Propranolol found superior to Metoprolol for electrical storm
Propranolol found superior to Metoprolol for electrical storm: Use of propranolol has gone down with the availability of newer beta blockers. Here is one study which suggests that we may have to go back to propranolol in certain situations. The study by Chatzidou S et al [1] has found that propranolol is superior to metoprolol in the treatment of electrical storm along with intravenous amiodarone. Propranolol has a membrane stabilizing effect (local anaesthetic effect), which is not there for metoprolol. Of course metoprolol is beta one specific and has other advantages which propranolol does not have, being a non select...
Source: Cardiophile MD - April 30, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology Source Type: blogs
Beta blocker in HOCM – Cardiology MCQ
Which of the following beta blockers is not an ideal choice in the treatment of hypertrophic obstructive cardiomyopathy?
a) Metoprolol
b) Propranolol
c) Sotalol
d) Carvedilol
Post your answer as a comment below. Correct answer will be published on: Apr 24, 2018 @ 19:32
The post Beta blocker in HOCM – Cardiology MCQ appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - April 23, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
The cirrhosis chalk talk
Some days on ward rounds we have time for relatively short chalk talks. Over the years I have developed many. Learners seem to like this one in particular.
We start with this question – name complications that cirrhotic patients develop for which we have secondary prevention. Knowing this list and the associated drugs allows us to peruse the drug list to add to the PMH when it is not readily available.
Here is my list:
Esophageal varices – most patients with significant varices are taking a non-specific beta blocker. More recently evidence suggests that carvedilol might be better than propranolol or nad...
Source: DB's Medical Rants - April 2, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Cardiology MCQ Test 6
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Source: Cardiophile MD - October 27, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Enthusiasm for Rapamycin and Polypills in the Search for Ways to Slow Aging
The author of this paper is one of the more outspoken advocates in the research community when it comes to mTOR and rapamycin as a path to slowing the progression of aging. He keeps up quite the output of position papers, such as this one, which calls for immediate human trials of polypills made up of rapamycin and a brace of other drugs broadly used in treatment of age-related conditions, such as statins and metformin. I have to think that the evidence to date suggests this will be less effective than hoped, while still very plausibly being better than doing nothing, even considering the side-effects of the drugs involved...
Source: Fight Aging! - June 21, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Are these prescription drugs preventing your weight loss?
A number of drugs prescribed to treat common conditions, such as hypertension, allergies, depression, inflammation, and diabetes, block your ability to lose weight. Several of these drugs actually cause weight gain, and most doctors fail to inform their patients of such side effects. Among the drugs that block weight loss are:
Beta-blockers: metoprolol, atenolol, carvedilol, and propranolol
Antidepressants: amitriptyline (Elavil), nortriptyline (Pamelor), doxepin, paroxetine (Paxil), trazodone, and others
Steroids: prednisone and hydrocortisone (but not inhaled or nasal steroids for allergies)
Antihistamines: diphenhydr...
Source: Wheat Belly Blog - September 13, 2016 Category: Cardiology Authors: Dr. Davis Tags: Depression Dr. Davis Drugs and wheat Nutritional supplements Weight loss Wheat Belly Wheat Belly Lifestyle Wheat Belly Total Health Wheat-Free Lifestyle anxiety Source Type: blogs
Nitrates – Cardiology MCQ
Wrong statement about nitrates:
a) Predominantly venodilators
b) Have coronary vasodilator effects
c) Contraindicated in vasospastic angina
d) Should be avoided in hypotensive patients
Correct answer: c) Contraindicated in vasospastic angina
Nitrates are useful in vasospastic angina. Non selective betablockers like propranolol are avoided in vasospastic angina as they can cause alpha overactivity. Nitrates are contraindicated in those on phosphodiesterase-5 inhibitor sildenafil. (Source: Cardiophile MD)
Source: Cardiophile MD - August 24, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
DM / DNB Cardiology Entrance New Test Series 5
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Source: Cardiophile MD - August 6, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
DM / DNB Cardiology Entrance New Test Series 4
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Source: Cardiophile MD - July 16, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Beta-Blockers for Cocaine and other Stimulant Toxicity
Dogma: “a belief or set of beliefs that is accepted by the members of a group without being questioned or doubted; a point of view or tenet put forth as authoritative without adequate grounds.”
Years ago I treated a university student who presented to the emergency department (ED) after drinking several cans of a popular caffeinated energy drink to “pull an all-nighter” during final exam week. He was tremulous, agitated, and pale, with sinus tachycardia ranging from 140 to 160 bpm and normal blood pressure (BP). The house officer (registrar) working with me that night proposed treating him with a benzodiazepine, bu...
Source: Life in the Fast Lane - July 4, 2016 Category: Emergency Medicine Authors: John Richards Tags: Toxicology and Toxinology alpha stimulation amphetamines Beta Blockers cocaine dogma John Richards Stimulant Toxicity Stimulants Source Type: blogs
MKSAP: 61-year-old woman with progressive dyspnea and fatigue
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 61-year-old woman is evaluated for a 4-month history of progressive dyspnea and fatigue without chest pain. Eighteen months ago, she was diagnosed with liver cirrhosis due to nonalcoholic steatohepatitis (NASH). Medical history is also significant for obesity. Medications are propranolol, spironolactone, and lactulose.
On physical examination, temperature is 36.4 °C (97.5 °F), blood pressure is 112/64 mm Hg, pulse rate is 60/min, and respiration rate is 16/min; BMI is 36. Mild scleral icterus is noted. Cardi...
Source: Kevin, M.D. - Medical Weblog - May 7, 2016 Category: Journals (General) Authors: mksap Tags: Uncategorized Source Type: blogs
STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes
Conclusions: In the select group of hypokalemic patients studied, potassium infusions of 20 to 40 mmol delivered over 1 hr were safe to administer and effectively increased serum potassium levels in a dosedependent and predictable fashion. Furthermore, these results were independent of the patient's underlying renal function or associated diuretic administration. (Crit Care Med 1991; 19:694)Concentrated Potassium Chloride Infusions in Critically Ill Patients with HypokalemiaThe Journal of Clinical Pharmacology. Volume 34, Issue 11, pages 1077–1082, November 1994Although concentrated infusions of pota...
Source: Dr. Smith's ECG Blog - April 7, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 23
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Source: Cardiophile MD - March 25, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Orthostatic tremor - pearls
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); var pageTracker = _gat._getTracker("UA-3639768-12"); pageTracker._initData(); pageTracker._trackPageview(); Hassan A, Ahlskog AE, Matsumotos JY. Orthostatic tremor: clinical, electrophysiologic and treatment findings in 184 patients. Neurology 2016; 86: 458-464.The article is a Mayo series of 184 patients seen over 37 years. Definition: lower body tremor activated on standing, absent when s...
Source: neurologyminutiae - February 23, 2016 Category: Neurology Source Type: blogs
MKSAP: 54-year-old man with a tremor
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 54-year-old man is seen for follow-up evaluation of a tremor in his upper extremities that has been present since age 20 years. The tremor was mild for many years and did not interfere with his work but has become more prominent in recent years. He has difficulty writing and using utensils during meals. He has no associated slowness, stiffness, or change in gait. The patient started a trial of propranolol, which provided better control of the tremor, but after a few months, the tremor again worsened. He has su...
Source: Kevin, M.D. - Medical Weblog - December 19, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Neurology Source Type: blogs
