Pts W/ DM and HF
Angiotensin-converting enzyme (ACE) inhibitors
Therapeutic actions ㅡ ACE inhibitors block ACE in the lungs from converting angiotensin 1, activated when renin is released from the kidneys, to angiotensin 2, a powerful vasoconstrictor. Blocking this conversion leads to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synth…
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Stroke
Guide safe use of antiarrhythmics for atrial fibrillation
As a clinical pharmacist, you will see antiarrhythmics used more often for “rhythm control” in some patients with atrial fibrillation. Older data found that reducing frequency and duration of atrial fibrillation with antiarrhythmics doesn’t reduce mortality versus rate control with beta-blockers, CCBs, and may increase hospitalizations. …
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Hypertension Medications
How to choose CCB for your patient
As a clinical pharmacist, there’s often confusion about how to choose a calcium channel blocker (CCB) due to the laundry list of products and uses. Think of dihydropyridine CCBs (amlodipine, nifedipine, etc) as more potent vasodilators, but they can bump up heart rate. NONdihydropyridines (diltiazem, verapamil) slow heart rate. Preferred choice…
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Side Effects
Using of potassium binders when ACEIs or ARBs cause hyperkalemia
New Rx Lokelma will pique interest in the role of potassium binders to treat CHRONIC high potassium due to ACEIs or ARBs. Think of Lokelma (sodium zirconium cyclosilicate) as most similar to sodium polystyrene sulfonate ( Kayexalate , etc) for hyperkalemia. Both exchange sodium to bind potassium. Lokelma also exchanges hydrogen. But Lokelma may cause fewer GI side e…
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Stroke
Optimize anticoagulants to reduce stroke risk in atrial fibrillation patients
There will be buzz about optimizing anticoagulant use in atrial fibrillation patients based on the latest American Heart Association and Chest guidelines. Use these strategies to balance risks and benefits. Identify stroke risk factors in atrial fibrillation using the "CHA 2 DS 2 -VASc" score... Calculate CHA 2 DS 2 -VASc" score from MD+Calc (CH…
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