Diabetes mellitus chronic obstructive pulmonary

The most serious side effects early in ACS are hypotension, bradycardia, and heart block. Initial acute administration of //-blockers is not appropriate for patients presenting with decompensated heart failure. However, therapy may be attempted in most patients before hospital discharge after treatment of acute heart failure. Diabetes mellitus is not a contraindication to //-blocker use. If possible intolerance to //-blockers is a concern (e.g., due to chronic obstructive pulmonary disease), a short-acting drug such as metoprolol or esmolol should be administered IV initially. 

Prinzmetal s vasospastic angina, bronchospastic chronic obstructive pulmonary disease (COPD), asthma, occlusive peripheral vascular disease, type I diabetes mellitus that is prone to hypoglycemia, heart block, and excessive bradycardia are contraindications to /3-blockers. The main side effects of /S-blockers are... 

The standards issue becomes most problematic with patients who have multiple problems. It may be sensible to delay the treatment of pneumonia, for instance, while more urgent investigations and treatments are instituted. An additional problem is that of combining multiple treatments with the risk of adverse drug events and actually producing harm through the application of standard procedures. Wachter (2006) has argued that quality measurement is bewildered by the patient with multiple conditions, which is, of course, most people admitted to hospital and many older people outside hospital. He considers a hypothetical 79-year-old woman with five common diseases hypertension, osteoporosis, osteoarthritis, type 2 diabetes mellitus and chronic obstructive pulmonary disease ... 

---