Nitrates
Optimize therapy for angina
As a hospital pharmacist, you will get questions about how to optimize therapy for angina when the maximum tolerated dose of a beta-blocker isn't enough. Follow these steps... Use a calcium channel blocker (CCB) . SWITCH from a beta-blocker to verapamil ( Isopten , initial 80 mg TID to QID; max 480 mg/day, divided) or diltiazem ( Altiazem , initial 120 to 18…
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Nicorandil
Nicorandil can cause serious skin ulceration
INTRODUCTION ㅡ Angina is a pain that comes from the heart. It is usually caused by narrowing of one or more of the arteries that supply blood to your heart. This narrowing reduces the blood supply to parts of heart muscle. When heart needs more blood and oxygen than it can get through the narrowed arteries (for example, when patient walk fast or climb stairs, he fee…
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Nicorandil
Nicorandil, serious side effects (ulceration)
This article was written by: Islam M. Eid, BS Pharm, PGDipClinPharm. Senior Out-patient Pharmacist, Pharmacy Practice Department, Tanta Universal Teaching Hospital, Tanta University. Introduction ㅡ Angina is a pain that comes from the heart. It is usually caused by narrowing of one or more of the arteries that s…
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Statins
Pharmacology of HMG-CoA inhibitors (Statins)
Therapeutic actions ㅡ HMG-CoA inhibitors are antihyperlipidemic. They are a fungal metabolite that inhibits the enzyme that catalyzes the first step in the cholesterol synthesis pathway in humans, resulting in a decrease in serum cholesterol and serum LDLs (associated with increased risk of CAD); either an increase or no change in serum HDLs (associated with decreas…
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Myocardial Infarction
Management of stable coronary artery disease (Stable Angina)
Assessment (stable chest pain) ― Stable angina should be suspected on the basis of the clinical assessment, and the typicality of chest pain. Classify the symptoms according to their typicality. People with... Typical angina presents with all three of the following features: precipitated by physical exertion, constricting discomfort in the front of the chest,…
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Myocardial Infarction
Use "ABCDs" to optimize medications for stable coronary artery disease
Recent evidence suggests coronary stents don't improve chest pain more than optimal medications in patients with stable coronary artery disease. Remember these "ABCDs: A- antiplarelet; B- blood pressure; C- cholesterol; D- diabetes; S- symptom relief" to help manage patients with angina or who've had a heart attack more than a year ago... Anti…
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