Clinical Pharmacology of Antianginal Drugs


Book Description

When I was asked some years ago by the editors of the Handbook of Experimental Pharmacology to edit a new volume on Antianginal Drugs, I agreed on the condition that, in accordance with my scientific background, primary emphasis be given to clinical pharmacology and therapeutics. It soon turned out that, due to rapid developments in this field, nothing of the previous volume on Antianginal Drugs by Charlier (Vol. 31, 1971) could be retained apart from its basic idea of devoting considerable space to methodology. Since editors must operate within certain limits, I had to abstain from dealing with acute myocardial infarction in detail despite the well-known overlap between unstable angina, the preinfarction syndrome, and acute myocardial infarction. It was only possible for acute myocardial infarction and the concept of reduction of infarct size to be briefly discussed within the chapter on pathophysiology of acute coronary insufficiency. The chapter on invasive methods provided an opportunity to touch on new approaches to early intervention in acute myocardial infarction. Here, intracoronary streptokinase therapy and PTCA are considered, again with attention to the overlap between mechanical and pharmacological interventions.







Coronary Microvascular Dysfunction


Book Description

In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.




Pharmacological Treatment of Chronic Stable Angina Pectoris


Book Description

This book is intended for general cardiologists and other physicians involved in the care of patients with chronic stable angina (CSA). The goal of this book is to update clinicians on recent data on the medical management of patients with CSA. Ischemic heart disease remains a major public health problem. Chronic stable angina is the initial manifestation of ischemic heart disease in approximately one half of patients. Stable coronary artery disease is generally characterized by episodes of reversible myocardial demand/supply mismatch, related to ischaemia or hypoxia, which are usually inducible by exercise, emotion or other stress and reproducible—but, which may also be occurring spontaneously. Such episodes of ischaemia/hypoxia are commonly associated with transient chest discomfort (angina pectoris). The aim of the management of CSA is to reduce symptoms and improve prognosis. The management of these patients encompasses lifestyle modification, control of coronary artery disease risk factors, evidence-based pharmacological therapy and patient education. All patients with stable angina should be offered optimal medical treatment, defined as one or two anti-anginal drugs as necessary, plus drugs for secondary prevention of cardiovascular disease. Regarding the role of revascularization, randomised trials provide compelling evidence that myocardial revascularisation by coronary artery bypass grafting or by percutaneous coronary intervention improves symptoms of angina relative to continued medical treatment.




Organic Nitrates


Book Description

Nitroglycerin and other organic nitrates have been used for over a century in the treatment of angina pectoris. Millions of patients, throughout the world, have placed nitroglycerin tablets under the tongue and have experienced rapid and dramatic relief from the chest pain that frequently occurs as a manifestation of disease of the coronary arteries. The empirical observation of the safe use of nitrates for tile alleviation of the symptoms of angina have led to their widespread medical acceptance. The use of organic nitrates preceded any knowledge of their mechanism of action or their ultimate metabolic fate. Thus, more simply stated, although sub lingual nitrates helped the patients, little was known concerning what these drugs do to the body or what the body does to the drugs. A substantial number of investigators have focused on these questions especially during the last two decades. We now have considerably more insight into the pathways of degradation of organic nitrates and the relationship of the metabolic processes to the biological action of these agents. Similarly, considerable effort has been expended in understanding the mechanism of action of these agents directly on vascular smooth muscle and on cardiac work and performance. Finally, there is a more substantive understanding of the physiology of the coronary circulation as well as the" pathophysiologic manifestations of myocardial disease.




Heart and Toxins


Book Description

The Heart and Toxins brings together global experts to provide the latest information and clinical trials that make the connection between genetic susceptibility, gene expression, and environmental factors in cardiovascular diseases. This unique reference, edited by renowned cardiologist Meenakshi Sundaram Ramachandran, solves the problem of managing multiple clinical cases of cardiovascular toxicity. It allows connections to be made between research, diagnosis, and treatment to avoid higher morbidity and mortality rates as a result of cardiovascular toxicity. - Structured to bring together exploration into the epidemiology, molecular mechanism, pathogenesis, environmental factors and management in cardiovascular toxins - Included various topics on cardiovascular toxins such as plant, chemical, animal, nanomaterial and marine biology induced cardiac damage – which are new ideas discussed in detail - Comprehensive chapters on the cardiovascular toxicity from drugs, radiotherapy and radiological imaging - Enables you to manage multiple clinical cases of cardiovascular toxicity - Outlined conclusions at the end of each chapter providing "key learning points to help you organize the chapter's details without losing insight




Heart Failure: A Companion to Braunwald's Heart Disease E-Book


Book Description

Up-to-date, authoritative and comprehensive, Heart Failure, 4th Edition, provides the clinically relevant information you need to effectively manage and treat patients with this complex cardiovascular problem. This fully revised companion to Braunwald's Heart Disease helps you make the most of new drug therapies such as angiotensin receptor neprilysin inhibitors (ARNIs), recently improved implantable devices, and innovative patient management strategies. Led by internationally recognized heart failure experts Dr. G. Michael Felker and Dr. Douglas Mann, this outstanding reference gives health care providers the knowledge to improve clinical outcomes in heart failure patients. - Focuses on a clinical approach to treating heart failure, resulting from a broad variety of cardiovascular problems. - Covers the most recent guidelines and protocols, including significant new updates to ACC, AHA, and HFSA guidelines. - Covers key topics such as biomarkers and precision medicine in heart failure and new data on angiotensin receptor neprilysin inhibitors (ARNIs). - Contains four new chapters: Natriuretic Peptides in Heart Failure; Amyloidosis as a Cause of Heart Failure; HIV and Heart Failure; and Neuromodulation in Heart Failure. - Covers the pathophysiological basis for the development and progression of heart failure. - Serves as a definitive resource to prepare for the ABIM's Heart Failure board exam. - 2016 British Medical Association Award: First Prize, Cardiology (3rd Edition).




Cardiovascular Therapeutics E-Book


Book Description

Manage cardiovascular problems more effectively with the most comprehensive resource available! A trusted companion to Braunwald's Heart Disease, Cardiovascular Therapeutics, 4th Edition addresses pharmacological, interventional, and surgical management approaches for each type of cardiovascular disease. This practical and clinically focused cardiology reference offers a balanced, complete approach to all of the usual and unusual areas of cardiovascular disease and specific therapies in one concise volume, equipping you to make the best choices for every patient. Consult this title on your favorite e-reader with intuitive search tools and adjustable font sizes. Elsevier eBooks provide instant portable access to your entire library, no matter what device you're using or where you're located. Understand current approaches to treating and managing cardiovascular patients for long-term health, for complex problems, and for unusual cardiac events. Benefit from the substantial experience of Elliott M. Antman, MD, Marc S. Sabatine, MD, and a host of other respected authorities, who provide practical, evidence-based rationales for all of today's clinical therapies. Expand your knowledge beyond pharmacologic interventions with complete coverage of the most effective interventional and device therapies being used today. Easily reference Braunwald's Heart Disease, 9th Edition for further information on topics of interest. Make the best use of the latest genetic and molecular therapies as well as advanced therapies for heart failure. Cut right to the answers you need with an enhanced focus on clinically relevant information and a decreased emphasis on pathophysiology. Stay current with ACC/AHA/ESC guidelines and the best ways to implement them in clinical practice. Get an enhanced visual perspective with an all-new, full-color design throughout.




Introduction to Basics of Pharmacology and Toxicology


Book Description

This book explains the pharmacological relationships between the various systems in the human body. It offers a comprehensive overview of the pharmacology concerning the autonomic, central, and peripheral nervous systems. Presenting up-to-date information on chemical mediators and their significance, it highlights the therapeutic aspects of several diseases affecting the cardiovascular, renal, respiratory, gastrointestinal, endocrinal, and hematopoietic systems. The book also includes drug therapy for microbial and neoplastic diseases. It also comprises sections on immunopharmacology, dermatological, and ocular pharmacology providing valuable insights into these emerging and recent topics. Covering the diverse groups of drugs acting on different systems, the book reviews their actions, clinical uses, adverse effects, interactions, and subcellular mechanisms of action. It is divided into 11 parts, subdivided into several chapters that evaluate the basic pharmacological principles that govern the different types of body systems. This book is intended for academicians, researchers, and clinicians in industry and academic institutions in pharmaceutical, pharmacological sciences, pharmacy, medical sciences, physiology, neurosciences, biochemistry, molecular biology and other allied health sciences.




Pharmacology in 7 Days for Medical Students


Book Description

Pharmacological knowledge among medical students can have a very short 'half life': students often fail not because they have failed to study, but because they have been unable to retain key knowledge and reproduce it in an exam setting. This book takes an alternative route to the conventional approach of comprehensively exploring each individual drug and its features: not only can such an approach overwhelm and make knowledge retention difficult, but the current exam format makes questions structured in this way unlikely anyway. Instead of aiming to be completely comprehensive, it examines drugs systematically by classifications, mechanisms of action, therapeutic uses and side effects, enabling students to gain the distilled, functional grasp of pharmacology that their exams actually demand quickly and clearly.