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Alpha Adrenergic Antagonist

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181. Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

–q26.2, Xq26 Desmin, myotilin, LIM domain binding protein 3, crystallin alpha B, filamin C gamma, BCL2-associated athanogene 3, four-and-a-half LIM domains 1 AD Common Rare (late; AF) Rare (AVB) AD indicates autosomal dominant; AF, atrial fibrillation; AFL, atrial flutter; AR, autosomal recessive; AT, atrial tachycardia; AVB, atrioventricular block; DCM, dilated cardiomyopathy; HCM, hypertrophic cardiomyopathy; LGMD, limb-girdle muscular dystrophy; LVNC, left ventricular noncompaction; RCM (...) associated with MFM, and mutations in these genes account for ≈50% of all cases of MFM: DES (encoding desmin), MYOT (encoding myotilin), LDB3 / ZASP (encoding LIM domain binding 3), CRYAB (encoding crystallin alpha B), FLNC (encoding filamin C, gamma) and BAG3 (encoding BCL2-associated athanogene 3). Recently, mutations in FHL1 (encoding four-and-a-half LIM domains 1), DNAJB6 (encoding a DNAJ protein family member), and TTN (encoding titin) have also been linked to MFM, and the list of genes causing MFM

2017 American Heart Association

182. Management of Cancer Pain in Adult Patients: ESMO Clinical Practice Guidelines

and tolerability of morphine administered orally or by epidural [159, 160]. An improvement in pain control as well as in adverse effects was shown by switching from oral to epidural infusion of mor- phine [159]. However, Kalso et al. showed no signi?cant bene?ts, either in ef?cacy or in adverse effects, by administering morphine via the epidural route compared with the s.c. route. The authors concluded that the co-administration of local anaesthetic agents, alpha-2-adrenergic agonists or NMDA antagonists may (...) strontium, samarium or rhenium has been investigated in a sys- tematic review [138]. The results showed only a small bene?cial ef- fect on pain control in the short and medium term (1–6 months), with no modi?cation of the analgesics used but relatively frequent adverse effects including leukopaenia and thrombocytopaenia. A randomised trial has evaluated the effect of radium-223 (an alpha emitter releasing short-range radiation, with little bone mar- row toxicity) in patients with castrate-resistant

2018 European Society for Medical Oncology

183. Pharmacological Management of Hypertension

controlled with triple therapy (i.e., thiazide-type diuretics, ACEI or ARB, and CCBs). Drug classes to consider include aldosterone receptor antagonists (e.g., spironolactone); peripherally acting antiadrenergic agents (e.g., reserpine); direct vasodilators (e.g., hydralazine); dual alpha-beta adrenergic blockers (e.g., carvedilol); and centrally acting antiadrenergic drugs (e.g., clonidine). The ACP/AAFP guideline does not address pharmacologic treatment of refractory hypertension. Areas of Difference (...) diuretics, ACEI or ARB, and CCBs] described in Recommendation 43) or as supplementary therapy in some clinical indications. Drug classes for consideration can include (not in priority order): Aldosterone/mineralocorticoid receptor antagonists (e.g., spironolactone, eplerenone) Other potassium-sparing diuretic (i.e., amiloride) Alpha-adrenergic blockers Beta-adrenergic blockers Non-dihydropyridine CCBs Combined alpha-beta adrenergic blockers Peripherally acting antiadrenergic agents (reserpine, pending

2017 National Guideline Clearinghouse (partial archive)

186. CRACKCast E099 – Urological Disorders

of the catheter [3] What are two medication classes of drugs for prostatic enlargement? ALPHA-ADRENERGIC RECEPTOR ANTAGONIST Alfuzosin 10 mg once daily Doxazosin 1 mg once daily Tamsulosin 0.4 mg once daily Terazosin 1 mg once daily or at bedtime 5-ALPHA-REDUCTASE INHIBITORS Dutasteride 0.5 mg once daily Finasteride 5 mg once daily [4] Describe the testicular salvage rates (Fig. 89.9) Any delay beyond 6 hrs is associated with testicular loss and infertility (>60% after 6 hrs). By 24 hrs there is a 50% salvage (...) by dropping GRF to the obstructed kidney) Fentanyl prn ondansetron prn Fluids (although no evidence for this) What is medical expulsive therapy? When can it be used? Useful for distal ureteral stones less than 10 mm. Alpha1-antagonists Tamsulosin 0.4 mg po daily OR Calcium channel blockers Nifedipine xr 30 mg po daily Thought to facilitate distal stone expulsion, decrease time to stone passage, and block ureteral smooth muscle contraction More evidence for alpha blockers, but there are notable side

2017 CandiEM

187. Tadalafil Medical Expulsive Therapy in Ureteral Calculi: A New Kid on the Block?

a high ureteral stone expulsion rate as well as significant pain control. You wonder how it might compare to α-receptor blockers, such as tamsulosin or silodosin. Search Strategy Medline 1966-11/15 using OVID interface, Cochrane Library (2015), and Embase (exp ureteral obstruction/ or exp ureteral calculi/ or exp renal colic) AND [(exp adrenergic alpha-antagonists/ or tamsulosin.mp or silodosin.mp) AND (exp phosphodiesterase-5 inhibitors/ or tadalafil.mp)]. Limit to human, English language Search (...) Episodes Group B had a lower mean number of colic episodes than Group A (0.45 vs. 1.60, p Mean Number of Hospital Visits Group B had a lower mean number of hospital visits than Group A (2.2 vs. 2.85, p=0.001). Adverse Effects There was no statistically significant difference in rates of adverse effects, but there was a trend towards increased rates of adverse effects in Group B compared to Group A. Comment(s) α-adrenergic antagonists such as tamsulosin have been used to treat patients with renal colic

2017 BestBETS

188. Hypertension management and renin-angiotensin-aldosterone system blockade in patients with diabetes, nephropathy and/or chronic kidney disease

, PubMed/MEDLINE, Google Scholar and Embase, using the following key terms: type 1 diabetes, type 2 diabetes, hypertension, albuminuria, microalbuminuria, microvascular complications, nephropathy, chronic kidney disease, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and mineralocorticoid antagonists. Table 1 Differentiating renal disease in diabetes Diabetic nephropathy (DN) Damage to the glomerular capillaries in patients with diabetes mellitus resulting in albuminuria (...) % of patients on losartan developed microalbuminuria compared with 6% on a placebo and 4% on enalapril over 5 years. It has been suggested that aldosterone escape during long-term RAAS blockade may be a mechanism by which ACE inhibition fails to prevent progressive renal disease in patients with type 1 diabetes. 61 Thus the use of aldosterone antagonists in such patients may be useful. Spironolactone has been investigated in a small study of patients with type 1 diabetes and microalbuminuria. 62

2017 Association of British Clinical Diabetologists

189. CrackCAST E129 – Bacteria

about 4 days after the onset of disease. Long-acting nondepolarizing agents are preferred. Progress to IV NDMR (pancuronium) Consider for early Tracheostomy Autonomic instability requires monitoring and aggressive treatment. Sympathetic hyperactivity can be treated with combined alpha- and beta-adrenergic antagonists, such as labetalol and propranolol. Esmolol is ideal. Consider morphine and magnesium infusions. Try to avoid catecholamines. Elimination of unbound tetanospasmin Passive immunization (...) alpha (TNF-α), and interleukins at a rate and magnitude many fold greater than with the normal antigen presentation, which begin the cascade of systemic vasculitis and the multisystem manifestations of the disease. Anything that puts you at risk for developing Staph. Aureus infections! Orifices packed with foreign bodies, concurrent infections, comorbidities Non-menstrual staphylococcal TSS is associated with superinfection of various skin lesions, including burns, surgical sites, dialysis catheters

2017 CandiEM

190. CRACKCast E119 – Allergy, Hypersensitivity, Angioedema, and Anaphylaxis

to the site, and start the inflammatory reaction. No antibodies are involved. This type of reaction is seen in contact dermatitis, erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. [2] Describe 5 mechanism of epinephrine in anaphylaxis Epinephrine derives its therapeutic value from its combined alpha-adrenergic and beta-adrenergic actions: Receptor Stimulation Physiologic Response Alpha-1 ● Vasoconstriction ● Increased PVR ● Decreased mucosal edema Beta-1 ● (+) Inotropy (...) , but it is believed to be non-immunologic (non-IgE). Clinically, the risk for severe adverse reaction with ionic and nonionic contrast materials is less than 1%. Standard Treatment Protocol for Patients with Hx of RCI Anaphylaxis Prednisone 50 mg by mouth given 13 hours, 7 hours, and 1 hour before the procedure Consider an H2 antagonist, such as ranitidine 150 mg by mouth given 3 hours before the procedure Diphenhydramine 50 mg PO given 1 hour before the procedure Consider ephedrine 25 mg by mouth given 1 hour

2017 CandiEM

191. Interventions Targeting Sensory Challenges in Children with Autism Spectrum Disorder - An Update

and Independent Transitioning by Students with Autism Spectrum Disorder. Journal of Autism & Developmental Disorders. 2011;41(6):687- 704 18p. doi: 10.1007/s10803-010-1088-6. PMID: 104896825. Language: English. Entry Date: 20110719. Revision Date: 20150711. Publication Type: Journal Article.X-3, X-4 754. Mehta MV, Gandal MJ, Siegel SJ. mGluR5-antagonist mediated reversal of elevated stereotyped, repetitive behaviors in D-65 the VPA model of autism. PLoS One. 2011;6(10):e26077. doi: 10.1371/journal.pone

2017 Effective Health Care Program (AHRQ)

193. Atrial Fibrillation

with atrial fibrillation 32 8.4 Structured follow-up 32 8.5 Defining goals of atrial fibrillation management 32 9 Stroke prevention therapy in atrial fibrillation patients 33 9.1 Prediction of stroke and bleeding risk 34 9.1.1 Clinical risk scores for stroke and systemic embolism 34 9.1.2 Anticoagulation in patients with a CHA 2 DS 2 -VASc score of 1 in men and 2 in women 35 9.1.3 Clinical risk scores for bleeding 35 9.2 Stroke prevention 36 9.2.1 Vitamin K antagonists 36 9.2.2 Non-vitamin K antagonist (...) oral anticoagulants 37 9.2.3 Non-vitamin K antagonist oral anticoagulants or vitamin K antagonists 41 9.2.4 Oral anticoagulation in atrial fibrillation patients with chronic kidney disease 41 9.2.5 Oral anticoagulation in atrial fibrillation patients on dialysis 42 9.2.6 Patients with atrial fibrillation requiring kidney transplantation 42 9.2.7 Antiplatelet therapy as an alternative to oral anticoagulants 42 9.3 Left atrial appendage occlusion and exclusion 43 9.3.1 Left atrial appendage occlusion

2016 European Society of Cardiology

194. Odefsey (emtricitabine / rilpivirine / tenofovir alafenamide) - HIV-1

values up to 8.0. Tenofovir alafenamide fumarate is freely soluble in methanol, soluble in ethanol, sparingly soluble in isopropanol and slightly soluble in acetone. Tenofovir alafenamide exhibits stereoisomerism due to the presence of three chiral centres. The chiral centre at the propyloxy- side chain is in the R-configuration. The absolute stereoconfiguration of the carbonylethylamino- substituent has the S-configuration at the alpha-carbon. The remaining stereocentre is located at the phosphorus

2016 European Medicines Agency - EPARs

195. Effect of weight reduction on severity of lower urinary tract symptoms in obese men with benign prostatic hyperplasia. (Abstract)

, Department of Surgery, The Chinese University of Hong Kong. So W Y WY Department of Medicine and Therapeutics, Prince of Wales Hospital. Yip S Kh SK Private practice. Wu E E Physiotherapy Department, Prince of Wales Hospital. Yau P P Dietetic Department, Prince of Wales Hospital. eng Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't China Hong Kong Med J 9512509 1024-2708 0 Adrenergic alpha-Antagonists IM Adrenergic alpha-Antagonists therapeutic use Aged Hong Kong Humans Lower

2018 Hong Kong medical journal = Xianggang yi xue za zhi Controlled trial quality: uncertain

196. Urinary incontinence in neurological disease: assessment and management

project team 38 Guideline Development Group 38 Co-optees/expert advisors 39 National Clinical Guideline Centre 39 NICE project team 40 Appendix B: Glossary 41 Alpha-blocking agents 41 Antimuscarinic drugs 41 Augmentation cystoplasty 41 Autologous fascial sling surgery 41 Behavioural management programmes 41 Biofeedback 42 Bladder retraining 42 Bladder stone 42 Cauda equina compression 42 Cystectomy 42 Filling cystometry 42 Habit retraining 42 Hydronephrosis 42 Ileal conduit diversion 43 Neurogenic 43 (...) with the device, the possible need for repeat operations and alternative procedures ensure that the bladder has adequate low-pressure storage capacity. 1.4.6 Monitor the upper urinary tract after artificial urinary sphincter surgery (for example, using annual ultrasound scans), as bladder storage function can deteriorate in some people after treatment of their neurogenic stress incontinence. 1.5 Treatment to improve bladder emptying Alpha-block Alpha-blockers ers 1.5.1 Do not offer alpha-blockers to people

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

197. Omidria - phenylephrine / ketorolac

, and to reduce acute postoperative pain. Phenylephrine is an a1-adrenergic receptor agonist and acts as a mydriatic agent by contracting the radial muscle of the iris, dilating the pupil with little or no cycloplegia. Vasoconstriction occurs in the conjunctival circulation and in other ocular vessels to the extent that they are exposed to drug. Assessment report EMA/CHMP/289528/2015 Page 22/67 Ketorolac is an NSAID that inhibits both cyclooxygenase enzymes (COX1 and COX2), reducing pain and inflammation

2015 European Medicines Agency - EPARs

198. Genvoya - elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide

in isopropanol and slightly soluble in acetone. Tenofovir alafenamide exhibits stereoisomerism due to the presence of three chiral centres. The chiral centre at the propyloxy side chain is in the R-configuration. The absolute stereoconfiguration of the carbonylethylamino substituent is derived from the amino acid L-alanine, which has the S-configuration at the alpha-carbon. The remaining stereocentre is located at the phosphorus atom and is in the Sp configuration. Enantiomeric purity is controlled routinely

2015 European Medicines Agency - EPARs

199. Aripiprazole Mylan - aripiprazole

. Aripiprazole exhibited antagonist properties in animal models of dopaminergic hyperactivity and agonist properties in animal models of dopaminergic hypoactivity. Aripiprazole exhibited high binding affinity in vitro for dopamine D2 and D3, serotonin 5HT1a and 5HT2a receptors and moderate affinity for dopamine D4, serotonin 5HT2c and 5HT7, alpha-1 adrenergic and histamine H1 receptors. Aripiprazole also exhibited moderate binding affinity for the serotonin reuptake site and no appreciable affinity

2015 European Medicines Agency - EPARs

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