism, hypertension, atherogenic dyslipidaemia, endothelial biology and platelet related pathways. The source material also describes possible antiarrhythmic effects, associated with reductions in sudden cardiac…

…approximately 1 in 250–300 people and is the most common inherited metabolic disorder associated with premature cardiovascular disease. Prevalence is higher in populations with…

…myocardial scar, ventricular function, and, in selected circumstances, myocardial viability. Both techniques rely on intravenous radiopharmaceuticals that are taken up by myocardial tissue. The distribution…

Cardiology Endocrinology & metabolism Definition and pathophysiology Primary aldosteronism (PA), also termed primary hyperaldosteronism or Conn syndrome, comprises disorders in which aldosterone secretion is inappropriately increased…

…one fifth of the risk of all cause mortality in the cited international cohort evidence. Metabolic risk factors make a particularly large contribution to cardiovascular…

…metabolism Pharmacology & dosing Definition and pharmacological basis Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of oral agents initially developed for glucose lowering in…

…conventional risk factors, together with diabetes specific vascular and metabolic abnormalities. Diabetes is associated with inflammation, thrombosis and accelerated atherosclerosis. In CKD, additional mechanisms include…

…with the electronics in the pulse generator or dislodgement or fracture of the leads. External causes are less common and include electrolyte disorders, metabolic disorders…

…of aerobic metabolism, is transported from the tissues back to the lungs where it is exhaled. The final partial pressure of carbon dioxide in exhaled…

…In such instances, favorable neurological outcomes are possible even with prolonged periods of no blood flow, due to the reduced metabolic rate that accompanies declining…

…be discussed in this article. Metabolic equivalent (MET): measuring oxygen consumption Estimation of oxygen consumption is central to the assessment of exercise capacity. Metabolic equivalents…

…rhythm is shockable). This is explained by the fact that there are no means of determining what phase the patient is in. The three phases…

…hyperkalaemia and metabolic disturbance, hypothermia, tamponade, toxins, thrombosis (coronary or pulmonary), tension pneumothorax. No drug has been shown to improve the neurological outcome in cardiac…

…refill, cold or mottled skin Metabolism and perfusion A lactate above 2 mmol/L, metabolic acidosis or a rising lactate Kidney A rise in creatinine…

…drowsiness or syncope oliguria a rising lactate or metabolic acidosis repeated fresh haematemesis haematochezia in combination with circulatory compromise a rapidly falling haemoglobin after fluid…

…overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic alkalosis or an arterial pH above 7.55 already before starting. Severe hypernatraemia…

…kidney metabolic syndrome, in which adiposity, insulin resistance, diabetes, hypertension, CKD and CVD reinforce one another. Dysfunctional adipose tissue contributes to inflammatory and metabolic abnormalities…

…the number one killer worldwide since the 1960s. In 1948 the NHLBI initiated the Framingham Heart Study, which demonstrated that high blood pressure and high…

…by exercise duration, workload or metabolic equivalents, is among the strongest predictors of mortality in patients with cardiovascular disease after accounting for age. Chronotropic response…

…in conditions like osteoarthritis and obstructive sleep apnea primarily reflect the extent of weight loss, the reductions in hard cardiovascular outcomes (MI, stroke) and metabolic…

…Obesity Insulin resistance or metabolic syndrome Elevated triglycerides Low or apparently well controlled LDL C with suspected residual atherogenic particle burden In patients with diabetes…

… myocardial bridging; myocardial metabolic abnormalities; and abnormal pain perception in patients without demonstrable ischaemia. The absence of obstructive disease therefore does not establish a benign…

Cardiology Endocrinology & metabolism Definition and pathophysiology Obesity is a chronic, relapsing and biologically complex disease characterized by excessive accumulation of adipose tissue. It is an…

…Failure with improved Ejection Fraction" (HFimpEF) is now applied to patients with a baseline LVEF ≤40% who have experienced a ≥10 point increase in LVEF…

…blood flow despite changes in coronary perfusion pressure, typically within a range of 50 120 mmHg. This process is primarily mediated by local metabolic mechanisms…

Endokrinologi & metabolism Farmakologi & dosering Lathundar Two situations are often confused: replacement therapy in adrenal insufficiency (which must be increased under stress) and pharmacological anti inflammatory…

Endokrinologi & metabolism Akutsjukvård Lathundar Emergency overview Measure the plasma glucose immediately in everyone with a reduced level of consciousness, seizures, confusion, a change in behaviour…

Endokrinologi & metabolism Lathundar An inpatient has a different insulin sensitivity from at home: less food, more stress, often corticosteroids, often impaired renal function. Prescribe basal…

Cardiology Endocrinology & metabolism Definition and pathophysiology Hypertriglyceridaemia (HTG) is defined by an increased concentration of circulating triglycerides. Both fasting and non fasting measurements provide prognostic…

…Endocrinology & metabolism Definition and pathophysiology Secondary hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every patient…

…hypertensive emergency. Acute left ventricular failure. Mechanism of action Enalaprilat is the active metabolite (ester) of enalapril, an angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers…

…They evolved from balloon angioplasty and bare metal stents (BMS) in response to restenosis caused principally by neointimal hyperplasia. Contemporary DES combine a metallic scaffold…

…Halve the dose in older people and in renal failure Morphine PO 5–10 mg as needed The active metabolite accumulates in renal failure Oxycodone…

…mg once daily. Rationale: Patients in this age group have higher bleeding risk and increased exposure to the active metabolite of prasugrel. Patients weighing <…

…hepatic metabolism. Alcohol dehydrogenase converts ethanol to acetaldehyde, which is subsequently converted by aldehyde dehydrogenase to acetate. The remaining fraction is excreted unchanged in urine…

…its metabolite accumulate extensively in various tissues, including the liver, lung, fat, and skin, with myocardial concentrations reaching 10 to 50 times those found in…

…regulates substrates involved in lipid metabolism and inflammatory signalling. ACLY additionally influences fatty acid synthesis and may affect epigenetic regulation through changes in DNA acetylation…

…a rate reducing effect in selected circumstances. Ivabradine undergoes extensive first pass hepatic metabolism through CYP3A4. Dose adjustment is required in severe hepatic or renal…

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…

…syndrome (DI LQTS) [1]. The condition arises in the setting of both modifiable and nonmodifiable risk factors. Modifiable risk factors include electrolyte abnormalities such as…

…leading to unconsciousness. The myocardium responds to hypoxia by downregulating metabolism and thus contractility (a consistent finding in acute coronary syndromes). Between 3 8 minutes…

…to anaerobic metabolism. This is possible because cardiac myocytes store glycogen (a storage form of glucose) which can be used to produce ATP in absence…

…stunning . This is a protective mechanism since the cessation of contractions leads to a marked reduction in cell metabolism and thus prolongs survival. Myocardial stunning…

…a fixed dose is given without assessment, when a modified release preparation is started in an opioid naive patient, or when a conversion between drugs…

…1 and 2 in patients over 75, with a weight below 60 kg, heart failure, hepatic impairment, malnutrition, concurrent amiodarone or known slow CYP2C9 metabolism…

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…

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…

…Palpitations. Headache Hypotension. Facial flushing. Sweating. Bronchospasm Dyspnea Nausea Metallic taste Tightness in throat Lightheadedness, dizziness, tingling in arms, numbness, blurred vision, burning sensation. Relevant…

…resuscitation care Victims of out of hospital cardiac arrest (OHCA) who achieve ROSC in the emergency room (ER) are transferred to the intensive care unit …

…the ischemia/infarction. The location of the thrombus in the artery: a proximally located thrombus will cut off blood flow to more branches, and thus…

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