Results 71 to 80 of 154
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July 10th, 2011 12:52 AM #71
marami factors sir uls.. on my part, i do not give beta blockers on elderly patients. they work by lowering your heart rate, lowering the amount of blood pumped out of heart, lowering bp. as we age, normally our heart slows down, so you cant afford to slow it down more. also beta blockers is the opposite of beta agonist (like salbutamol, w/c increases heart rate, palpitations as effects), that is why you cant give it to those with history of asthma, it can exacerbate it. combination drugs work better because the 2 drugs work synergistically (usually these 2 drugs are of different class, therefore different mode of actions, enhancing bp lowering effect)
ace inhibitors are also good.. but the most common side effect is what the patient hates, COUGH. arb's present their action on the later part of the chain, eliminating the cough side effect. in the long run, lots of factors are involved in the decision making.. one thing important is the medication price, of which metoprolol is the cheapest. kaya you see most people who are hypertensives are started on this... esp the younger, non-asthmatic ones...
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July 10th, 2011 01:26 AM #72
*surgeon_jm: just curious. what are your thoughts about giving citicoline among acute post-stroke patients?
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July 10th, 2011 01:30 AM #73
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July 10th, 2011 01:37 AM #74
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July 10th, 2011 07:31 AM #75
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July 10th, 2011 08:25 AM #76
dito rin.. and as well as the big medical centers here both in davao and tagum cities. citicoline is used more often than piracetam. its classified as a neuroprotector right? so it would be far more better given as prior to stroke rather than after the incident.
yup, for the edema. much like cva-bleed, or head trauma w/ bleeding, IV dexa would be better initially, but this is just my POV....
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July 10th, 2011 09:09 AM #77
citicoline supposedly helps neural regeneration, pero no effect on mortality..
the trend here is to use mannitol for the edema... that and diuretics.
hehe. am currently rotating in neurology... 90% of our ER admissions are strokes and I'm getting surprised with how many young stroke patients we have
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July 10th, 2011 01:26 PM #78
yehey! 2 medical professionals here
docs jm and scharnhorst, question...
since nasa stroke ang topic
i understand there are 2 kinds of stroke -- embolic and hemmorhagic
so when a patient is brought to you showing symptoms of stroke (slurred speech, weakness on 1 side of body etc) how do you find out what kind of stroke is it? i mean how do you find out really fast?
coz i also understand there is a 3 hour window of opportunity to prevent permanent damage if you inject the patient with tissue plasminogen activator to dissolve the blot clot
but you gotta find out first if the stroke is caused by a blood clot
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July 10th, 2011 01:30 PM #79
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July 10th, 2011 01:32 PM #80
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