Nem Dec 09
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Presentation at CME program organized by Bangladesh Academy of Family Physicians (BAFP) in December 2009
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2. Reperfusion therapy uses thrombolytic drugs like streptokinase, alteplase, and tenecteplase to break up blood clots.
3. Other drugs are given to reduce blood pressure and heart strain, such as nitrates, beta blockers, and ACE inhibitors. Analgesics and anti-anxiety drugs provide pain relief. Anticoagulants like heparin prevent further clotting.
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This was prepared overnight with 4-5 hrs work time for the job interview, quantity and quality of ppt may be not upto mark
Thank You.
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Direct oral anticoagulants (DOACs) have similar efficacy to vitamin K antagonists (VKAs) for treating venous thromboembolism based on evidence from phase 3 trials. DOACs significantly reduce the risk of major bleeding, intracranial bleeding, and fatal or clinically relevant non-major bleeding compared to VKAs. The efficacy and safety of DOACs are maintained in key subgroups including those with cancer, obesity, renal impairment or advanced age. DOACs offer an improved benefit-risk profile for venous thromboembolism treatment compared to VKAs.
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Dabigatran is a direct thrombin inhibitor approved for reducing risk of stroke in non-valvular atrial fibrillation and for preventing blood clots after orthopedic surgery. It is administered orally twice daily and has similar efficacy to warfarin but does not require routine monitoring. However, dabigatran has risks including lack of antidote, difficulty modulating dose, and bleeding in elderly or renally impaired patients. It was the first new oral anticoagulant approved in the United States in decades.
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This document discusses NOAC anticoagulants and their reversal agents. It provides information on:
1. The advantages of NOACs over VKAs including their predictability, fewer drug interactions, and improved safety profile.
2. A meta-analysis found NOACs were associated with lower risks of major bleeding, fatal bleeding, and intracranial bleeding compared to VKAs.
3. Idarucizumab, a specific reversal agent for dabigatran, demonstrated 100% reversal of dabigatran's anticoagulant effect based on interim results from the RE-VERSE AD trial of 90 patients with uncontrolled bleeding or those requiring emergency surgery.
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how to increase and decrease the doses.
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1. The advantages of NOACs over VKAs including their predictability, fewer drug interactions, and improved safety profile.
2. A meta-analysis found NOACs were associated with lower risks of major bleeding, fatal bleeding, and intracranial bleeding compared to VKAs.
3. Idarucizumab, a specific reversal agent for dabigatran, demonstrated 100% reversal of dabigatran's anticoagulant effect based on interim results from the RE-VERSE AD trial of 90 patients with uncontrolled bleeding or those requiring emergency surgery.
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Dabigatran, rivaroxaban, and apixaban are novel oral anticoagulants (NOACs) that are alternatives to warfarin for preventing strokes in atrial fibrillation and treating deep vein thrombosis. Large clinical trials found these NOACs to be as effective as warfarin with less risk of bleeding. Dabigatran 150mg twice daily was more effective than warfarin at preventing strokes while 110mg twice daily had similar efficacy but lower bleeding. Rivaroxaban and apixaban were noninferior to warfarin with similar or lower risks of bleeding. Edoxaban is another NOAC that was found noninferior to warfarin in
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Tamsulosin hydrochloride is an alpha-1A and alpha-1D adrenoceptor antagonist used to treat benign prostatic hyperplasia by relaxing smooth muscles in the prostate and bladder. It is administered orally and works by selectively blocking alpha-1A and alpha-1D receptors, improving urinary flow. Common side effects include dizziness, headache, and diarrhea. Due to its selectivity, tamsulosin has fewer cardiovascular side effects than older non-selective alpha-blockers but can still cause hypotension. It is contraindicated in patients with orthostatic hypotension or taking other alpha-blockers and interactions may occur with cimetidine or sildenafil.
Treatement of Angina Pectoris
This document discusses the medical management of angina pectoris. It describes different types of angina that can be categorized and stresses the importance of notifying the physician about any changes in pain characteristics. Nitroglycerin is highlighted as the mainstay treatment for angina through various mechanisms like reducing myocardial oxygen demand and improving blood flow distribution. Beta-blockers and diuretics are also discussed as they decrease oxygen consumption and preload/afterload respectively. The roles of digitalis, antiarrhythmic drugs, exercise, anticoagulants and hypothyroidism in angina treatment are summarized.
Anti thrombotic therapy in difficult clinical conditions
This document discusses anti-thrombotic therapy in difficult clinical conditions. It summarizes various antiplatelet and anticoagulant drugs, difficult situations for their use including high ischemic or bleeding risk, and strategies for balancing thrombotic and hemorrhagic risks. Certain drugs like prasugrel and ticagrelor are preferred for high ischemic burden due to more potent platelet inhibition, while dose adjustments and shorter durations are recommended for high bleeding risk. Careful management is needed in situations like surgery, renal dysfunction, and pregnancy to minimize risks.
CASE PRESENTATION ON SYSTEMIC HYPERTENSION IN SOAP FORMAT.pptx
Systemic hypertension, or high blood pressure, is a chronic condition characterized by elevated pressure in the arteries. Typically measured in millimeters of mercury (mmHg), it's diagnosed when readings consistently exceed 130/80 mmHg. This condition, often symptomless, increases the risk of serious health complications like heart disease, stroke, and kidney failure. Contributing factors include genetics, age, unhealthy lifestyle habits, obesity, and stress. Treatment involves lifestyle changes—such as a healthy diet, regular exercise, and stress management—and, if necessary, medications to lower blood pressure. Regular monitoring and management are crucial to mitigate risks and maintain overall health.
Techno assignment 3 marks
Nifedipine is the active ingredient in PROCARDIA XL, which is an extended release tablet used to treat hypertension and chest pain called angina. It works by blocking calcium channels and relaxing blood vessels. PROCARDIA XL tablets have an osmotic pump system that slowly releases nifedipine over 24 hours for continuous effect. Common side effects include headache, dizziness, and ankle swelling. It can be used alone or combined with other blood pressure medications and is generally started at a low dose that is increased gradually based on the patient's response.
Presentation nsaids ams
- NSAIDs are the most commonly prescribed drugs for chronic pain but can have serious side effects.
- While effective for pain relief and inflammation, all NSAIDs inhibit the COX enzyme and can increase risks of gastrointestinal bleeding, kidney damage, and cardiovascular events.
- Newer COX-2 inhibitors were found to have lower risk of gastrointestinal side effects but similar or higher risk of cardiovascular events compared to other NSAIDs.
- Due to their risks and side effects, NSAIDs should generally only be used at the lowest effective dose for the shortest necessary time period. Non-drug alternatives and treatments should also be considered.
SOAPping MI
- The patient is a 60-year-old male who presented to the clinic with severe chest pain for 3 hours. Tests showed ST elevation on ECG and positive troponin levels, indicating ST elevation myocardial infarction (STEMI).
- The patient has a history of hypertension and hyperlipidemia. Echo showed no blood flow to part of the myocardium.
- The initial treatment plan included aspirin, clopidogrel, metoprolol, atorvastatin, lisinopril, ranitidine, morphine, and glyceryl trinitrate as needed for pain. Long-term medication and lifestyle changes were also recommended.
Anestesia
1. An epidural hematoma is a rare but potentially catastrophic complication of neuraxial procedures due to bleeding outside the dura that can compress neural tissue. Risk factors include low platelet count, anticoagulant use, and the procedure itself.
2. During pregnancy, changes like decreased LES tone and delayed gastric emptying increase the risk of aspiration. All pregnant patients are considered at high risk of aspiration regardless of last oral intake.
3. To reduce aspiration risk, guidelines recommend following fasting times, limiting clear liquid intake before procedures, and considering aspiration prophylaxis medications due to the low gastric pH and increased gastric volume common in pregnancy. The risk of complications from both neuraxial procedures and general
Chronic stable angina
Chronic stable angina is a chronic condition where episodes of chest pain occur periodically due to temporary deficiencies in the heart's blood supply. The document outlines the objectives, definition, epidemiology, pathophysiology, differences between chronic stable angina and acute coronary syndrome, pharmacological treatments including beta blockers, calcium channel blockers, nitrates, antiplatelet agents, ACE inhibitors, and ranolazine. It discusses patient education on drug effects, potential adverse effects and interactions, and monitoring requirements. Lifestyle recommendations including diet, exercise, smoking cessation, and weight loss are also provided.
ART: Management of associated conditions
This document discusses the management of various medical conditions that are commonly associated with infertility and may impact assisted reproductive technology (ART) outcomes. It covers conditions like obesity, polycystic ovary syndrome, diabetes, thyroid disease, and systemic lupus erythematosus. For each condition, it provides guidance on evaluation, treatment optimization before ART, protocols for ovarian stimulation, monitoring during ART cycles, prevention of ovarian hyperstimulation syndrome, and management during pregnancy. The goal is to counsel patients, minimize health risks, and improve the success rates of ART for patients with these associated conditions.
Myocardial infarction
This case presentation describes an 80-year-old female patient admitted to the ICU with a diagnosis of NSTEMI. Her medical history includes diabetes mellitus. On admission, her ECG showed NSTEMI and lab work was notable for elevated WBC and blood sugar. She was started on medications including aspirin, clopidogrel, atorvastatin, ISDN, and insulin. Over her 14-day hospital stay, her medications were adjusted for blood pressure control and management of symptoms like dyspnea and joint pain. Potential drug-drug interactions between her medications including omeprazole and clopidogrel were also assessed.
Schizophrenia
During my training in AL Amal psychiatric hospital I found cases that include many medication errors , so I did an analysis for this case and tried to address the medication error and mention the intervention according to the guideline.
Antiplatelets : target site, evidences, guidelines
This document discusses antiplatelet therapies and summarizes several studies on their use. It provides guidelines for antiplatelet treatment in different clinical scenarios, such as acute coronary syndrome or stent placement. It also discusses controversies around restarting aspirin after intracerebral hemorrhage and managing dual antiplatelet therapy following a bleed. The document emphasizes the need to balance bleeding risks against risks of stent thrombosis.
Similar to Nem Dec 09 (20)
Anti thrombotic therapy in difficult clinical conditions
Anti thrombotic therapy in difficult clinical conditions
CASE PRESENTATION ON SYSTEMIC HYPERTENSION IN SOAP FORMAT.pptx
CASE PRESENTATION ON SYSTEMIC HYPERTENSION IN SOAP FORMAT.pptx
Antiplatelets : target site, evidences, guidelines
Antiplatelets : target site, evidences, guidelines
More from Gauranga Dhar
2014 november-nem
WHAT IS NEW IN MEDICINE TODAY?
Bangladesh Academy of Family Physicians organizes continuing medical education (CME) program last Friday of each month during 9AM to 12 noon. Part of this CME program is a 15-20 minutes presentation on "What is new in medicine today?" This presentation is prepared and presented exclusively by me.
To prepare this presentation I need to go through number of journals, recently released guidelines etc., collect specific information regarding newest researches and present.
Bafp Free 2009
Mustard oil is generally considered heart healthy due to its low saturated fat content. However, it contains high levels of erucic acid, which studies have shown can damage heart muscles in large quantities. Tilapia fish also contains high levels of omega-6 fatty acids compared to omega-3, with ratios as high as 20:1. This imbalance promotes inflammation and heart disease more than red meat like bacon or hamburgers. While fish is typically recommended for a heart healthy diet, tilapia should be avoided due to its fatty acid profile.
Nem Oct 09
Presentation at CME program organized by Bangladesh Academy of Family Physicians (BAFP) in October 2009
Nem Nov 08
Presentation at CME program organized by Bangladesh Academy of Family Physicians (BAFP) in November 2008
Nem Oct 08
Presentation at CME program organized by Bangladesh Academy of Family Physicians (BAFP) in October 2008
Management Of Obesity In Family Practice Cme 30 May08
The document discusses obesity management in family practice. It defines obesity as a BMI of 30 kg/m2 or higher and notes that obesity is now a global epidemic according to the WHO. The management of obesity involves assessment to determine the degree and overall health status, followed by management focusing on weight loss, weight maintenance, and controlling other risk factors like cardiovascular disease and diabetes. Lifestyle and diet changes, physical activity, and behavior modification are emphasized as the primary non-pharmacological treatment approaches.
Dyslpidemia Cme Com 25 May09
This presentation was presented by me in one of the CME programs, held in Comilla, Bangladesh on the 25th. May 2009.
More from Gauranga Dhar (7)
Management Of Obesity In Family Practice Cme 30 May08
Management Of Obesity In Family Practice Cme 30 May08
Nem Dec 09
- 2. DR. G. C. DHAR. MD, DTM&H, MCFP (Canada) N E W I N M E D I C I N E ?
- 3. N O : 1
- 6. Associated with significant reduction in blood pressure Aspirin used after dinner is
- 7. No effect on blood pressure When used with breakfast
- 9. N O : 2
- 10. Urinary incontinence in post-menopausal women
- 11. Post-menopausal urinary incontinence. Estrogen deficiency is one of the reasons of
- 12. Prescription of estrogen / HRT May be considered BUT HOW?
- 15. N O : 3
- 19. N O : 4
- 20. B A C T E R I A
- 21. C O - T R I M O X A Z O L E
- 24. N O : 5
- 25. C O R T I C O S T E R O I D S A n t i-T N F M T X