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

Cardinal manifestation of cardiovascular disorders, CARDINAL MANIFESTATION ...

CARDINAL MANIFESTATION OF CARDIOVASCULAR DISORDERS Cardiovascular symptoms that most often trouble patients are: 1. Chest Pain 2. Shortness of Breath 3. Palpitation

Explain adverse effects of tenofovir disoproxil fumarate, Adverse effects o...

Adverse effects of Tenofovir disoproxil fumarate  The most common adverse effects have been nausea, vomiting and diarrhea. Renal failure, including a Fanconi-like syndrome, has

Which type of gamete produced by a heterozygous individual, Which is the ty...

Which is the type of gamete produced by a heterozygous individual? What is the genotypical proportion of these gametes? Heterozygous individuals, for instance, AA, produce two

Define the interaction of vitamin c with iron and cadmium, Define the inter...

Define the interaction of vitamin c with iron and cadmium? Toxic levels of dietary cadmium (5-200 ppm) interfere with iron absorption and produces iron deficiency. Supplements

Heart, Septa prevent oxygenated and deoxygenated blood. Give reason

Septa prevent oxygenated and deoxygenated blood. Give reason

Explain about the simple proteins, Explain about the Simple Proteins? S...

Explain about the Simple Proteins? Simple proteins are those that are made of amino acid units just joined by peptide bond. Upon hydrolysis they yield a mixture of amino acids

Explain cartilaginous and the osseous tissue, Which type of tissue are the ...

Which type of tissue are the cartilaginous and the osseous tissue? The cartilaginous and the osseous tissues are considered connective tissues as they are tissues in which the

Domestic waste water management, All the water used in the home that goes i...

All the water used in the home that goes into the drain or into sewage collection system is called waste water. Domestic sewage is the waste water from kitchens, bathrooms etc. It

What are the body fat measurements, What are the Body Fat Measurements? ...

What are the Body Fat Measurements? Obesity is best classified in adults based on Body Mass Index (BMI) classification. BMI, you already know, is a measure of body jut based on

Write down all the four quantum numbers of the electron, Write down all the...

Write down all the four quantum numbers of the electron in the outermost shell of rubidium (At. no.= 37) atom. a) What type of hybridization is associated with N in NH 3 ? b

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