By Adam Schneeweiss M.D., Gotthard Schettler M.D. (auth.)
Cardiovascular drug treatment has markedly improved within the contemporary many years. not just have new medicines been brought to scientific perform, yet new sessions of gear were constructed. whereas in 1960 the working towards cardiolo gist had a variety of approximately basically ten medications, in 1987 approximately one hundred fifty medications are repeatedly utilized in cardiovascular illnesses. aged sufferers, despite the fact that, frequently don't benefit from the complete advantage of this growth. this could be because of lack of knowledge, a conservative technique, or the global tendency to not try out new medications within the aged. it truly is now transparent that most of sufferers that may be handled in automobile diovascular clinics should be, within the close to destiny, aged sufferers. Even now, aged sufferers shape approximately one-third of the sufferers with cardiovascular ailments. those sufferers are approached, besides the fact that, in response to standards devel oped for more youthful populations. this is often even though aged sufferers fluctuate from more youthful ones in such a lot points, together with pathology, epidemiol ogy, pathophysiology, diagnostic procedure, administration, pharmacology, pharmacokinetics, rehabilitation, and supportive therapy. it's the goal of this e-book to provide to the clinician all medicinal drugs with which there's scientific adventure within the aged or that may be almost certainly necessary for the aged with cardiovascular ailments. the knowledge are provided with no the authors taking a place. this could enable the clinicians to make their very own choice and individualize remedy, vii viii Preface in accordance with a large information base. Comparative info are awarded merely whilst particular comparative experiences have been performed.
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Additional info for Cardiovascular Drug Therapy in the Elderly
53. Taylor BB, et al: Digoxin studies in the elderly. Age Ageing 3:79, 1974. 54. Lukas DS: Some aspects of the distribution and disposition of digoxin in man. Ann NY Acad Sci 179:338, 1971. 55. Lindenbaum ], et al: Inhibition of digoxin absorption by neomycin. Gastroenterology 71:339, 1976. 56. Cook], Smith ]A: Absence of interaction of digoxin with antacids under clinical conditions. Br Med] 21:1166, 1978. 57. Hager WD, et al: Digoxin bioavailability during quinidine administration. Clin Pharmacol Ther 30:594, 1981.
Treatment of arrhythmias usually consists of lidocaine or phenytoin. This is because these agents do not enhance AV nodal conduction disturbances associated with digitalis and may even improve A V nodal conduction. Moreover, these agents do not interact with digitalis. Antiarrhythmic agentssuch as quinidine, verapamil, and amiodarone-which interact with digoxin to increase its serum concentration and aggravate digoxin-induced A V nodal conduction disturbances, should not be used in cases of digoxin toxicity.
In our experience, dobutamine is less well tolerated hemodynamically in the elderly, but this may be attributed to more advanced diseases in these patients. 5 p,g/ kg·min. 0 p,g/kg·min and gradually titrated to the optimal dose. REFERENCES 1. Wagner], Schumann H]: Stimulation of beta-ad reno receptors by dobutamine in the guineapig atrium and tracheal chain. Naunyn Schmiedebergs Arch Pharmacal 308:19, 1979. 2. Maccarrone C, et al: Beta-adrenoceptor selectivity of dobutamine: in vivo and in vitro studies.
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