…coronary syndrome. The available evidence supports consideration of low dose colchicine as an adjunct to, rather than a replacement for, established secondary prevention treatment. Its…

…or severity; angina that awakens the patient from sleep. Patients receiving modified antiplatelet therapy require clinical surveillance for both recurrent ischemia and bleeding. The source…

…statin therapy remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease, and other…

…more common in women than in men and can last for years. ACE Inhibitor Induced Angioedema Angioedema secondary to ACE inhibitor therapy occurs in approximately…

…skeletal muscle, a pharmacological feature that may limit muscle related toxicity despite bempedoic acid acting within the same broad cholesterol synthesis pathway as statins. The…

…should not be used. Specific dosing adjustments are required in certain patient populations: Pediatric patients: For patients weighing less than 50 kg, the dosing should…

…persistence with prescribed therapy; Inadequate dosing; An inappropriate diuretic for kidney function; Excess dietary sodium and volume overload; Concomitant drugs or conditions that increase blood…

…or atheroembolic material, but pharmacological and mechanical strategies directed specifically at reperfusion injury have not generally demonstrated sufficient clinical benefit for routine use. No reflow…

…triglyceride rich lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk categories Primary prevention For adults aged 40–75 years without diabetes…

…and thus the selection between them may be guided by individual patient needs rather than by a distinct advantage of one drug over the other…

…anti inflammatory drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs Selective serotonin reuptake inhibitors Patient selection Aspirin should not be prescribed routinely to individuals without…

…first line pharmacological therapy for patients at increased ASCVD risk. Ezetimibe is appropriate when the LDL C goal is not achieved with statin therapy or…

…patients have frequent symptomatic episodes, whereas others have brief or asymptomatic episodes that are not detected during routine clinical assessment. The clinical burden of AF…

…is considered sufficiently high to support BP lowering treatment, whether through lifestyle intervention, pharmacological therapy, or both. A person may also be considered at increased…

…since it may affect the choice of device therapy and also suggest whether other interventions (e.g. heart failure management, evaluation for coronary artery disease…

…such that the vein can be fully compressed in the supine position in a cardiac arrest. For women beyond the 20 th week of pregnancy…

…adequate volume control. It is also utilized for ventricular rate control in atrial fibrillation, particularly when other therapeutic options cannot be pursued. Patients receiving digoxin…

…progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and aggregation…

…reactions (radiation therapy), frequently involves the conduction system. In these conditions, involvement of the AVN and the conduction system occurs more often than sinus node…

…relief by lowering heart rate and limiting adrenergic stimulation. When prescribed for antianginal purposes in CCS, the target resting heart rate is generally 55–60…

…rather than deferred until outpatient follow up. High intensity statin treatment is recommended for all patients with ACS to reduce major adverse cardiovascular events. Therapy…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiology Dual antiplatelet therapy (DAPT) is the combined use of aspirin and an oral P2Y12 receptor inhibitor…

…Adults with blood pressure ≥140/90 mmHg should receive both lifestyle and antihypertensive drug therapy. For grade 1 hypertension, pharmacological treatment has demonstrated cardiovascular benefit…

…Association (NYHA) classification. The source material specifically frames many pharmacological recommendations for patients with symptomatic NYHA class II–IV HFrEF. Advanced or refractory heart failure…

…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…

…therapy is preferred when feasible because it may provide greater benefit than either drug alone. Long term efficacy data remain limited, and the possibility that…

Cardiology Pharmacology & dosing Definition and Pathophysiology Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a hepatic protein that regulates the availability of the low density…

…immune activity. Statin intolerance refers to adverse effects attributed to statin treatment that improve or resolve after reducing the dose or stopping therapy. It is…

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

…altered mental status rather than prominent breathlessness. Hemodynamic phenotypes Initial assessment should distinguish congestion from hypoperfusion. This distinction provides a practical framework for selecting treatment:…

…length. Clinical Presentation and Symptoms The source material does not cover the baseline clinical presentation and symptoms of the arrhythmias for which sotalol is prescribed…

Arrhythmias and arrhythmology Pharmacology & dosing Pharmacokinetic Considerations Relevant to Dosing Amiodarone exhibits highly variable and complex pharmacokinetics that profoundly influence its dosing strategies. The drug…

…specific context of perioperative care in patients with pulmonary arterial hypertension (PAH), progression of right heart failure may indicate the need for inodilator therapy. Furthermore…

…rather than treatments directed at a particular symptom complex. The source material does not describe a characteristic symptom profile at initiation or during routine therapy…

…uncertain, cardiogenic shock is present, or symptoms have been present for more than 2–3 hours. Patients with a working diagnosis of STEMI should, whenever…

…adherence to prescribed treatment. Rehabilitation programmes that incorporate psychosocial care and, where appropriate, primary care personnel and home visits may reduce rehospitalization for recurrent ischaemia…

…trials, the field has transitioned from a predominantly pharmacological strategy to one that heavily integrates early catheter ablation and sophisticated device therapy [1] [2] . This…

…by step algorithms for alternative therapies when initial pharmacological approaches fail to suppress the arrhythmia. However, the context indicates that if pharmacological therapy is inadequate…

…receiving medications that increase bleeding risk, including oral anticoagulants, clopidogrel, NSAIDs, or fibrinolytics. For patients with active bleeding requiring reversal of prasugrel's pharmacological effect…

…with chylomicronaemia, has a well established observational association with acute pancreatitis. No clinical trial has definitively established that pharmacological triglyceride reduction prevents pancreatitis; nevertheless, treatment…

Cardiology Indications for pharmacologic agents Pharmacologic stress tests are indicated in the following scenarios: Inability to exercise due to physical limitations. Contraindications to exercise, such…

…where defects appear worse at rest than during stress, potentially indicating microvascular dysfunction or other pathologies. The software allows for detailed regional analysis of myocardial…

…or high degree AV block. Caffeine and other methylxanthines, which antagonize adenosine receptors, should be avoided for at least 12 hours before testing. Dobutamine : Contraindicated…

…resting full cycle ratio [RFR], and related resting indices) simplified the procedure by removing the need for pharmacologic hyperemia, and angiography derived indices (quantitative flow…

…collectively modulate coronary vascular resistance to ensure that myocardial oxygen supply matches demand (Duncker et al). Reference values for coronary blood flow Normal coronary blood…

Arrhythmias and arrhythmology Emergency medicine Pharmacology & dosing Definition and Pathophysiology Bradycardia encompasses a spectrum of rhythm disturbances characterized by an inappropriately slow heart rate. Within…

…worse than baseline. Contact relatives, home care services, the residential care home or the previous care provider. 5. Confirm delirium with a structured instrument , for…

…It is defined during maximal pharmacological coronary vasodilation as the ratio of mean pressure distal to the stenosis to mean aortic pressure: FFR = Pd…

…hypertrophy, LV dysfunction, or other pathology that could affect the safety or interpretation of the examination. Evaluation and Physical Examination Before stress echocardiography, clinical assessment…

…and should be managed urgently. The risk of cardiogenic shock and cardiac arrest is high and pharmacological interventions are frequently futile. It is often necessary…

…valve, CHA₂DS₂ VA 0–1 Cardioversion (electrical or pharmacological) can be performed directly. An anticoagulant is then given according to CHA₂DS₂ VA 24–48 hours…

…Mixed ar less cardiac failure severe Apretude CABOTEGRAVIR CABOTEGRAVIR SODIUM NA CLINICAL PHARMACOLOGY no QT interval is not prolonged Fulvestrant FULVESTRANT Fulvestrant NA no no…

…on stress and rest images may represent scar, although interpretation must account for attenuation and other technical factors. Relative perfusion assessment has an important limitation…

…other genes (e.g., CACNA1C , GPD1L , TRPM4 ). However, rigorous reappraisals using the ClinGen framework have demonstrated that only SCN5A possesses definitive disease gene validity for…

…can only be established after all other causes have been ruled out. Inappropriate sinus tachycardia is presumably more common than previously thought and the condition…

…setting that allows frequent blood pressure measurement and continuous monitoring. An arterial line is often appropriate when very rapid or precise control is required, for…

…for stopping must be documented when the drug is started. Sources WHO guidelines on the pharmacological management of pain. The summary of product characteristics for…

…patients undergoing pharmacological treatment for AF with class IC drugs or amiodarone. In these instances, the flutter rate may be reduced to less than 200…

…Studies have shown that if the myocardium obtains 30% of its resting perfusion from collaterals, it may survive for 60 minutes in the case of…