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Cardiovascular

Welcome to the cardiovascular category for physicians and pharmacists. This clinical category has links to a wide range of resources. Search and find cardiology guidelines, cardiovascular disease risk prediction tools, medical journal articles, guidance on prescribing cardiac drugs and more.

Potency of Beta-Adrenergic Blocking Agents

Table showing the beta-1 blockade potency ratios for beta-adrenergic receptor blockers compared to propranolol.

Source: resourceclinical.com
Clinical Resource: Table

 

Pharmacological and Pharmacokinetic Properties of Beta-Adrenergic Blocking Agents

Table showing the pharmacological and pharmacokinetic properties (e.g. half-life, lipid solubility, beta-1 selectivity, route of elimination) of beta-adrenergic blocking agents.

Source: resourceclinical.com
Clinical Resource: Table

 

European Society of Cardiology Clinical Practice Guidelines

Source: escardio.org
Clinical Resource: Guidelines
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Last Checked: 08/06/15 Link Error: Report It

 

American College of Cardiology Practice Guidelines & Quality Standards

Source: cardiosource.org
Clinical Resource: Guidelines and Standards
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Last Checked: 22/04/13 Link Error: Report It

 

American Heart Association Statements and Guidelines

Source: my.americanheart.org
Clinical Resource: Statements and Guidelines
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Last Checked: 22/04/13 Link Error: Report It

 

Canadian Cardiovascular Society Guidelines and Position Statements

Source: ccs.ca
Clinical Resource: Guidelines and Position Statements
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Last Checked: 19/08/15 Link Error: Report It

 

National Institute for Health and Care Excellence (NICE) Guidance > Cardiovascular conditions

Source: nice.org.uk
Clinical Resource: Guidance
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Last Checked: 10/11/17 Link Error: Report It

 

Cardiovascular - CLEAR: clinical enquiry and response service

The CLEAR service is delivered by a team of information professionals based at Healthcare Improvement Scotland and NHS Greater Glasgow and Clyde.

CLEAR aims to provide clinicians with summarised evidence relating to aetiology, diagnosis, prognosis and treatment queries about patient care.

Source: knowledge.scot.nhs.uk
Clinical Resource: Evidence Based Answers to Clinical Questions
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Last Checked: 22/04/13 Link Error: Report It

 

BestBETs
Cardiovascular system

BETs were developed in the Emergency Department of Manchester Royal Infirmary, UK, to provide rapid evidence-based answers to real-life clinical questions, using a systematic approach to reviewing the literature. BETs take into account the shortcomings of much current evidence, allowing physicians to make the best of what there is.

Source: bestbets.org
Clinical Resource: Evidence Based Answers to Clinical Questions
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Last Checked: 22/04/13 Link Error: Report It

 

The Cochrane Collaboration
Cochrane Reviews - Heart & Circulation

The Cochrane Collaboration is an international, non-profit, independent organisation, established to ensure that up-to-date, accurate information about the effects of healthcare interventions is readily available worldwide. It produces and disseminates systematic reviews of healthcare interventions, and promotes the search for evidence in the form of clinical trials and other studies of the effects of interventions.

Source: cochrane.org
Clinical Resource: Systematic Reviews
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Last Checked: 13/07/15 Link Error: Report It

 

Bandolier Knowledge
Cardiac

In these pages are collected the stories from Bandolier relating to heart disease.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

The Merck Manual for Health Care Professionals
Cardiovascular Disorders

Source: merckmanuals.com
Clinical Resource: Manual
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Last Checked: 22/04/13 Link Error: Report It

 

theheart.org

theheart.org provides information on caring for people with disorders of the heart and circulation, and on preventing such disorders.

Source: theheart.org
Clinical Resource: Various
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Last Checked: 22/04/13 Link Error: Report It

 

Cardiology Rounds

The educational objective of this site and the corresponding published version of Cardiology Rounds is to provide interested physicians throughout Canada and around the world with a unique window on some of the most current information and discussion on important scientific and clinical developments in the field of cardiovascular medicine.

Cardiology Rounds is derived from recent Rounds presented at St. Michael's Hospital, and has been designed as an efficient resource for the busy physician. The selection of topics and all editorial content are determined solely by the members of the Division of Cardiology.

Source: cardiologyrounds.ca
Clinical Resource: Publication
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Last Checked: 02/09/15 Link Error: Report It

 

Bandolier Knowledge
Aspirin

This resource centre aims to pull together stuff on aspirin.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

The Use of Aspirin in Primary Prevention of Cardiovascular Disease

Statement from the British Hypertension Society

Source: bhsoc.org
Clinical Resource: Statement
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Last Checked: 22/04/13 Link Error: Report It

 

South London Cardiac and Stroke Networks Guidance on Prescribing Clopidogrel for Cardiac Patients

Clopidogrel indications and durations guidance

Source: slcsn.nhs.uk
Clinical Resource: Guidance
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Last Checked: 22/04/13 Link Error: Report It

 

Clopidogrel and Possible Interaction with Proton Pump Inhibitors

The interaction between clopidogrel and PPIs has been examined recently in systematic reviews and metaanalyses. In general, the studies included in these reviews, investigate the effects of PPIs as a class on the incidence on major adverse cardiac events in patients who are treated with clopidogrel and include patients taking any PPI.

Source: ggcprescribing.org.uk
Clinical Resource: Bulletin
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Last Checked: 22/04/13 Link Error: Report It

 

Digoxin Dosing Calculator

Source: globalrph.com
Clinical Resource: Calculator
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Last Checked: 17/02/14 Link Error: Report It

 

Digoxin Monitoring: Why, When & How

This bulletin summarises digoxin therapy and provides advice on TDM.

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
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Last Checked: 13/05/16 Link Error: Report It

 

Digoxin - Loading Dose Guide (Adults)

The intravenous route should be reserved for use in patients requiring urgent digitalisation for supraventricular arrhythmias

Source: icid.salisbury.nhs.uk
Clinical Resource: Guidance
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Last Checked: 22/02/17 Link Error: Report It

 

Angiotensin-II receptor antagonists: what is the evidence for their place in therapy?

ACE inhibitors and A2RAs are used in a wide range of indications including hypertension, heart failure, treatment post-myocardial infarction (MI), diabetes and chronic kidney disease (CKD). Prescribing can either be with an ACE inhibitor alone, an A2RA alone or, in some limited circumstances, combination therapy with an ACE inhibitor plus an A2RA.

Source: webarchive.org.uk
Clinical Resource: National Prescribing Centre Publication
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Last Checked: 24/04/15 Link Error: Report It

 

Antihypertensive Algorithm for Patients without Diabetes

Equivalency Chart for ACE-Inhibitors
Equivalency Chart for Angiotensin II Blockers
Equivalency Chart for β-Blockers

Source: med.unc.edu
Clinical Resource: Algorithm
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Last Checked: 28/11/16 Link Error: Report It

 

Are All Angiotensin Receptor Blockers Created Equal in the Management of Heart Failure?

This article will briefly review the classification of HF according to current guidelines, the role of ARBs in HF, review the recommended dosing for ARBs, and discuss the major ARB HF Trials.

Source: ufl.edu
Clinical Resource: Publication
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Last Checked: 28/11/16 Link Error: Report It

 

Appendix B Beta-Blockers (BB) > Page 2 - Beta-Blocker Equivalent Doses

Source: gov.bc.ca
Clinical Resource: Table
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Last Checked: 28/11/16 Link Error: Report It

 

How should conversion between doxazosin formulations be carried out in patients with hypertension?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

Doxazosin is a long acting alpha-1 adrenergic blocker which is licensed for the treatment of hypertension. It is available as both immediate and modified release tablets.

Source: sps.nhs.uk
Clinical Resource: Medicines Question and Answer
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Last Checked: 22/09/16 Link Error: Report It

 

Cardiac Enzymes and Markers for Myocardial Infarction

Cardiac biomarkers should be measured in all patients who present with chest discomfort consistent with acute coronary syndrome (ACS). Elevations of cardiac enzyme levels should be interpreted in the context of clinical and ECG findings.

Source: patient.co.uk
Clinical Resource: Article
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Last Checked: 13/03/14 Link Error: Report It

 

Cardiac Markers

Cardiac markers are used in the diagnosis and risk stratification of patients with chest pain and suspected acute coronary syndrome (ACS). The cardiac troponins, in particular, have become the cardiac markers of choice for patients with ACS. Indeed, cardiac troponin is central to the definition of acute myocardial infarction (MI) in the consensus guidelines from the American College of Cardiology (ACC) and the European Society of Cardiology (ESC).

Source: medscape.com
Clinical Resource: Article
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Last Checked: 13/03/14 Link Error: Report It

 

The role of troponin testing in Primary Care

Introduction | Other causes of raised troponin level | Troponin has no role in ‘screening’ for CVD | Laboratory versus point-of-care troponin testing | What are troponins? | References

Source: bpac.org.nz
Clinical Resource: Article
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Last Checked: 13/03/14 Link Error: Report It

 

Electrocardiogram (ECG / EKG) Library

An electrocardiogram (ECG / EKG) is an electrical recording of the heart and is used in the investigation of heart disease. This library is a collection of realistic looking recordings which will help improve your ECG skills. Information about the library and the techniques used to reproduce the recordings is available.

Source: ecglibrary.com
Clinical Resource: Recordings
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Last Checked: 13/03/14 Link Error: Report It

 

ECG Learning Centre

This tutorial is dedicated to the memory of Dr. Alan E. Lindsay, master teacher of electrocardiography, friend, mentor, and colleague. Many of the excellent ECG tracings illustrated in this learning program are from Dr. Lindsay's personal collection of ECG treasures. For many years these ECG's have been used in the training of medical students, nurses, housestaff physicians, cardiology fellows, and practicing physicians in Salt Lake City, Utah as well as at many regional and national medical meetings. It is an honor to be able to provide this tutorial on the World Wide Web in recognition of Dr. Lindsay's great love for teaching and for electrocardiography.

Source: ecg.utah.edu
Clinical Resource: Learning Centre
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Last Checked: 22/04/13 Link Error: Report It

 

ECG Basics, ECG Rhythms and ECG Rules

The electrocardiogram (ECG) is a diagnostic tool that measures and records the electrical activity of the heart in detail. Being able to interpretate these details allows diagnosis of a wide range of heart problems.

Source: ambulancetechnicianstudy.co.uk
Clinical Resource: CE / CPD / Learning
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Last Checked: 13/03/14 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Cardiac Rehabilitation

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 28/09/17 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Risk Estimation and the Prevention of Cardiovascular Disease

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 28/09/17 Link Error: Report It

 

Cardiovascular disease - Background and risk assessment

The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.

Source: webarchive.org.uk
Clinical Resource: e-Learning
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Last Checked: 24/04/15 Link Error: Report It

 

myhealthywaist.org

The website myhealthywaist.org is produced by the International Chair on Cardiometabolic Risk of Université Laval.

The most comprehensive educational website on the relationships between abdominal obesity, type 2 diabetes and cardiovascular disease.

Source: myhealthywaist.org
Clinical Resource: Various
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Last Checked: 22/04/13 Link Error: Report It

 

Framingham Heart Study
Risk Functions

Risk prediction estimates for the risk of various cardiovascular disease outcomes in different time horizons are available as score sheets and direct risk functions. The choice of the appropriate risk prediction algorithm should take into account the following components: cardiovascular outcome, population of interest, time horizon, and risk factors. Outcome specific algorithms preceded by the descriptions of the above four components are available for the following:

  • Atrial Fibrillation (10-year risk) and Calculator
  • Cardiovascular Disease (10-year risk) and Calculator
  • Cardiovascular Disease (30-year risk) and Calculator – HCVD
  • Congestive Heart Failure
  • Hard Coronary Heart Disease (10-year risk) and Calculator
  • Coronary Heart Disease (10-year risk)
  • Recurrent Coronary Heart Disease
  • Coronary Heart Disease (2-year risk) – Second Event
  • Diabetes
  • Hypertension and Calculator
  • Intermittent Claudication
  • Stroke
  • Stroke after Atrial Fibrillation and Calculator
  • Stroke or Death after Atrial Fibrillation and Calculator
Source: framinghamheartstudy.org
Clinical Resource: Algorithms
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Last Checked: 22/11/13 Link Error: Report It

 

UK Prospective Diabetes Study Risk Engine

Risk calculators based on equations from the Framingham Heart Study tend to underestimate risks for people with diabetes as this study included relatively few diabetic subjects. The UKPDS Risk Engine is a type 2 diabetes specific risk calculator based on 53,000 patients years of data from the UK Prospective Diabetes Study, which also provides an approximate 'margin of error' for each estimate.

Source: dtu.ox.ac.uk
Clinical Resource: Calculator
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Last Checked: 22/04/13 Link Error: Report It

 

Primary Prevention of Cardiovascular Disease and Type 2 Diabetes in Patients at Metabolic Risk : An Endocrine Society Clinical Practice Guideline

Source: endocrine.org
Clinical Resource: Guideline
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Last Checked: 07/06/13 Link Error: Report It

 

The University of Edinburgh
Cardiovascular Risk Calculator

Risk scores are for estimating the probability of cardiovascular disease for individuals who have not already developed major atherosclerotic disease. They are an aid to making clinical decisions about how intensively to intervene on lifestyle and whether to use antihypertensive, lipid lowering medication and aspirin.

The calculator can produce risk scores based on the following calculations:

  • Framingham
  • Joint British Societies (JBS) / British National Formulary (BNF)
  • ASSIGN
Source: cvrisk.mvm.ed.ac.uk
Clinical Resource: Calculator
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Last Checked: 22/04/13 Link Error: Report It

 

JBS3 Risk Calculator
Joint British Societies for Prevention of Cardiovascular Disease

The JBS3 risk calculator is a tool to help communicate the risk of CVD and the benefits of interventions, whether they are lifestyle or pharmacological.

The JBS3 Risk Calculator with its new measures and communication tools aims to empower patients to make appropriate decisions about their lifestyle and drug treatments based on a better understanding of their personal cardiovascular disease (CVD) risks. It helps GPs and Clinicians to address three key questions for their patients:

  • Why should I start CVD risk reduction?
  • When should I start?
  • What should I do?
Source: jbs3risk.com
Clinical Resource: Calculator
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Last Checked: 19/08/15 Link Error: Report It

 

The ASSIGN Score

ASSIGN is a cardiovascular risk score developed in Dundee University, Scotland in 2006.

ASSIGN includes social deprivation for the first time, and family history of cardiovascular disease with the classic risk factors.

It identifies people free of cardiovascular disease most likely to develop it over ten years. ‘High risk’ (score 20 or more) implies risk-lowering medication and/or other medical help.

ASSIGN is the cardiovascular risk score chosen for use by SIGN (Scottish Intercollegiate Guidelines Network) and Scottish Government Health Directorates.

Source: assign-score.com
Clinical Resource: Calculator
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Last Checked: 22/04/13 Link Error: Report It

 

HeartScore: cardiovascular disease (CVD) risk assessment and management
The interactive tool for predicting and managing the risk of heart attack and stroke

HeartScore is aimed at supporting clinicians in optimizing individual cardiovascular risk reduction. It is the electronic and interactive version of the SCORE (Systematic Coronary Risk Evaluation) risk charts, published by the European Society of Cardiology.

Source: heartscore.org
Clinical Resource: Tool
Register to Access Content: Yes - registration is FREE

Last Checked: 22/04/13 Link Error: Report It

 

The Renal Association Guideline - Cardiovascular Disease in Chronic Kidney Disease

Source: renal.org
Clinical Resource: Guideline
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Last Checked: 30/12/13 Link Error: Report It

 

Assessment and Management of Cardiovascular Risks in Women
A Short Guide for Menopause Physicians

The guide provides details of the key cardiovascular risk factors in women and describes how risk can be determined and monitored within the gynaecological setting, and in which populations. The guide contains practical guidance for menopause physicians to follow to help them to reduce cardiovascular risk in their patients.

Source: imsociety.org
Clinical Resource: Guide
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Last Checked: 22/04/13 Link Error: Report It

 

American Association of Clinical Endocrinologists (AACE) Position Statement on Hormone Replacement Therapy (HRT) and Cardiovascular Risk

Source: aace.com
Clinical Resource: Position Statement
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Last Checked: 22/04/13 Link Error: Report It

 

Faculty of Sexual & Reproductive Healthcare Clinical Guidance
Contraceptive Choices for Women with Cardiac Disease

Source: fsrh.org
Clinical Resource: Guidance
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Last Checked: 10/06/15 Link Error: Report It

 

Contraceptive Hormone Use and Cardiovascular Disease

This review outlines the physiology and mechanisms of cardiovascular action of contraceptive hormones, particularly those found in OCs. It includes basic science, animal and human clinical studies that address contraceptive hormone use and cardiovascular disease. We also review the current guidelines for contraceptive hormone use in women with elevated cardiovascular risk.

Source: content.onlinejacc.org
Clinical Resource: Journal Article
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Last Checked: 08/04/14 Link Error: Report It

 

Cardiovascular disease - Lipids

The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.

Source: webarchive.org.uk
Clinical Resource: e-Learning
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Last Checked: 24/04/15 Link Error: Report It

 

Bandolier Knowledge
Statins

In these pages contain stories from Bandolier relating to statins. They will be supplemented by additional material, as resources become available through sponsorship or other means.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

Lipid Modification
Frequently Asked Questions

This guidance represents the consensus view of the South London Cardiac Network Prescribing Forum.

Source: slcsn.nhs.uk
Clinical Resource: Guidance
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Last Checked: 22/04/13 Link Error: Report It

 

Update on Lipid-Lowering Therapies

This bulletin will focus on the different types of lipid-lowering agents and their uses.

Source: stjames.ie
Clinical Resource: Medicines Information Centre Bulletin
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Last Checked: 22/04/13 Link Error: Report It

 

Management of hyperlipidaemia

This article focusses on primary hypercholesterolaemia, its relationship with CHD, and its management in the community setting.

Source: racgp.org.au
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Association of British Clinical Diabetologists position statement on lipid modifying drug therapy in diabetes

Source: diabetologists-abcd.org.uk
Clinical Resource: Position Paper
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Last Checked: 22/04/13 Link Error: Report It

 

American Association of Clinical Endocrinologists' Guidelines for Management of Dyslipidemia and Prevention of Atherosclerosis

Source: aace.com
Clinical Resource: Guideline
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Last Checked: 22/04/13 Link Error: Report It

 

Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline

Source: endocrine.org
Clinical Resource: Guideline
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Last Checked: 07/06/13 Link Error: Report It

 

Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines for Managing Dyslipidemias in Chronic Kidney Disease

Source: kidney.org
Clinical Resource: Guideline
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Last Checked: 21/08/15 Link Error: Report It

 

Be on the Alert for Increasing Drug Interactions with Statins

Statins are very safe drugs that occasionally produce adverse events. Toxicity involving skeletal muscles most commonly results in pain, weakness, or cramps with or without creatine kinase elevations (myalgia or myopathy), but it usually is not associated with longterm sequelae. Rhabdomyolysis is a much more severe form of muscle toxicity that is quite rare. Both types of statin toxicity, however, appear to be drug-dose– and plasma-concentration– related. The coadministration of drugs that interact with statins can increase the risk of muscle toxicity by up to 10- fold.

Source: hanstenandhorn.com
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Q: What is the best time of day to administer the statins?

Drugs such as lovastatin, simvastatin, and fluvastatin have relatively short elimination half-lives and their labeling recommends they be taken in the evening. On the other hand, atorvastatin, rosuvastatin, and pravastatin, along with their metabolites, possess half-lives of twenty or more hours. Labeling for these three agents advises that they be administered at any time of the day.

Source: duq.edu
Clinical Resource: Pharmaceutical Information Centre Publication
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Last Checked: 22/04/13 Link Error: Report It

 

Statins: Morning vs Evening Dosing?

Optimal Low-Density Lipoprotein Cholesterol Lowering -- Morning Versus Evening Statin Administration

Source: medscape.com
Clinical Resource: Viewpoint
Register to Access Content: Yes - registration is FREE

Last Checked: 22/04/13 Link Error: Report It

 

Is there a lactose-free lipid regulating medicine?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

The following table lists which lipid regulating medicines do not contain lactose, i.e. are defined as lactose-free.

Source: sps.nhs.uk
Clinical Resource: Medicines Question and Answer
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Last Checked: 22/09/16 Link Error: Report It

 

European Society of Hypertension Clinical Practice Newsletters

The European Society of Hypertension has on a regular basis issued Scientific Newsletters: Update on Hypertension Management on the latest news and research.

Source: eshonline.org
Clinical Resource: Newsletters
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Last Checked: 19/08/15 Link Error: Report It

 

American Society of Hypertension Position Papers

Source: ash-us.org
Clinical Resource: Position Papers
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Last Checked: 22/04/13 Link Error: Report It

 

2013 Canadian Hypertension Education Program Recommendations

Source: hypertension.ca
Clinical Resource: Recommendations
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Last Checked: 22/04/13 Link Error: Report It

 

American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Hypertension

Source: aace.com
Clinical Resource: Guideline
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Last Checked: 22/04/13 Link Error: Report It

 

Management of High Blood Pressure in Blacks: An Update of the International Society on Hypertension in Blacks Consensus Statement

Source: ishib.org
Clinical Resource: Consensus Statement
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Last Checked: 22/04/13 Link Error: Report It

 

International Society on Hypertension in Blacks
Risk Stratification of Hypertension and Treatment Algorithm

Source: ishib.org
Clinical Resource: Algorithm
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Last Checked: 22/04/13 Link Error: Report It

 

New Hypertension Guidelines: Do Blood Pressure Goals Need to Change with Age?

The focus of this newsletter is to highlight the key recommendations and controversies with JNC8 guidelines in the context of the scientific literature to date.

Source: oregonstate.edu
Clinical Resource: Newsletter
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Last Checked: 23/10/15 Link Error: Report It

 

Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease

Source: kidney.org
Clinical Resource: Guideline
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Last Checked: 21/08/15 Link Error: Report It

 

Management of Hypertension for People with Diabetes

Hypertension is a common problem in people with diabetes. This resource provides a summary for practicing clinicians about the treatment of hypertension in people with diabetes

Source: hypertension.ca
Clinical Resource: Clinical Paper
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Last Checked: 22/04/13 Link Error: Report It

 

British Hypertension Society - Therapeutics

Descriptions and usage of the various classes of drugs most commonly used to treat hypertension.

Alpha-Adrenoceptor Antagonists
Angiotensin Converting Enzyme (ACE) Inhibitors
Angiotensin Receptor Blockers (ARBs)
Beta-Adrenoceptor Antagonists (Beta-Blockers)
Calcium Channel Blockers (CCBs)
Centrally Acting Agents
Direct Renin Inhibitors
Thiazide and Thiazide-Like Diuretics
Other Diuretics
Potent Direct Vasodilators

Source: bhsoc.org
Clinical Resource:
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Last Checked: 17/02/14 Link Error: Report It

 

Bandolier Knowledge
Blood pressure, lifestyle and treatment

This site takes a look at things that put up your blood pressure, especially salt, and how changing lifestyle can reduce your blood pressure.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

Management of hypertension and pre-eclampsia in pregnancy

The authors discuss the importance of early identification of women at risk of developing hypertension or pre-eclampsia during pregnancy.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 07/05/14 Link Error: Report It

 

Blood Pressure Measurement
Recommendations of the British Hypertension Society

This Website is the result of a collaborative project between the British Hypertension Society and the British Medical Journal. It was designed and constructed by the Faculty of Medicine & Medical Sciences Medi-CAL Unit at the University of Aberdeen. Its content was prepared by clinical experts at the University of Aberdeen and the Blood Pressure Unit of Beaumont Hospital, Dublin and members of the BHS Working Party Group.

Source: abdn.ac.uk
Clinical Resource: Various
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Last Checked: 22/04/13 Link Error: Report It

 

Blood Pressure Measurement With Electronic Blood Pressure Monitors

Source: bhsoc.org
Clinical Resource: Poster
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Last Checked: 22/04/13 Link Error: Report It

 

Blood Pressure Measurement With With Manual Blood Pressure Monitors

Source: bhsoc.org
Clinical Resource: Poster
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Last Checked: 22/04/13 Link Error: Report It

 

Decongestant Use in Hypertension

This article will focus on standards of care and medications used for nasal congestion, including oral and topical nasal decongestants and alternatives to decongestants.

Source: uspharmacist.com
Clinical Resource: Journal Article
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Last Checked: 25/03/13 Link Error: Report It

 

Orthostatic hypotension: a review of the diagnosis and management

Orthostatic hypotension is a common problem in the elderly that can lead to potentially dangerous situations such as falls, blackouts and light-headedness. The condition has a number of possible causes and, fortunately, an increasing number of potential treatments. Drs James Milton and Aza Abdulla present a guide to the causes, investigations and treatment of this condition.

Source: gmjournal.co.uk
Clinical Resource: Journal Article
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Last Checked: 05/03/13 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Stable Angina

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 28/09/17 Link Error: Report It

 

Current approaches to the management of stable angina

Current angina management focuses on the prevention of future cardiac events and control of symptoms. Our Drug review describes the various antianginal drugs available, followed by sources of further information and an analysis of prescription data.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Cardiovascular disease - Post MI

The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.

Source: webarchive.org.uk
Clinical Resource: e-Learning
Register to Access Content: No

Last Checked: 24/04/15 Link Error: Report It

 

Current Management of Acute Coronary Syndrome

This bulletin will review the clinical presentation and current management of acute coronary syndromes.

Source: stjames.ie
Clinical Resource: Medicines Information Centre Bulletin
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Last Checked: 22/04/13 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Acute Coronary Syndrome

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 28/09/17 Link Error: Report It

 

Acute coronary syndrome

The term ‘acute coronary syndrome’ encompasses STEMI, NSTEMI, and UA. The electrocardiogram identifies those with STEMI. An elevated troponin level measured at least 12 hours after the onset of pain distinguishes NSTEMI from UA. However, the separation of NSTEMI and UA is somewhat artificial, as the management of individual patients is based on their risk score, with troponin being only a small part of the equation.

Source: rcpe.ac.uk
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Optimizing the Dose of Clopidogrel and Aspirin in Acute Coronary Syndrome

A management goal in ACS is relief of ischemia by initiating pharmacological therapy with aspirin or clopidogrel. The purpose of this article is to review the available literature regarding the dosing of aspirin and clopidogrel in ACS.

Source: ufl.edu
Clinical Resource: Publication
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Last Checked: 22/04/13 Link Error: Report It

 

Does Calcium Supplementation Increase the Risk of MI?

Clinical Question: Does calcium (Ca+) supplementation contribute to increased risk of myocardial infarction (MI) and other cardiovascular disease (CVD)?

Source: acfp.ca
Clinical Resource: Article
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Last Checked: 21/08/15 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Chronic Heart Failure

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 28/09/17 Link Error: Report It

 

Treatment of chronic heart failure

This bulletin discusses the drug treatment of CHF associated with left ventricular systolic dysfunction.

Source: wemerec.org
Clinical Resource: Medicines Resource Centre Bulletin
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Last Checked: 16/11/17 Link Error: Report It

 

Evidence-based drug therapy in the management of heart failure

This article provides an update on the drug treatment for heart failure (HF) mostly based on the recent clinical guidelines issued by the National Institute of Clinical Excellence (NICE). New high quality evidence from randomised controlled trials has resulted in greater value being given to the use of beta-blockers (BBs) and to the use of the hydralazine-nitrate combination. The importance of monitoring laboratory and clinical parameters to ensure safe and effective drug treatment is also highlighted.

Source: mcppnet.org
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Heart failure

The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.

Source: webarchive.org.uk
Clinical Resource: e-Learning
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Last Checked: 24/04/15 Link Error: Report It

 

Heart Failure

Heart failure develops when the heart, via an abnormality of cardiac function (detectable or not), fails to pump blood at a rate commensurate with the requirements of the metabolizing tissues or is able to do so only with an elevated diastolic filling pressure.

Source: medscape.com
Clinical Resource: Article
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Last Checked: 22/04/13 Link Error: Report It

 

Beta-Blockers for Treatment of Heart Failure in the Elderly

Pharmacotherapy for heart failure focuses on neurohormonal blocking strategies using predominantly angiotensin converting enzyme inhibitors and beta-blockers, both conferring improved outcomes in patients with systolic chronic heart failure. Despite this, there is ongoing underutilisation of beta-blockers in this context in clinical practice. Advanced age is cited as a common reason for non-prescription of beta-blockers. The concerns are usually perceived reduced efficacy and tolerability of the drug class.

Source: shpa.org.au
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Guide for initiation and up-titration of beta-blockers in patients with heart failure

Source: saferx.co.nz
Clinical Resource: Guide
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Last Checked: 22/04/13 Link Error: Report It

 

Guide for initiation and up-titration of ACE inhibitors in patients with heart failure

Source: saferx.co.nz
Clinical Resource: Guide
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Last Checked: 22/04/13 Link Error: Report It

 

The management of hyperuricemia and gout in patients with heart failure

The treatment of gout in patients with heart failure is complicated by their fragile volume state and chronic renal failure, both of which prohibit the use of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. Moreover, drug interactions exist between drugs used for the treatment of hyperuricemia and gout and pharmacological agents used for the therapy of heart failure. This review therefore focuses on the treatment of hyperuricemia and gout in patients with heart failure.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 17/06/14 Link Error: Report It

 

Seattle Heart Failure Model

The Seattle Heart Failure Model (SHFM) is a calculator of projected survival at baseline and after interventions for patients with heart failure.

Source: washington.edu
Clinical Resource: Calculator
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Last Checked: 05/01/15 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Cardiac Arrhythmias in Coronary Heart Disease

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 28/09/17 Link Error: Report It

 

Arrhythmia Alliance Toolkit

  • Patient & Professional Information Sheets
  • Checklists
  • Booklets
  • Paediatric Resources
  • Care Pathways
  • Drug Protocols
Source: heartrhythmcharity.org.uk
Clinical Resource: Toolkit
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Last Checked: 22/04/13 Link Error: Report It

 

Composite List of All QTDrugs and the List of Drugs to Avoid for Patients with Congenital LQTS

QT Drugs Lists: This portal includes QTdrugs.org, a list of drugs categorized by their potential to cause QT prolongation and/or torsades de pointes (TdP).

The lists can be exported as PDF or Excel files, printed and can be searched and sorted by: Generic Name, Brand Name, Risk Category, Pharmacologic Class, and Therapeutic Use.

Source: crediblemeds.org
Clinical Resource: Lists
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Last Checked: 22/11/13 Link Error: Report It

 

Drug-Induced QT Prolongation

Drug-induced prolongation of the QT interval has been known to occur after administration of antiarrhythmics formore than 20 years. Recently, drug-induced long QT syndrome (LQTS) has been observed after administration of non-antiarrhythmic medications. The additional attention paid to the mechanisms of hereditary QT prolongation has led to numerous advances in our understanding of how drugs produce QT prolongation.

Source: utah.edu
Clinical Resource: Poison Control Centre Newsletter
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Last Checked: 21/08/15 Link Error: Report It

 

QT Prolongation, Torsades de Pointes, and Drug Safety

The term torsades de pointes(TdP) is used to describe a polymorphic ventricular arrhythmia that occurs only in the presence of a prolonged QT interval.

Source: uwyo.edu
Clinical Resource: Newsletter
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Last Checked: 22/04/13 Link Error: Report It

 

Atrial Fibrillation

The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.

Source: webarchive.org.uk
Clinical Resource: e-Learning
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Last Checked: 24/04/15 Link Error: Report It

 

Bandolier Knowledge
Atrial fibrillation

This site is gathering the best evidence available about atrial fibrillation and heart failure.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

Update on Oral Anticoagulation Therapy

This, the first of two bulletins will review the pharmacology of the OACs and summarise the evidence for the use of the new OACs(NOACs). A companion bulletin will provide an update on the management of non-valvular AF.

Update on Management of Non-Valvular Atrial Fibrillation

This, the second of two bulletins, will outline the management of non-valvular AF in current practice.

AF is associated with increased rates of death, stroke and other thromboembolic events, heart failure and hospitalisations, reduced quality of life, reduced exercise capacity and left ventricular dysfunction. Management includes prevention of AF-related thromboembolic events, rhythm and/or rate control, adequate therapy of concomitant cardiac disease and relief of concomitant symptoms.

Source: stjames.ie
Clinical Resource: Medicines Information Centre Bulletins
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Last Checked: 16/12/13 Link Error: Report It

 

Current management of atrial fibrillation

Atrial fibrillation is a common condition and carries the risk of cerebral thromboembolism.The CHADS2 score is often used to stratify this risk. Anticoagulant therapy with warfarin significantly reduces this risk, but there are limitations to its use. This has prompted the use of antiplatelet drugs. Patients with mitral valve disease should always be considered for anticoagulant therapy. However for other patients with atrial fibrillation, the decision about which drug to use is based on the patient's risk of thromboembolism. In addition to stroke prevention, management is directed towards restoring and maintaining sinus rhythm or controlling the ventricular rate in those for whom permanent atrial fibrillation is accepted.

Source: nps.org.au
Clinical Resource: Journal Article
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Last Checked: 08/08/16 Link Error: Report It

 

NHS Greater Glasgow & Clyde Guidelines on the Management of Persistant Atrial Fibrillation

Source: nhsggc.org.uk
Clinical Resource: Guideline
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Last Checked: 22/04/13 Link Error: Report It

 

Anticoagulation for Non-Valvular Atrial Fibrillation in Older People

Stroke risk stratification schemes have been developed to guide assessment of risks versus benefits. Other considerations in older people include monitoring anticoagulation, and assessing falls risk, compliance and the potential for drug interactions. A range of novel oral anticoagulants, such as direct thrombin inhibitors and factor Xa inhibitors, have been developed. These anticoagulants have demonstrated advantages in safety, efficacy and convenience of use in large randomised clinical trials. These novel anticoagulants could provide alternatives to warfarin for preventing stroke in older people with AF.

Source: shpa.org.au
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

UKCPA (United Kingdom Clinical Pharmacy Association) position statement on the introduction of new oral anticoagulants for stroke prevention in atrial fibrillation

This position statement is intended to assist decision makers in defining the appropriate use of NOACs for stroke prevention in AF until national guidance is published and long-term service redesign can be implemented.

Source: ukcpa.net
Clinical Resource: Position Statement
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Last Checked: 22/04/13 Link Error: Report It

 

 

SPARC - Stroke Prevention in Atrial Fibrillation Risk Tool

for estimating risk of stroke and benefits & risks of antithrombotic therapy in patients with chronic atrial fibrillation

Source: sparctool.com
Clinical Resource: Tool
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Last Checked: 22/04/13 Link Error: Report It

 

Atrial fibrillation and stroke prevention in elderly people

This article reviews antiplatelet and anticoagulant treatments used for prevention of stroke in patients with atrial fibrillation, with reference to evidence for risk of bleeding, and discusses risk stratification for starting warfarin.

Source: gmjournal.co.uk
Clinical Resource: Journal Article
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Last Checked: 05/03/13 Link Error: Report It

 

Anne Arundel Medical Center
Guidelines for Use of Intravenous Amiodarone (Cordarone®)

Source: aahs.org
Clinical Resource: Guideline
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Last Checked: 22/02/17 Link Error: Report It

 

Amiodarone monitoring protocol
Derbyshire Medicine Management Prescribing and Guidelines

Source: derbyshiremedicinesmanagement.nhs.uk
Clinical Resource: Protocol
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Last Checked: 19/08/15 Link Error: Report It

 

Q: Is there a risk in using amiodarone in patients with iodine hypersensitivity?

A: Amiodarone is a popular drug for the treatment of supraventricular and ventricular arrhythmias. Each 200 mg tablet contains 75 mg (37.3%) of iodine. The product literature includes a contraindication to its use in patients with hypersensitivity to iodine. The question arises, what is iodine hypersensitivity?

Source: duq.edu
Clinical Resource: Pharmaceutical Information Centre Publication
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Last Checked: 15/04/14 Link Error: Report It

 

European Stroke Organization Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008

European Stroke Organization Guideline Update – January 2009

The ESO Guidelines have been updated with regard to thrombolytic therapy. The modifications were discussed and prepared at the Karolinska Stroke Update Meeting, November 2008, and have been approved by the ESO Guideline Committee and the ESO Executive Committee.

Source: eso-stroke.org
Clinical Resource: Guideline and Update
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Last Checked: 19/08/15 Link Error: Report It

 

 

Canadian Best Practice Recommendations for Stroke Care

The Canadian Best Practice Recommendations for Stroke Care are intended to provide up-to-date evidence-based guidelines for the prevention and management of stroke.

Source: strokebestpractices.ca
Clinical Resource: Recommendations
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Last Checked: 22/04/13 Link Error: Report It

 

Cardiovascular disease - Stroke

The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.

Source: webarchive.org.uk
Clinical Resource: e-Learning
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Last Checked: 24/04/15 Link Error: Report It

 

The Internet Stroke Center
Stroke Resources for Health Professionals

The Internet Stroke Center provides health professionals with multiple tools and educational presentations about stroke assessment, stroke treatment and management. Physicians and medical students will also find a library of more than 1800 images of cerebrovascular and neurological diseases.

Source: strokecenter.org
Clinical Resource: Various
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Last Checked: 22/04/13 Link Error: Report It

 

Bandolier Knowledge
Stroke

In these pages are collected the stories from Bandolier relating to stroke.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

European Stroke Organisation
Frequently Asked Questions on Stroke

  1. Introduction to the Management of Stroke
  2. Epidemiology of Stroke
  3. High Blood Pressure
  4. Diabetes and Stroke
  5. Lipids and Stroke
  6. Other Risk Factors for Stroke
  7. Carotid Surgery
  8. Antiplatelets, Therapy for Stroke Prevention
  9. Anticoagulant Therapy and Stroke Prevention
  10. Prevention in Atrial Fibrillation and Other Cardiac Sources of Embolism
  11. Stroke Services
Source: eso-stroke.org
Clinical Resource: Frequently Asked Questions
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Last Checked: 19/08/15 Link Error: Report It

 

Massachusetts General Hospital
Stroke Service

Acute Ischemic Stroke

The protocols and guidelines we use to treat acute ischemic stroke.

  • t-PA Dosing Calculator
  • Thrombolysis
  • Eptifibatide Dosing
Source: massgeneral.org
Clinical Resource: Various
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Last Checked: 22/04/13 Link Error: Report It

 

Stroke Risk Calculator

This tool can predict a patient's stroke risk 90 days after a Transient Ischemic Attack (TIA).

Source: bmc.org
Clinical Resource: Tool
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Last Checked: 22/04/13 Link Error: Report It

 

Choice of antiplatelet agent for secondary prevention of stroke

The risk of recurrent stroke is as high as 43% over 10 years. Antiplatelet therapy is an accepted strategy for reduction in this risk. The common choices are aspirin, aspirin plus extended release Dipyridamole (ASA-ESDP), and clopidogrel. When selecting an antiplatelet there should be consideration of co-morbidities (especially acute coronary disease), tolerance, and recurrence of stroke while on an antiplatelet.

Source: auspharmlist.net.au
Clinical Resource: Pharmacy E-Bulletin
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Last Checked: 22/04/13 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Patients With Stroke: Identification and Management of Dysphagia

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 28/09/17 Link Error: Report It

 

 

Glycaemic management during the inpatient enteral feeding of stroke patients with diabetes
Joint British Diabetes Societies (JBDS) for inpatient care

This document has been produced by the Joint British Diabetes Societies for Inpatient Care (JBDS – IP) on behalf of Diabetes UK, the Association of British Clinical Diabetologists (ABCD), and the Diabetes Inpatient Specialist Nurse (DISN) UK Group, in collaboration with NHS Diabetes and the Primary Care Diabetes Society (PCDS).

Source: diabetologists-abcd.org.uk
Clinical Resource: Guideline
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Last Checked: 22/04/13 Link Error: Report It

 

British Society for Haematology Guidelines - Haemostasis and Thrombosis

Source: b-s-h.org.uk
Clinical Resource: Guidelines
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Last Checked: 16/11/16 Link Error: Report It

 

Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines

Source: chestnet.org
Clinical Resource: Guideline
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Last Checked: 02/07/14 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Antithrombotics: Indications and Management

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 28/09/17 Link Error: Report It

 

Thrombosis Canada Clinical Guides

The Thrombosis Canada™ Clinical Guides are:

  • Developed by Thrombosis Canada™ members, internationally recognized as experts
  • Reflect recommendations of evidence based clinical practice guidelines
  • Designed to be robust, yet concise enough to be applicable at the point of care
Source: thrombosiscanada.ca
Clinical Resource: Guides
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Last Checked: 02/07/14 Link Error: Report It

 

Bloody Easy Coagulation Simplified
Published by Ontario Regional Blood Coordinating Network

This handbook provides practical information on Coagulation. It is designed to enhance the knowledge of physicians, nurses and medical laboratory technologists about the basics of coagulation from laboratory testing to anticoagulant drugs and management of common bleeding disorders.

Source: transfusionontario.org
Clinical Resource: Handbook
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Last Checked: 10/12/13 Link Error: Report It

 

Clinical Practice Guide on Antithrombotic Drug Dosing and Management of Antithrombotic Drug Associated Bleeding Complications in Adults February 2014

Presented by the American Society of Hematology, adapted in part from the American College of Chest Physicians Evidence-Based Clinical Practice Guideline on Antithrombotic and Thrombolytic Therapy (9th Edition).

Source: hematology.org
Clinical Resource: Guide
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Last Checked: 20/08/15 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Prevention and Management of Venous Thromboembolism

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 28/09/17 Link Error: Report It

 

e-VTE
A web based education resource designed to help raise awareness and improve understanding of Venous Thromboembolism

The e-learning session for healthcare professionals in Secondary Care first published in 2010 and updated in 2013 is aimed at nurses, pharmacists and junior doctors to help them understand the concept of hospital-associated thrombosis and how to prevent it.

Source: e-lfh.org.uk
Clinical Resource: CE / CPD / Learning
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Last Checked: 19/08/15 Link Error: Report It

 

Lifeblood: The Thrombosis Charity
Professional Section

The professional section offers healthcare professionals an extensive resource to stay up to date with the latest developments in the diagnosis and management of venous thromboembolism.

Professional

  • Hospital-Based Health Professionals
  • GP's and Community Healthcare Professionals
Source: thrombosis-charity.org.uk
Clinical Resource: Various
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Last Checked: 02/07/14 Link Error: Report It

 

Venous thromboembolism

Venous thrombosis is the process of clot (thrombus) formation within veins. Although this can occur in any venous system, the predominant clinical events occur in the vessels of the leg, giving rise to deep vein thrombosis, or in the lungs, resulting in a pulmonary embolus. Collectively referred to as venous thromboembolism, these have a high prevalence both in the community and in hospitals, and bring a considerable burden of morbidity and possible mortality.

Source: nih.gov
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Pulmonary embolism

This article reviews the epidemiology, clinical features, diagnostic process, and treatment of pulmonary embolism.

Source: racgp.org.au
Clinical Resource: Journal Article
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Last Checked: 02/07/14 Link Error: Report It

 

Diagnosing pulmonary embolism

Objective testing for pulmonary embolism is necessary, because clinical assessment alone is unreliable and the consequences of misdiagnosis are serious. No single test has ideal properties (100% sensitivity and specificity, no risk, low cost).

Source: europepmc.org
Clinical Resource: Journal Article
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Last Checked: 07/04/14 Link Error: Report It

 

Royal College of Obstetricians and Gynaecologists Guideline on Reducing the Risk of Venous Thromboembolism during Pregnancy and the Puerperium

Source: rcog.org.uk
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

Royal College of Obstetricians and Gynaecologists Guideline on Thromboembolic Disease in Pregnancy and the Puerperium: Acute Management

Source: rcog.org.uk
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

Venous Thromboembolism (VTE) and Hormonal Contraception
Faculty of Sexual & Reproductive Healthcare Statement

Source: fsrh.org
Clinical Resource: Statement
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Last Checked: 10/06/15 Link Error: Report It

 

Risk of venous thromboembolism in users of non-oral contraceptives
Statement from the Faculty of Sexual & Reproductive Healthcare

Source: fsrh.org
Clinical Resource: Statement
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Last Checked: 10/06/15 Link Error: Report It

 

Management of venous thrombosis in pregnancy

The management of venous thromboembolism in pregnancy is challenging, as many diagnostic tests are less accurate in pregnant than in non-pregnant patients, and some of the radiological procedures are potentially hazardous to the fetus. In addition, anticoagulant treatment with coumarins can cause embryopathy. The authors recommend strategies for women at risk of deep venous thrombosis or pulmonary thromboembolism during pregnancy and outline appropriate investigations and treatment.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 07/05/14 Link Error: Report It

 

Prescribing clopidogrel with asprin

The possibility of combining aspirin and clopidogrel for more stable cardiovascular disease, to give added benefit, appears attractive. However, studies have shown that combining their effects could also increase the risk of adverse effects, in particular the risk of bleeding. This document discusses these studies and the implications for practice.

Source: wemerec.org
Clinical Resource: Medicines Resource Centre E-Note
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Last Checked: 16/11/17 Link Error: Report It

 

Reducing the risk of adverse thrombotic events
The role of aspirin and clopidogrel

Clopidogrel and aspirin both inhibit platelet aggregation, but have differing mechanisms of action that are additive in terms of antithrombotic function. The additive antithrombotic effect of aspirin and clopidogrel combination therapy provides additional clinical benefit compared to monotherapy in some circumstances, but the risk of major bleeding with combination therapy is greater than with either agent alone.

Source: racgp.org.au
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

WarfarinDosing.org

Welcome to WarfarinDosing.org, a free Web site to help doctors and other clinicians begin warfarin therapy by estimating the therapeutic dose in patients new to warfarin. This site is supported by the Barnes-Jewish Hospital at Washington University Medical Center, the NIH, and donations. Estimates are based on clinical factors and (when available) genotypes of two genes: cytochrome P450 2C9 (CYP2C9) and vitamin K epoxide reductase (VKORC1).

Recommendations on this Web site are based on data from over 1000 patients.Once information is entered onto the next page, the initial estimate of therapeutic dose explains 53% of the variability in a warfarin dose. If you return to the Web site and enter an INR value after 3 and/or 4 warfarin doses, the dose refinement is even more accurate.

Source: warfarindosing.org
Clinical Resource: Calculator
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Last Checked: 17/02/14 Link Error: Report It

 

Management of Warfarin Overdose and Supratherapeutic INR

Full reversal of warfarin-induced coagulopathy is indicated in patients who do not require warfarin therapy. However, special consideration must be given to patients who require therapeutic anticoagulation in the event of a warfarin overdose. The purpose of this discussion is to review treatment guidelines for these patents.

Source: utah.edu
Clinical Resource: Poison Control Centre Newsletter
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Last Checked: 02/07/14 Link Error: Report It

 

Laboratory Monitoring of Warfarin Therapy

Crystalline warfarin sodium (Coumadin, Panwarfin, Sofarin, Coufarin, Athrombin-K) is the most widely used oral anticoagulant in the world. Warfarin interferes with the hepatic synthesis of the vitamin-K dependent coagulation factors by interfering with the vitamin K cycle. Laboratory monitoring of warfarin therapy is mandatory, since the agent has a relatively narrow therapeutic range.

Source: pathology.vcu.edu
Clinical Resource: Educational Resource
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Last Checked: 17/02/14 Link Error: Report It

 

Warfarin, antiplatelet drugs and their interactions

Patients who are being treated with warfarin may sometimes be prescribed or buy antiplatelet drugs, such as aspirin. As warfarin and antiplatelet drugs increase the risk of bleeding, their combination can put patients at risk of a major haemorrhage. This risk may be further increased by the patient's age and other illnesses.

Source: nps.org.au
Clinical Resource: Journal Article
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Last Checked: 08/08/16 Link Error: Report It

 

Warfarin Drug Interactions

The drugs in this list are more usually associated with loss of INR control in patients already established on warfarin.

Source: derbyhospitals.nhs.uk
Clinical Resource: List
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Last Checked: 02/07/14 Link Error: Report It

 

Anticoagulants and pregnancy: When are they safe?

While anticoagulants are useful in many circumstances, their use during pregnancy increases the risk of hemorrhage and other adverse effects on the mother and the fetus. Treatment with anticoagulants during pregnancy must therefore be carefully considered, with judicious selection of the agent, and with reflection on the physiologic changes of pregnancy to ensure appropriate dosing. In this article, we review these issues.

Source: mdedge.com
Clinical Resource: Journal Article
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Last Checked: 19/06/17 Link Error: Report It

 

Can small volume intramuscular injections be given to patients taking oral anticoagulants?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

This Medicines Q&A focuses on the potential risks of adverse effects associated with the administration of small volume IM injections to patients taking oral anticoagulants.

Source: sps.nhs.uk
Clinical Resource: Medicines Question and Answer
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Last Checked: 22/09/16 Link Error: Report It

 

British Society of Gastroenterology Clinical Guideline for the Management of Anticoagulant and Antiplatelet Therapy in Patients Undergoing Endoscopic Procedures

Source: bsg.org.uk
Clinical Resource: Guideline
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Last Checked: 13/03/14 Link Error: Report It

 

Management of antithrombotic agents for endoscopic procedures

The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text.

Source: asge.org
Clinical Resource: Guideline
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Last Checked: 02/07/14 Link Error: Report It

 

Using low molecular weight heparin

This bulletin looks at the appropriate prescribing and monitoring of LMWH for the treatment and prophylaxis of VTE in adults.

Source: wemerec.org
Clinical Resource: Medicines Resource Centre Bulletin
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Last Checked: 16/11/17 Link Error: Report It

 

Enoxaparin in patients with severe renal impairment

There have been a number of medication incidents reported recently involving the use of enoxaparin in patients with severe renal impairment (creatinine clearance less than 30ml/min) who, as a result of treatment have suffered a haemorrhage.

Source: medicinesgovernance.hscni.net
Clinical Resource: Memo
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Last Checked: 31/03/14 Link Error: Report It

 

Laboratory Monitoring of Low Molecular Weight Heparins

Routine laboratory monitoring is not routinely required, with the exception of patients with renal insuffciency. However, since LMWHs inhibit factor Xa more than thrombin, assays for anti-factor Xa activity, rather than the aPTT, must be used for monitoring.

Source: pathology.vcu.edu
Clinical Resource: Educational Resource
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Last Checked: 17/02/14 Link Error: Report It

 

Laboratory Monitoring of Unfractionated Heparin

Heparin therapy requires rigorous laboratory monitoring with the activated partial thromboplastim time (aPPT), since its bioavailability is variably affected by binding to plasma and cellular proteins. Unfractionated heparin is gradually being replaced by low molecular weight heparin, which has a longer half-life and more predictable bioavailability.

Source: pathology.vcu.edu
Clinical Resource: Educational Resource
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Last Checked: 17/02/14 Link Error: Report It

 

The essentials of diet and supplements for improving cardiovascular health

Approximately two-thirds of adults are now overweight or obese. The lifetime incidence of hypertension is 90%, diabetes or prediabetes affects one in three people, and CV disease kills almost half of us. Physicians have an ever-expanding array of prescription drugs to treat these problems, but relying exclusively on pharmacologic therapies, which are often expensive and occasionally toxic, to treat epidemics caused by a maladaptive diet is less rational than simply realigning our eating habits to conform to the natural diet on which we are genetically programmed to thrive.

Source: pccj.eu
Clinical Resource: Journal Article
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Last Checked: 24/02/14 Link Error: Report It

 

Supplementation of Vitamins E and C for the Prevention of Cardiovascular Disease

Antioxidants such as ascorbic acid, betacarotene and vitamin E have been studied in numerous clinical trials to prove that supplementation reduces risk of cardiovascular events.

Source: belmont.edu
Clinical Resource: Drug Information Centre Newsletter
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Last Checked: 24/02/14 Link Error: Report It

 

Antiplatelet effects of Fish Oil supplements

Two of the most important omega-3 fatty acids in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Source: auspharmlist.net.au
Clinical Resource: Pharmacy E-Bulletin
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Last Checked: 24/02/14 Link Error: Report It

 

Cardiovascular and gastrointestinal safety of NSAIDs

This article summarises current evidence of relative CV and GI risks for non-aspirin NSAIDs and highly selective COX-2 inhibitors (coxibs), and provides prescribing advice which is consistent with previous advice from the Commission on Human Medicines.

Source: webarchive.org.uk
Clinical Resource: National Prescribing Centre Publication
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Last Checked: 24/04/15 Link Error: Report It

 

NSAID Selection: Consideration of Cardiovascular & Gastrointestinal Risk
Gwent Partnership Medicines & Therapeutics Committee

Source: wales.nhs.uk
Clinical Resource: Guideline
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Last Checked: 22/04/13 Link Error: Report It

 

Oral Adverse Drug Reactions to Cardiovascular Drugs

This review focuses on those cardiovascular drugs reported to induce oral drug reactions. In addition, it will provide data on specific drugs or drug classes, and outline and discuss recent research on possible mechanisms linking ADRs to drug metabolism patterns.

Source: sagepub.com
Clinical Resource: Journal Article
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Last Checked: 25/03/13 Link Error: Report It

 

Is it safe to use beta-blockers for cardiac disease in people with COPD?

Cardioselective beta-blockers such as metoprolol and atenolol are usually safe and effective in patients with well controlled COPD with or without a reversible obstructive component. Carvedilol (a combined non-selective beta-blocker and alpha-blocker) also appears to be safe to use in COPD patients without reversible airways obstruction.

Source: bpac.org.nz
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Beta-Blockers and Beta-Agonists: What Is the Risk?

Beta-agonists are commonly used in the treatment of asthma and chronic obstructive pulmonary disease(COPD). Beta-blocker use in asthma has been widely studied. In general, cardioselective beta-blockers (eg, acebutolol, atenolol, bisoprolol, celiprolol, metoprolol) appear to be effective for the treatment of thyrotoxicosis, tachyarrhythmias, hypertension, heart failure, and acute coronary syndrome without increased risk of asthma exacerbation.

Source: hanstenandhorn.com
Clinical Resource: Journal Article
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Last Checked: 12/06/17 Link Error: Report It

 

Beta-blocker selectivity and airways obstruction

In this Drug Points article the author describes a case of unrecognised airways disease where prescribing timolol resulted in shortness of breath and comments on the issues it raises

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Beta-blockers for the treatment of elderly patients with coexisting heart failure and chronic obstructive pulmonary disease

In this review we will discuss common pathophysiological mechanisms involved in the development of COPD and HF and we will review the evidence derived from trials on beta-blocker use, safety and benefits among elderly patients.

Source: sigg.it
Clinical Resource: Journal Article
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Last Checked: 12/06/17 Link Error: Report It

 

Cross-Reactivity of ACE Inhibitor–Induced Angioedema with ARBs

Angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors are highly utilized classes of medications that affect the renin-angiotensin-aldosterone system (RAAS). Both have been shown to be beneficial in the treatment of disease states--such as hypertension, chronic heart failure, chronic kidney disease, and myocardial infarction--in which the RAAS system plays a significant role.

Source: uspharmacist.com
Clinical Resource: Journal Article
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Last Checked: 16/03/13 Link Error: Report It

 

Can angiotensin receptor blockers (ARBs) be administered to patients who develop angioedema on angiotensin-converting enzyme inhibitor (ACEI) therapy?

Source: uic.edu
Clinical Resource: Frequently Asked Question
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Last Checked: 04/12/15 Link Error: Report It

 

Interactions between drugs for erectile dysfunction and drugs for cardiovascular disease

The present review will focus on the effects of drugs for cardiovascular disease on erectile function and make special emphasis on the interactions of drugs for treatment of ED with drugs for treatment of heart disease.

Source: nature.com
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Perioperative Cardiac Management

The cardiovascular systems of patients who undergo general anesthesia and noncardiac surgical procedures are subject to multiple stresses and complications. A previously stable patient may decompensate postoperatively, leading to significant postoperative morbidity and mortality. A substantial number of all deaths among patients undergoing noncardiac surgery are caused by cardiovascular complications.

Source: medscape.com
Clinical Resource: Article
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Last Checked: 25/02/15 Link Error: Report It

 

Preoperative cardiac evaluation and management of patients undergoing elective non-cardiac surgery

In this article, we supplement evidence presented in previous guidelines relating to preoperative evaluation and management of cardiac risk in patients undergoing elective non-cardiac surgery.

Source: mja.com.au
Clinical Resource: Journal Article
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Last Checked: 25/02/15 Link Error: Report It

 

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