Myocardial Infarction
Aspirin for PRIMARY prevention is different story
As a cardiovascular pharmacist, you will be asked whether "an aspirin a day" is still good for the heart, based on new U.S. Preventive Services Task Force recommendations. Help patients sort out the facts. This is a case of guidance catching up with the evidence... Recommend aspirin 81 mg/day for SECONDARY prevention , such as…
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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, 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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Myocardial Infarction
Angiotensin II receptor blockers (ARBs)
Therapeutic actions ㅡ ARBs selectively block the binding of angiotensin II to specific tissue receptors found in the vascular smooth muscle and adrenal gland. This action blocks the vasoconstriction effect of the renin-angiotensin system as well as the release of aldosterone leading to decreased BP; may block vessel remodeling that occurs in hypertension and contribu…
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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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