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The article analyzes properties of potassium and magnesium, which may exert vasodilatory, anti-inflammatory, anti-ischemic, antiaggregant, and antiarrhythmic effects. These are extremely important microelements and potentially beneficial therapeutic agents for treatment of cardiovascular diseases.
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Deficiencia de Magnesio , Antiarrítmicos , Enfermedades Cardiovasculares , Humanos , Magnesio , PotasioRESUMEN
We analyzed documentation of 648 outpatients with nonvalvular atrial fibrillation receiving ambulatory care in 3 cities in Russia (Moscow, Krasnodar, and Bryansk). Frequency of use of any anticoagulant in patients with AF and high risk of stroke and systemic embolism was low (30.9% overall, novel oral anticoagulants - 5.7%). But portions of patients who according to documents received antiaggregants or no antithrombotic drugs at all were high (53.6 and 13.4%, respectively). Among patients receiving warfarin only 19.6% checked international normalized ratio (INR) every month while 75% did it once in 3 months or rarer or did not control this parameter at all. Among patients in whom INR control was sufficiently regular only in 44% percentage of time in the therapeutic range exceeded 60%. Thus persistent effective anticoagulation was achieved only in 12.6% of warfarin treated outpatients.
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Aim of the study was to analyze the validity of pharmacoepidemiological purpose and structure of lipid-lowering therapy (LLT) in patients with hypertension and dyslipidemia in clinical practice. Demonstrated commitment to the basic principles of medical verification of cardiovascular events with an adequate definition of risk SCORE scale for patients with high and very high risk. However, the lack of definition of fractions of cholesterol is not allowed to make the right decision on the appointment of GLT for a number of patients with low and moderate risk. The advantage in the appointment of atorvastatin used (32.3%), simvastatin (27.8%) and rosuvastatin (20.9%), and from the antihypertensive subgroups - angiotensin converting enzyme inhibitors, -blockers, calcium antagonists, sartan. Revealed insufficient control of blood lipid in the dynamics on the background of LLT, low activity of doctors in the statin dose titration and use of combined LLT (6.9%) in order to achieve target levels of atherogenic key biochemical parameters. Taking into account the literature data on the most effective and priorities destination rosuvastatin and its high safety in clinical situations of forced polypharmacy we conducted pharmacoeconomic comparison of rosuvastatin several manufacturers of direct cost. Established a price advantage of rosuvastatin (tevastor) with respect to both the original drug, and to a number specified in the prescribing of generics. No fixed assignment LLT is testimony not revealed irrational combinations of drugs with contraindications recommendations, including the appointment of antihypertensive drugs. CONCLUSION: Further work is needed to evaluate pharmacoeconomic indicators LLT, to raise awareness of physicians to enhance quality control of medical assistance and measures to reduce the risk of complications in patients with cardiovascular disease of atherosclerotic origin.
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We conducted an anonymous survey among 382 physicians (58% internists, 42% cardiologists) in order to obtain information on their opinion on various aspects of antithrombotic therapy in atrial fibrillation. The survey revealed low level of awareness about algorithms of stratification of risks of stroke, systemic embolism, and bleeding. Reported rates of clinical use of recommended antithrombotic agents were: warfarin--30, aspirin monotherapy--19, dabigatran--10, rivaroxaban--8, and combination of aspirin and clopidogrel--8%. Rate of use of drugs without sufficient evidence base in AF was 25%. When asked to designate antithrombotic drug of choice 85% of physicians indicated warfarin and 12%--novel anticoagulants (NOAC). The following factors were considered as limiting wide application of NOAC: high cost (59%), lack of data on these drugs (14%), and impossibility to control safety of their administration (9%).
Asunto(s)
Fibrilación Atrial/tratamiento farmacológico , Actitud del Personal de Salud , Fibrinolíticos , Médicos , Accidente Cerebrovascular/prevención & control , Fibrilación Atrial/complicaciones , Competencia Clínica/normas , Fibrinolíticos/clasificación , Fibrinolíticos/farmacología , Humanos , Médicos/psicología , Médicos/normas , Garantía de la Calidad de Atención de Salud , Medición de Riesgo , Federación de Rusia , Accidente Cerebrovascular/etiología , Encuestas y CuestionariosRESUMEN
People with increased arterial pressure have more low regulatory-adaptive abilities than people with normal arterial pressure. The achievement of target blood pressure level with antihypertensive drugs is accompanied by normalization the regulatory-adaptive abilities. It is true only for people who had arterial hypertension less than 160/90 mm Hg until treatment.
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Adaptación Fisiológica , Presión Sanguínea , Hipertensión/fisiopatología , Antihipertensivos/uso terapéutico , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Masculino , Persona de Mediana EdadRESUMEN
The efficiency of drug therapy should be evaluated by not only its directed action on specific organ or target parameter, but also its effects on general regulatory and adaptive status.
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Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Antagonistas Adrenérgicos alfa/uso terapéutico , Bloqueadores de los Canales de Calcio/uso terapéutico , Doxazosina/uso terapéutico , Humanos , Nifedipino/uso terapéutico , Resultado del TratamientoRESUMEN
I.v. neurotensin induced acceleration of the heart rate which was prevented by with beta-adrenoreceptor blocker in anesthetised cats. Both neurotensin and adrenaline potentiated the vagal chronotropic effect and its tonic component. The synchronizing vagal component was inhibited by adrenaline. The findings suggest that the adrenergic link is involved in implementation of the cardiac effect exerted by neurotensin.
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Cardiotónicos/farmacología , Epinefrina/farmacología , Neurotensina/farmacología , Antagonistas Adrenérgicos beta/farmacología , Animales , Gatos , Interacciones Farmacológicas , Estimulación Eléctrica , Electrocardiografía/efectos de los fármacos , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/fisiología , Masculino , Propranolol/farmacología , Nervio Vago/fisiologíaRESUMEN
In cats, magnesium, potassium and finoptin diminished the vagal chronotropic effect whereas calcium potentiated it. In potassium chloride administration, the vagotropic action was due to a selective diminishing of the tonic component.