1) The document defines hypertension and provides its classification and diagnostic criteria. It discusses non-pharmacological and pharmacological treatment options.
2) Specific treatment recommendations are provided for different hypertensive patient groups including those with diabetes, chronic kidney disease, heart disease and the elderly.
3) Treatment of hypertensive emergencies and crises is covered, along with definitions of resistant and refractory hypertension. Device-based renal denervation therapy is mentioned briefly.
Image result for hypertension
Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death. Blood pressure is the force that a person's blood exerts against the walls of their blood vessels.
This presentation consists of various approaches to treat hypertension depending on severity. It also include treatment according to international guidelines. Classification and brief description of each antihypertensive agent has been mentioned.
Hypertension pharmacotherapy part 2 pptPranatiChavan
First-line medications used in the treatment of hypertension include diuretics, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), beta-blockers, and calcium channel blockers (CCBs). Some patients will require 2 or more antihypertensive medications to achieve their BP target. As per special consideration, modified treatment is given in the presentation.
Image result for hypertension
Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death. Blood pressure is the force that a person's blood exerts against the walls of their blood vessels.
This presentation consists of various approaches to treat hypertension depending on severity. It also include treatment according to international guidelines. Classification and brief description of each antihypertensive agent has been mentioned.
Hypertension pharmacotherapy part 2 pptPranatiChavan
First-line medications used in the treatment of hypertension include diuretics, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), beta-blockers, and calcium channel blockers (CCBs). Some patients will require 2 or more antihypertensive medications to achieve their BP target. As per special consideration, modified treatment is given in the presentation.
Management of hypertensive condition in 2020 according to AHA/ASA guidelines. We will discuss the presentation, clinical assessment, investigations, and management of hypertension along with major randomized controlled trials and guidelines.
HYPERTENSION- THE LATEST MANAGEMENT
Dr. Awadhesh kumar sharma is a young, diligent and dynamic interventional cardiologist. He did his graduation from GSVM Medical College Kanpur and MD in Internal Medicine from MLB Medical college jhansi. Then he did his superspecilisation degree DM in Cardiology from PGIMER & DR Ram Manoher Lohia Hospital Delhi. He had excellent academic record with Gold medal in MBBS,MD and first class in DM.He was also awarded chief ministers medal in 2009 for his academic excellence by former chief minister of UP Smt Mayawati in 2009.He is also receiver of GEMS international award.He had many national & international publications.He is also in editorial board of international journal- Journal of clinical medicine & research(JCMR).He is also active member of reviewer board of many journals.He is also trainee fellow of American college of cardiology. He is currently working in NABH Approved Gracian Superspeciality Hospital Mohali as Consultant Cardiologist.
Management of hypertensive condition in 2020 according to AHA/ASA guidelines. We will discuss the presentation, clinical assessment, investigations, and management of hypertension along with major randomized controlled trials and guidelines.
HYPERTENSION- THE LATEST MANAGEMENT
Dr. Awadhesh kumar sharma is a young, diligent and dynamic interventional cardiologist. He did his graduation from GSVM Medical College Kanpur and MD in Internal Medicine from MLB Medical college jhansi. Then he did his superspecilisation degree DM in Cardiology from PGIMER & DR Ram Manoher Lohia Hospital Delhi. He had excellent academic record with Gold medal in MBBS,MD and first class in DM.He was also awarded chief ministers medal in 2009 for his academic excellence by former chief minister of UP Smt Mayawati in 2009.He is also receiver of GEMS international award.He had many national & international publications.He is also in editorial board of international journal- Journal of clinical medicine & research(JCMR).He is also active member of reviewer board of many journals.He is also trainee fellow of American college of cardiology. He is currently working in NABH Approved Gracian Superspeciality Hospital Mohali as Consultant Cardiologist.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
6. SBP ≥140 mmHg
with DBP <90
mmHg
Common after 50
years old
non-pharmacological and aim for adoption of
healthy living.
Isolated Systolic Hypertension
Isolated Office
(White Coat)
Hypertension
Masked
Hypertensio
n
Elevated Clinic BP Normal
Normal Home
BP
Elevated
8. History
Duration and level of elevated BP
if known
Symptoms of
Secondary causes of hypertension
Target organ complications
Risk factor
Dietary history
Drug history (OTC / traditional
/complementary medicine
Lifestyle factors
9. Physical examination
General examination including
height, weight and waist
circumference
Measure BP appropriately
Fundus examination
Examination for carotid bruit,
abdominal bruit, presence of
peripheral pulses and radio-
femoral delay
CVS:cardiomegaly, signs of
heart failure and aortic
regurgitation
P/A: renal masses/bruit and
aortic aneurysm
CNS: stroke
Signs of endocrine disorders
(e.g. Cushing syndrome,
acromegaly and thyroid
disease)
10. Investigation
Full blood count
Blood glucose
Renal function tests
(creatinine, eGFR, serum
electrolytes)
Lipid profile (total
cholesterol, HDL
cholesterol, LDL cholesterol
and triglycerides)
Urinalysis (dip stick:
albuminuria/microalbuminuri
a & microscopic
haematuria)
Electrocardiogram (ECG)
Chest x ray
16. Pharmacological therapy
At risk hypertension
that failed non-
pharmalogical
method
Medium/high CV
risk
SBP >160 and/or
DBP >100 mmHg
Start monotheraphy for
stage1
Combination therapy
for stage 2 and above /
Stage 1 with medium
risk
If ineffective, consider
increasing dose /add
another /substitute
drug
Measure the BP at the
same time each day.
WHEN TO TREAT : GUIDELINES
17. 1) A or C or D
2) If target not reached,
A+C or A +D
3) If target not reached,
A+C+D
ACE inhibitor or ARB
Calcium-channel
blocker
thiazide Diuretic
STARTING
REGIMENS
Group Target BP
<80 y/o <140/90
>80 y/o <150/90
High risk <130/80
18. 3-6 monthly stage I (mild)
hypertension with low
global CV risk
BP well-controlled for
>1 year on the same
medication at the same
dosage
Agree to be followed-up
at least 3-6 monthly
motivated to adopt
healthy living
Follow up Step down therapy
25. Hypertensive
Urgency
Severe increase in
BP which is not
associated with
acute end organ
damage/complicatio
n
damage/complicatio
n
Aka accelerated
/malignant
hypertension
26.
27. Hypertensive Emergency
Severe elevation of blood pressure associated
with new or progressive end organ
damage/complication
Eg. acute heart failure, dissecting aneurysm,
acute coronary syndromes, hypertensive
encephalopathy, acute renal failure,
subarachnoid haemorrhage and/or intracranial
haemorrhage
28.
29. Pg 1.26 sarawak
Drug
s
Dose Remarks
Labetolol
20 mg injected slowly for at least 2 min; followed by 40-80 mg every
10 min.
Max: 200 mg
Caution in heart
failure.
Nitroglycerin
e
Initial: 5-25 mcg/min.
Usual range: 10-200 mcg/ min; up to 400 mcg/min
in some cases.
Preferred in ACS and
acute pulmonary oedema.
Isoke
t
IV infusion 2-20 mg/hr, titrate based on target BP. Preferred in ACS
Hydralazin
e
Initial: 5-10 mg via slow inj, may repeat after 20-30 min.
Alternatively, as a continuous infusion, initial
dose of 0.2-0.3 mg/min.
Maintenance: 0.05-0.15 mg/min.
Caution in ACS, CVA and dissecting
aneurysm.
Unpredictable BP-lowering effects.
Nicardipin
e
Slow IVI at an initial rate of 5 mg/hr. Increase infusion rate as
necessary, up to max 15 mg/hr.
Consider reducing to 3 mg/hr
after response is achieved.
Caution in acute heart failure and
coronary ischaemia.
Esmolol
Loading dose of 80 mg over 15-30 sec, followed by an infusion of
150 mcg/kg/min, may increase to 300 mcg/kg/min if necessary.
Used in perioperative situations and
tachyarrhythmias.
Sodium
Nitroprusside
Initial: 0.3-1.5 mcg/kg/min, adjust gradually
as needed. Usual: 0.5-6 mcg/kg/min. Max rate: 8 mcg/kg/min,
discontinue if there is no response after 10 mins. May continue for a
few hr if there is response.
Caution in heart failure.
Require intraarterial blood pressure
monitoring. Lower dosing adjustmen
required for elderly and those alread
receiving antihypertensives.
34. Hypertension in Elderly
Respond to non-
pharmacological treatment
Drug dosage—Monotherapy
‘start low and go slow’
Treat when SBP>160
Age Target SBP
>80 <150
65- 80 <140
35. BP > 140/90mmHg
despite good medication
adherence while on
three or four anti-
hypertensive agents in
adequate doses.
Exclude secondary
causes
Spirinolactone is the
preferred 4th drug
BP are not
controlled after ≥5
antihypertensives
Beta blocker/ alpha
blocker or centrally
acting
Resistant Hypertension Refractory Hypertension
39. Reference
Clinical Practical Guideline, Management of
Hypertension, 5th edition, 2018
Eighth Joint National Committee Guidelines for
Management of Hypertension , 2014
Editor's Notes
33.6% in 2011 to 35.3% in 2015
2diag:3 undiag
More in rural, males.
Higher chance of mi, g\heart failure, stroke,kidney dis
Sbp rises through age, dbp after 50 years old
). Prognosis of masked hypertension is worse than isolated office hypertension.12
To exclude secondary causes of hypertension/presence of target organ damage or complication/assess lifestyle and identify other cardiovascular risk factors coexisting condition that affect prognosis and guide treatment
1kg =1 SBP, alc: 5-10mmHg
<5g salt or 2g K =8sbp/3dbp
150min of moderate aerobic exercise
When to choose : health , side effect, admin, cost, disorder
Stage 1 start monotherapy
S2, combination therapy
To refer when severe/ resistanr/ secondary/ onset TOD
side effects of the centrally acting agents include
drowsiness, dry mouth, headache, dizziness and mood change.
Rebound hypertension in clonidine
Reduce SBP to less than 140 mmHg during the first hour for patients with severe preeclampsia or eclampsia, and pheochromocytoma crisis. For patients with aortic dissection reduce SBP to less than 120 mmHg.
Labetolo n nicardipine is preferred, easy titrate n minimal vasodilation on cerebral perfusion
Within day to week after stroke,decrease in bp occur
Compliance, proper measurement, not white coat, combo drug ( ARS, CCB, diuretic), not on OCP, steroid tht may antagonisee antiHPT
Candidate for intervention/procedure based
