Heart failure arrhythmia

Sibutramine is more effective than placebo with the most significant weight loss during the first 6 months of use. Dry mouth, anorexia, insomnia, constipation, increased appetite, dizziness, and nausea occur two to three times more often than with placebo. Sibutramine should not be used in patients with coronary artery disease, stroke, congestive heart failure, arrhythmias, or monoamine oxidase inhibitor use. 

Cydobenzaprine (Flexeril) [Skeletal Muscle Relaxant/ANS A nt] Uses Relief of muscle spasm Action Centrally acting skeletal muscle relaxant reduces tonic somatic motor activity Dose 5-10 mg PO bid-qid (2-3 wk max) Caution [B, ] Shares the toxic potential of theTCAs urinary hesitancy, NAG Contra Do not use concomitantly or w/in 14 d of MAOIs hyperthyroidism heart failure arrhythmias Disp Tabs SE Sedation anticholinergic effects Interactions t Effects of CNS d ression W/ CNS dqjressants, TCAs, barbiturates, EtOH t risk of HTN convulsions W/MAOIs EMS Use caution w/ other CNS depressants concurrent EtOH use can t CNS d ession OD May cause N/V,... 

Vascular disease, MI, angina pectoris, atrial fibrillation, heart failure, arrhythmia, atrial arrhythmia, and pulmonary embolism have been reported. 

The prospective studies have also demonstrated an association between untreated moderate-to-severe levels of OSAS and hypertension, congestive heart failure, arrhythmias, myocardial infarction, pulmonary hypertension, cor pulmonale, and stroke after adjusting for confounding factors such as obesity (29-32). Preeclampsia and averse fetal outcome have recently been described (33-36). 

Because of its potent anticholinergic properties, thioridazine shonld be used cautiously in patients with cardiac diseases snch as congestive heart failure, arrhythmias, angina pectoris, or heart block in encephalitis, Reye s syndrome, head injnry, respiratory disease, epilepsy and other seizure disorders, glaucoma, prostatic hypertrophy, urinary retention, Parkinson s disease, and pheochromocytoma because the drug may exacerbate these conditions and in hypocalcemia because it increases the risk of extrapyramidal reactions. 

Decline in cardiac output due to worsening heart failure, arrhythmias, or other primary cardiac causes... 

Cardiomyopathy. Cardiomyopathy, or diseased heart muscle, may reach a point at which the heart can no longer function. It arises from a combination of factors, including hypertension, arrhythmias, and valve disease. Other problems, such as congestive heart failure, cause the interrelated heart—lung system to break down. Because the heart can no longer adequately pump, duid builds up in the lungs and other areas. 

The Class I agents have many similar side effects and toxicities. The anticholinergic side effects include dry mouth, constipation, and urinary hesitancy and retention. Common gastrointestinal (GI) side effects include nausea, vomiting, diarrhea, and anorexia. Cardiovascular adverse effects are hypotension, tachycardia, arrhythmias, and myocardial depression, especially in patients with congestive heart failure. Common central nervous system (CNS) side effects are headache, dizziness, mental confusion, hallucinations, CNS stimulation, paraesthesias, and convulsions. 

Cardiovascular—congestive heart failure, decrease or increase in blood pressure, and cardiac arrhythmias... 

Occurs when the volume of extracellular fluid is significantly diminished. Examples include hemorrhage, fluid loss caused by burns, diarrhea, vomiting, or excess diuresis Occurs when the heart is unable to deliver an adequate cardiac output to maintain perfusion to the vital organs. Examples include as the result of an acute myocardial infarction, ventricular arrhythmias, congestive heart failure (CHF), or severe cardiomyopathy. 

To reduce mortality, administration of an aldosterone antagonist, either eplerenone or spironolactone, should be considered within the first 2 weeks following MI in all patients who are already receiving an ACE inhibitor (or ARB) and have an EF of equal to or less than 40% and either heart failure symptoms or diagnosis of diabetes mellitus.3 Aldosterone plays an important role in heart failure and in MI because it promotes vascular and myocardial fibrosis, endothelial dysfunction, hypertension, left ventricular hypertrophy, sodium retention, potassium and magnesium loss, and arrhythmias. Aldosterone antagonists have been shown in experimental and human studies to attenuate these adverse effects.70 Spironolactone decreases all-cause mortality in patients with stable, severe heart failure.71... 

Angina, arrhythmias, congestive heart failure, mitral valve prolapse, myocardial infarction... 

Prolonged exposure to elevated GH and IGP-Is can lead to serious complications in patients with acromegaly. Aggressively manage comorbid conditions such as hypertension, diabetes, arrhythmias, coronary artery disease and heart failure to prevent vascular and neuropathic complications. It is critical to monitor patients indefinitely for management of the comorbidities associated with acromegaly8 (Table 43-4). 

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