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

How the slides and specimens used as instructional resources, Explain how t...

Explain how the slides and specimens used as instructional resources?  Ans) They act as an Identifier, so that we can judge them simply

What is the significance of rhynchocoel, What is the significance of Rhynch...

What is the significance of Rhynchocoel? The unique body cavity of the Nemertean worms, which comprise the retractable proboscis. There is some debate on whether this is a true

Are environmental phenotypical changes, Are environmental phenotypical chan...

Are environmental phenotypical changes transmitted to the offspring? Changes caused on phenotypes by the environment are not transmitted to the offspring (unless their primary

Agro industrial-female reproductive disorders, Heifers As efficient reprod...

Heifers As efficient reproductive performance is essential for economic livestock production, the female calves must grow rapidly to attain sexual maturity, ovulate and be mated b

Explain flow or recovery period -dietary management for burn, Explain the F...

Explain the Flow or Recovery Period - Dietary Management for Burns? After 48 to 72 hours, fluids and electrolytes are reabsorbed into the general circulation and excess fluid i

Technique of operation, Technique of Operation :  TEE probe i...

Technique of Operation :  TEE probe is passed in all cases soon after anaesthesia. The initial steps and exposure of mitral valve are done as for open mitral valvotom

Effect of ph or nutrient availability, Effect of pH or Nutrient Availabilit...

Effect of pH or Nutrient Availability One of the greatest influence of pH on plant growth is through its effect on the nutrient availability. When base saturation is less than

What is the constitution of the cartilaginous matrix, What is the constitut...

What is the constitution of the cartilaginous matrix? The cartilaginous matrix is made of collagen fibers, mostly collagen type II, and of proteoglycans, proteins associated to

What are the signs used in acute pericarditis, Q. What are the Signs used i...

Q. What are the Signs used in acute pericarditis? • Pericardial friction rub is pathognomonic of pericarditis. It is heard as a phasic scatching sound. It may vary with phases

Describe cutaneous diffusion, Q. In arthropods why isn't gas exchange done ...

Q. In arthropods why isn't gas exchange done through cutaneous diffusion? In arthropods the impermeability of the exoskeleton makes the way of gases difficult. In addition the

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