Rational in individual patient, Biology

Assignment Help:

Thiazide diuretics have been accepted as the primary foundation of antihypertensive therapy. The basis of this choice is that, apart from their primary hypotensive effect, they enhance the efficacy of other hypotensive drugs. It has been observed that most of the hypertensive patients would require 2 or more drugs for optimal control. Usually another drug from a different class can be added when BP is more than 20/10 above the goal. The drugs can be administered either separately or as fixed dose combinations. The presence of comorbid conditions should determine the choice of specific classes of hypotensive drugs.

a) Ischemic Heart Disease

In patients with hypertension and stable angina the drug of choice is usually a beta-blocker, with or without a long acting calcium channel blocker. In unstable angina, a beta-blocker, diltiazem and ACE inhibitors or an ARB are the preferred ones. In post infarction states beta-blockers and ACEI/ARB are the choices.

b) Heart Failure

With the current interest in diastolic heart failure there is a greater interest in the management of diastolic dysfunction usually detected on echocardiography. Beta-blockers and ACEI/ARB are the choices. Diuretics are not recommended since they decrease the LV filling pressure. In early systolic dysfunction, ACE/ARB are given. In florid heart failure it has to be diuretics, aldosterone antagonists, ARB/ACEI are recommended.

c) Diabetic with Hypertension

ACEI and ARBs are first choice since they have been found to retard the progression of diabetic nephropathy and may reduce albuminuria. Other drugs can be added to obtain the target BP of 130/80.


Related Discussions:- Rational in individual patient

Which of mendel''s postulates demonstrated in crosses, Which of Mendel's po...

Which of Mendel's postulates can only be demonstrated in crosses involving at least two pairs of traits? a) Segregation b) dominance/recessiveness c) independent assortment d) unit

Shapes - types of nursing units, Shapes: Nightingale Ward  In the 1...

Shapes: Nightingale Ward  In the 1940s,  this traditional nursing unit was based on  the long rectangle pavilion type ward and self-contained unit. This concept is establis

What is meant by concentration gradient, What is meant by concentration gra...

What is meant by concentration gradient? Is it correct to refer to "concentration gradient of water"? Concentration gradient is the difference of concentration of a substance

Describe integrative systems of the body, Q. Why is the endocrine system co...

Q. Why is the endocrine system considered one of the integrative systems of the body? What is the other physiological system that also has this function? The endocrine system i

Human evolution, In the last unit we traced the human evolutionary history ...

In the last unit we traced the human evolutionary history mostly from a palaeontological viewpoint. Although still fragmentary, the available fossil evidence makes it possible to c

What kinds of mutation in disease-causing bacteria, What kinds of mutation ...

What kinds of mutation in disease-causing bacteria might make them more dangerous Pathogenic bacteria will become more dangerous to us if mutations make them more virulent or r

Define plate counts and colony forming unit, Define Plate Counts and Colony...

Define Plate Counts and Colony Forming Unit? Plate counts is the most frequently used method to measure microbial numbers. The technique, however, can be used only for those mi

Extravascular compression, Most of the coronary blood flow to the left vent...

Most of the coronary blood flow to the left ventricular myocardium occurs during diastole. Thus the contracting heart obstructs its own blood supply. The systolic compressive force

How to prevent and control pem, How to Prevent and Control PEM? Any pr...

How to Prevent and Control PEM? Any programme aimed at prevention of PEM should be holistic and comprehensive considering the family as a unit. Since the effects of under nutr

Finding the problem by communication process, Q. Finding the Problem by com...

Q. Finding the Problem by communication process? - Open up the patient with general talk. - Initiate topic easy to talk. - Ask simple questions easily understood. - As

Write Your Message!

Captcha
Free Assignment Quote

Assured A++ Grade

Get guaranteed satisfaction & time on delivery in every assignment order you paid with us! We ensure premium quality solution document along with free turntin report!

All rights reserved! Copyrights ©2019-2020 ExpertsMind IT Educational Pvt Ltd