Acute Coronary Syndrome ( A Group Of Conditions With Clinical Symptoms

Byerly, W. (2009). Working with the institutional review board. American Journal of Health-System Pharmacy: AJHP: Official Journal Of The American Society Of Health System Pharmacists, 66(2), 176-184. Retrieved from http://library.kaplan.edu/content.php?pid=150035

(NICE 2015). A Cochrane review article assessed 25 studies, encompassing almost 12,864 patients of published randomized controlled trials of various lengths from 12 to 52 weeks. The review highlighted that individual study sizes and lengths of study were different, renal and hepatic function patient inclusion criteria between studies was different, and therefore it was not possible to directly compare the efficacy of individual agents within this drug class. (Richter et al., 2008) It must also be noted that some of these trials were funded by pharmaceutical companies, and therefore may be prone to bias. Inzucchi SE et Al, 2015 compiled an independent comparative report using twelve peer reviewed published studies of randomized double blind trials, that indicates as an add-on to metformin therapy, the individual drugs within the class, showed between 0.5% to 0.83% reduction in HbA1c versus placebo, with Saxagliptin Linagliptin and Sitagliptin showing the greatest equal efficacy (Inzucchi SE et Al, 2015). However, episodes of hypoglycaemia were reported in significantly lower numbers of patients on Sitagliptin (1.3%) compared to Saxagliptin (5.2%), hence Sitagliptin was the prescribing choice for patient XY. It is important to bear in mind that the cost of both drugs is similar (BNF 2015), and with imminent loss of patent with

During Phase 1, sufficient information about the drug’s pharmacokinetics and pharmacological effects should be obtained to permit the design of well-controlled, scientifically valid, Phase 2 studies.

Coumadin (non specific name: warfarin) is an anticoagulant, or blood diminishing drug, that is endorsed to numerous patients who are at danger for creating blood clusters that could bring about heart assaults or strokes. Warfarin is near the most astounding purpose recently and simultaneous investigations of medications that provoke ER visits and occurring an expansion in healing center based offices with the affirmation of patients. Anticoagulation treatment stances perils to patients and over and over prompts unfavorable solution events in light of complex dosing, fundamental ensuing watching, and clashing patient consistence. As a result, various patients who meet current evidence based principles for warfarin treatment are not being managed

Coronary artery disease (CAD) is the commonest heart disease in the United States1. Approximately, 29% of patients with Myocardial Infarction ( MI ) present with ST- elevation Myocardial Infarction ( STEMI )2. STEMI is the result of complete occlusion of a major epicardial coronary artery due to thrombus formation. STEMI from a small coronary artery presenting as substantial EKG abnormalities similar to occlusion of a major artery and hemodynamic instability is a rare entity. The epidemiology, typical clinical presentation, outcomes, and optimal management in this group of patients are not sufficiently known.

2013)In a previous report, we demonstrated that the benefits of apixaban versus warfarin were irrespective of age (221.0 μmol/L or calculated creatinine clearance <0.001). Rates of GI bleeding were not significantly different.(Schwarz UI, Ritchie MD, Bradford Y, et al. 2008) Based on these two phase III studies, apixaban was shown superior compared to aspirin and warfarin for the prevention of stroke and systemic embolism.17,18 To note, efficacy was shown in a patient population with a mean CHADS2 score of approximately two, compared with a mean CHADS2 of 3.5 in the ROCKET-AF trial of rivaroxaban. Apixaban did not show a significant decrease in the rates of cardiovascular mortality when compared with warfarin.

The pathophysiology of ACS includes the stable plaque forms get converted into unstable plaque forms.2 These unstable plaque forms have numerous thin fibrous cap cells, inflammatory cells, activated macrophages, and smooth muscle cells. Sympathetic activity increases myocardial contractility, pulse rate, blood pressure, and coronary blood flow which leads to plaque rupture or fissure. As the artery ruptures, it causes thrombus formation and ischemia in this particular artery. Depending on the condition, different thrombi could form. The unstable angina forms a small thrombus formation, NSTEMI forms a partial thrombus formation, and STEMI forms a complete and persistent thrombus. The risk factors involved in ACS are age, physical inactivity, and history of hypertension, diabetes, or angina. The signs of acute coronary syndromes are an acute heart failure, tachycardia, bradycardia, or heart blockage, and the symptoms of ACS consist of chest pain, pain in the extremities, nausea, shortness of breath, heavy

ACS also referred to as Acute Coronary syndrome is the blockage of blood flow to the heart. Some symptoms that occur when ACS takes place is chest pains (angina pectoris), having pains in the upper and lower extremities, shortness of breath, nausea and sweating. There are risk factors that can increase your risk for ACS such as smoking, high blood pressure, high cholesterol and diabetes. Some ways in order to test for ACS is a blood test and electrocardiogram. It can show whether or not heart cells are dying. After being diagnosed with ACS, treatment is available. Some treatment options include medications, angioplasty and stents.

VI CURRENT MEDICATIONS: Divalproex 500mg 1 tab every evening Po, Abilify 15 mg Po q

The analysis involved four small, randomised controlled trials that compared the impact of the two drugs on ICP and cerebral perfusion pressure (CPP). Two of these studies also included the impact the two drugs had on mortality and GOS.

Acute coronary syndrome encompasses patients diagnosed with unstable angina, non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (Amsterdam et al., 2014). Per the American College of Cardiology (2014), a rapid evaluation to identify life-threatening cardiac conditions is imperative for patients presenting to emergency departments with symptoms of acute coronary syndrome and an electrocardiogram is an essential tool for diagnosis (Amsterdam et al., 2014). Patients with ST-elevation myocardial infarction have a 7.4% increase in risk of mortality with every half-hour that passes before implementing appropriate reperfusion therapy (Omar, Helal, Mangar,

Patient is a 45 yo male; 5’7”, 221 lbs who entered the emergency room at 6:30 am on 9/7/14 with severe chest pain (onset at 6:00 am) radiating to his arm, L arm numbness and nausea and vomiting. Past medical history reported by wife includes peptic ulcer, tobacco use (1-2ppd for 27 years), elevated blood pressure (controlled by lopressor). Wife did not know of any family history but reports patient’s father is deceased, died at 42 in his sleep. Mother alive and with high blood pressure.

Brisdelle, a non-hormonal therapy for the treatment of hot flushes in menopause women is approved by FDA, which was filed as a 505(b)(2) application in which the sponsor Noven Therapeutics LLC has abbreviated some studies from Paxil and Pexeva, that belong to the class of SSRI. FDA, the regulating authority review the applications from sponsor and give a decision based on the data provided. For an NDA, a sponsor is required to follow various regulations and guidance documents provided by FDA. Also sponsor need to submit a high quality pre-clinical data like CMC, Pharmacology, safety pharmacology and toxicology studies and clinical studies to ensure that the drug is safe and effective. Overall, it is the responsibility of FDA’s Center for Drug Evaluation and Research (CDER) to regulate the drug approval process in united states.

The purpose of this report is two discuss the Pharmacodynamics, pharmacokinetics, proposed benefits, research method, results of research, and possible-nursing implications of newly approved drugs for the treatment of hypertension. These drugs include Atacand HCT and Diltiazem HCL. All newly approved drugs from the FDA are either new drugs or new formulations of older drugs. The information contained in this report was derived from various web pages and online search engines.

Heart attacks , we have all seen them played out on our favorite drama shows but these shows do not address the real severity of an actual heart attack despite the great acting skills portrayed . A heart attack can also be known as a myocardial infarction (MI), acute myocardial infarction (AMI), acute coronary syndrome, coronary thrombosis, or coronary occlusion, either way it is not good news. Over 1.2 million people in American have heart attacks with many of them resulting in death (Heart attack, 2011). A heart attack is a serious life threatening condition that needs to be treated quickly.