…reference on inpatient insulin therapy Peptic ulcer A proton pump inhibitor with concomitant NSAID use or a history of ulcer, not routinely Infection Consider Pneumocystis…

…competitive athletics. In the context of Brugada syndrome (BrS), pharmacologic challenge with sodium channel blockers (ajmaline or flecainide) is utilized for diagnostic unmasking; if ventricula

…consideration for patients with low blood pressure secondary to a low cardiac output. Its primary clinical utility in contemporary practice is late line therapy for…

…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…

Cardiology Pharmacology & dosing Definition and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD…

…antianginal drugs have not been shown to improve long term cardiovascular outcomes in CCS. General strategy For most patients, initial therapy consists of a beta…

…sex. P2Y12 inhibitor monotherapy A P2Y12 inhibitor may be used instead of aspirin for long term secondary prevention, particularly when aspirin is contraindicated, not tolerated…

…3 month DAPT, but not 6 month DAPT, was associated with higher rates of myocardial infarction or stent thrombosis in ACS patients. Extension beyond 12…

…also an appropriate first line pharmacological option when a patient is unable to tolerate any statin regimen. The treatment sequence for patients with chronic coronary…

…at a particular symptom complex. The source material does not describe a characteristic symptom profile at initiation or during routine therapy. Potential clinically important complications…

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

…Patients receiving modified antiplatelet therapy require clinical surveillance for both recurrent ischemia and bleeding. The source material does not specify a symptom based surveillance protocol…

…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…

Cardiology Pharmacology & dosing Definition and Pathophysiology Angiotensin converting enzyme (ACE) inhibitors are foundational therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic…

…Symptoms The source material does not provide specific information on the clinical presentation and symptoms of the underlying conditions for which ACE inhibitors are prescribed…

…C target is not achieved. Addition of a PCSK9 inhibitor when the target remains unmet despite maximally tolerated statin therapy and ezetimibe. For patients with…

…This activating enzyme is not expressed in skeletal muscle, a pharmacological feature that may limit muscle related toxicity despite bempedoic acid acting within the same…

…level C. The European regulatory threshold described in the source material differs from the trial based threshold: ivabradine was approved for patients with HFrEF, LVEF…

…not cover the baseline clinical presentation and symptoms of the arrhythmias for which sotalol is prescribed. Evaluation and Physical Examination The source material does not…

Arrhythmias and arrhythmology Pharmacology & dosing Definition and pathophysiology Atrial fibrillation (AF) is a major independent risk factor for thromboembolism, including ischaemic stroke. This risk applies…

…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…

…allowing for sustained hemodynamic effects for days after the infusion is discontinued. Noradrenaline (norepinephrine) acts primarily as a vasopressor. While detailed receptor pharmacology is not…

…provides a practical framework for selecting treatment: Clinical state Principal management approach Congestion without hypoperfusion Intravenous loop diuretic therapy Congestion with hypoperfusion Loop diuretic therapy…

…strategy should be considered for presentation 12–48 hours after symptom onset. Routine PCI of an occluded infarct related artery is not recommended when presentation…

…revert a tachycardia and should not be used. Specific dosing adjustments are required in certain patient populations: Pediatric patients: For patients weighing less than 50…

…consideration should be given to initiating therapy with the patient hospitalized and monitored for at least several days. Intravenous Loading For emergencies requiring rapid loading…

…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…

…of antiplatelet therapy, including prasugrel, in ACS patients treated with PCI can increase the risk of thrombosis, myocardial infarction, or death. Treatment for up to…

…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…

…measurement; White coat hypertension; Poor adherence or persistence with prescribed therapy; Inadequate dosing; An inappropriate diuretic for kidney function; Excess dietary sodium and volume overload…

…Given in case of suspected digoxin intoxication. Table 4. Pharmacological treatment of acute bradycardia. Atropine Evidence: Class IIa recommendation Atropine is the first choice for…

…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…

…therapy is not recommended in individuals with previous virological failure if it risks loss of suppression. Clinical presentation and symptoms The source material does not…

…positioned as standard, and defibrillation energy levels should remain consistent with those used for non pregnant adults. The fetus is not harmed by defibrillation, amiodarone…

…without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is not affected by the concurrent use of beta blockers. The vasodilating effect reduces preload…

…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…

…C concentrations is associated with lower ASCVD risk. Atherogenic particle burden is not completely represented by LDL C alone. Non high density lipoprotein cholesterol (non…

Cardiology Pharmacology & dosing Definition and pathophysiology Statins inhibit 3 hydroxy 3 methylglutaryl coenzyme A reductase, the rate limiting enzyme in cholesterol synthesis. Reduced hepatic cholesterol…

…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…

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…

…further imaging may not be necessary. Rest Imaging : Conducted after a predefined interval to allow for radiotracer clearance or with a different radiotracer to capture…

Cardiology Indications for myocardial perfusion imaging Diagnosis of coronary artery disease (CAD) : Myocardial perfusion imaging can confirm or rule out CAD in patients with symptoms…

…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…

…angina at rest are not suitable candidates for perfusion imaging. Detecting ischemic regions requires provocation using pharmacologic agents or physical exercise. Pharmacologic agents include dipyridamole…

…For recurrent symptomatic bradycardia, temporary or permanent pacing may be required. However, transcutaneous pacing in the setting of cardiac arrest has not demonstrated clear benefit…

…quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work systematically through the possible causes, apply several non pharmacological measures…

…haemodynamic significance is weak, particularly for intermediate lesions. Even lesions with a visual diameter reduction of 50–70% may or may not produce ischaemia. Conversely…

…coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological stress. The physiological basis is an…

…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…

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

…imaging (MPI) with single photon emission computed tomography (SPECT) or positron emission tomography (PET) is a radionuclide based method for assessing regional myocardial blood flow…

…EPS), and the transition from a purely device based management strategy (implantable cardioverter defibrillators) to one that incorporates pharmacological and interventional (substrate ablation) therapies [5] …

…beats per minute. Although sinus tachycardia is the most common tachyarrhythmia, it may not always be straightforward to diagnose on the ECG. Moreover, many clinicians…

…the pharmacology of the drug, comorbidity, and the ability to titrate safely [5]. Availability in Sweden. Several of the drugs in this overview are not…

…unclear cause do not delay the diagnosis and should be given, but document the examination findings before the dose. A plan for stopping must be…

…typical flutter. Furthermore, typical flutter frequently emerges in patients undergoing pharmacological treatment for AF with class IC drugs or amiodarone. In these instances, the flutter…

…The reason why this is highly relevant is that the identification of a protective factor could guide the development of a pharmacological agent that can…