Ventricular Flutter
Digitalis Glycosides
Cardiac Glycosides
Digoxin
Digitalis
Digitoxin
Glycosides
Cardenolides
Treatment Outcome
Anti-Infective Agents
Microbial Sensitivity Tests
The natural history of asymptomatic ventricular pre-excitation a long-term prospective follow-up study of 184 asymptomatic children. (1/2)
(+info)Influence of the mode of management of acute myocardial infarction on the inducibility of ventricular tachyarrhythmias with programmed ventricular stimulation after myocardial infarction. (2/2)
BACKGROUND: Programmed ventricular stimulation (PVS) is a technique for screening patients at risk for ventricular tachycardia (VT) after myocardial infarction (MI), but the results might be difficult to interpret. OBJECTIVES: To investigate the results of PVS after MI, according to date of completion. METHODS: PVS results were interpreted according to the mode of MI management in 801 asymptomatic patients: 301 (group I) during the period 1982-1989, 315 (group II) during 1990-1999, and 185 (group III) during 2000-2010. The periods were chosen based on changes in MI management. Angiotensin-converting enzyme (ACE) inhibitors had been given since 1990; primary angioplasty was performed routinely since 2000. The PVS protocol was the same throughout the whole study period. RESULTS: Group III was older (61 +/- 11 years) than groups I (56 +/- 11) and II (58 +/- 11) (P < 0.002). Left ventricular ejection fraction (LVEF) was lower in group III (36.5 +/- 11%) than in groups I (44 +/- 15) and II (41 +/- 12) (P < 0.000). Monomorphic VT < 270 beats/min was induced as frequently in group III (28%) as in group II (22.5%) but more frequently than in group I (20%) (P < 0.03). Ventricular fibrillation and flutter (VF) was induced less frequently in group III (14%) than in groups I (28%) (P < 0.0004) and II (30%) (P < 0.0000). Low left ventricular ejection fraction (LVEF) and date of inclusion (before/after 2000) were predictors of VT or VF induction on multivariate analysis. CONCLUSIONS: Induction of non-specific arrhythmias (ventricular flutter and fibrillation) was less frequent than before 2000, despite the indication of PVS in patients with lower LVEF. This decrease could be due to the increased use of systematic primary angioplasty for MI since 2000. (+info)Ventricular flutter is a type of abnormal heart rhythm that originates from the ventricles, which are the lower chambers of the heart responsible for pumping blood to the rest of the body. This rapid and disorganized electrical activity in the ventricles can cause the heart to beat very quickly, often at rates greater than 300 beats per minute, with little or no effective pumping action.
In ventricular flutter, the ventricles quiver or "flutter" instead of contracting effectively. This life-threatening arrhythmia can rapidly degenerate into ventricular fibrillation, another dangerous heart rhythm disturbance that can lead to sudden cardiac arrest and death if not treated promptly with defibrillation.
Ventricular flutter is typically associated with serious underlying heart conditions, such as coronary artery disease, cardiomyopathy, or previous heart attacks. People who experience ventricular flutter often require immediate medical attention, including cardioversion or defibrillation to restore a normal heart rhythm and potentially lifesaving interventions like medications or an implantable cardioverter-defibrillator (ICD) to prevent future episodes.
Digitalis glycosides are a type of cardiac glycoside that are derived from the foxglove plant (Digitalis purpurea) and related species. These compounds have a steroidal structure with a lactone ring attached to the molecule, which is responsible for their positive inotropic effects on the heart.
The two main digitalis glycosides used clinically are digoxin and digitoxin. They work by inhibiting the sodium-potassium pump in cardiac muscle cells, leading to an increase in intracellular calcium levels and a subsequent enhancement of myocardial contractility. This makes them useful in the treatment of heart failure and atrial arrhythmias such as atrial fibrillation.
However, digitalis glycosides have a narrow therapeutic index, meaning that there is only a small difference between their therapeutic and toxic doses. Therefore, they must be administered with caution and patients should be closely monitored for signs of toxicity such as nausea, vomiting, visual disturbances, and cardiac arrhythmias.
Cardiac glycosides are a group of naturally occurring compounds that have a toxic effect on the heart. They are found in certain plants, including foxglove and lily of the valley, as well as in some toads and beetles. The most well-known cardiac glycoside is digoxin, which is derived from the foxglove plant and is used as a medication to treat heart failure and atrial arrhythmias.
Cardiac glycosides work by inhibiting the sodium-potassium pump in heart muscle cells, leading to an increase in intracellular calcium levels. This increases the force of heart contractions, which can be beneficial in treating heart failure. However, if the dose is too high, cardiac glycosides can also cause dangerous arrhythmias and even death.
It's important for healthcare professionals to carefully monitor patients taking cardiac glycosides, as the therapeutic and toxic doses are very close together. Additionally, certain medications and medical conditions can interact with cardiac glycosides and increase the risk of toxicity.
Digoxin is a medication that belongs to a class of drugs called cardiac glycosides. It is used to treat various heart conditions, such as heart failure and atrial fibrillation, by helping the heart beat stronger and more regularly. Digoxin works by inhibiting the sodium-potassium pump in heart muscle cells, which leads to an increase in intracellular calcium and a strengthening of heart contractions. It is important to monitor digoxin levels closely, as too much can lead to toxicity and serious side effects.
'Digitalis' is a medication that is derived from the foxglove plant (Digitalis purpurea). It contains cardiac glycosides, primarily digoxin and digitoxin, which have positive inotropic effects on the heart muscle, increasing its contractility. Digitalis is primarily used to treat various types of heart failure and atrial arrhythmias. It works by inhibiting the sodium-potassium pump in heart muscle cells, leading to an increase in intracellular calcium and enhanced cardiac muscle contraction.
It's important to note that digitalis has a narrow therapeutic index, meaning that the difference between a therapeutic and toxic dose is small. Therefore, it requires careful monitoring of serum drug levels and clinical response to ensure safe and effective use. Common side effects include gastrointestinal symptoms such as nausea, vomiting, and diarrhea, as well as visual disturbances and cardiac arrhythmias.
Digitoxin is a cardiac glycoside drug that is derived from the foxglove plant (Digitalis lanata). It is used in the treatment of various heart conditions, particularly congestive heart failure and certain types of arrhythmias. Digitoxin works by increasing the force of heart muscle contractions and slowing the heart rate, which helps to improve the efficiency of the heart's pumping action.
Like other cardiac glycosides, digitoxin inhibits the sodium-potassium pump in heart muscle cells, leading to an increase in intracellular calcium levels and a strengthening of heart muscle contractions. However, digitoxin has a longer half-life than other cardiac glycosides such as digoxin, which means that it stays in the body for a longer period of time and may require less frequent dosing.
Digitoxin is available in tablet form and is typically prescribed at a low dose, with regular monitoring of blood levels to ensure safe and effective use. Common side effects of digitoxin include nausea, vomiting, diarrhea, and dizziness. In rare cases, it can cause more serious side effects such as arrhythmias or toxicity, which may require hospitalization and treatment with medications or other interventions.
Glycosides are organic compounds that consist of a glycone (a sugar component) linked to a non-sugar component, known as an aglycone, via a glycosidic bond. They can be found in various plants, microorganisms, and some animals. Depending on the nature of the aglycone, glycosides can be classified into different types, such as anthraquinone glycosides, cardiac glycosides, and saponin glycosides.
These compounds have diverse biological activities and pharmacological effects. For instance:
* Cardiac glycosides, like digoxin and digitoxin, are used in the treatment of heart failure and certain cardiac arrhythmias due to their positive inotropic (contractility-enhancing) and negative chronotropic (heart rate-slowing) effects on the heart.
* Saponin glycosides have potent detergent properties and can cause hemolysis (rupture of red blood cells). They are used in various industries, including cosmetics and food processing, and have potential applications in drug delivery systems.
* Some glycosides, like amygdalin found in apricot kernels and bitter almonds, can release cyanide upon hydrolysis, making them potentially toxic.
It is important to note that while some glycosides have therapeutic uses, others can be harmful or even lethal if ingested or otherwise introduced into the body in large quantities.
Cardenolides are a type of steroid compound that are found in certain plants and animals. These compounds have a characteristic structure that includes a five-membered lactone ring, which is attached to a steroid nucleus. Cardenolides are well known for their toxicity to many organisms, including humans, and they have been used for both medicinal and poisonous purposes.
One of the most famous cardenolides is digitoxin, which is derived from the foxglove plant (Digitalis purpurea). Digitoxin has been used as a medication to treat heart conditions such as congestive heart failure, as it can help to strengthen heart contractions and regulate heart rhythm. However, because of its narrow therapeutic index and potential for toxicity, digitoxin is not commonly used today.
Other cardenolides include ouabain, which is found in the seeds of the African plant Acokanthera ouabaio, and bufadienolides, which are found in the skin and parotid glands of toads. These compounds have also been studied for their potential medicinal uses, but they are not widely used in clinical practice due to their toxicity.
It is important to note that cardenolides can be highly toxic to humans and animals, and exposure to these compounds can cause a range of symptoms including nausea, vomiting, diarrhea, seizures, and even death. As such, it is essential to use caution when handling or coming into contact with plants or animals that contain cardenolides.
Ciprofloxacin is a fluoroquinolone antibiotic that is used to treat various types of bacterial infections, including respiratory, urinary, and skin infections. It works by inhibiting the bacterial DNA gyrase, which is an enzyme necessary for bacterial replication and transcription. This leads to bacterial cell death. Ciprofloxacin is available in oral and injectable forms and is usually prescribed to be taken twice a day. Common side effects include nausea, diarrhea, and headache. It may also cause serious adverse reactions such as tendinitis, tendon rupture, peripheral neuropathy, and central nervous system effects. It is important to note that ciprofloxacin should not be used in patients with a history of hypersensitivity to fluoroquinolones and should be used with caution in patients with a history of seizures, brain injury, or other neurological conditions.
Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.
Anti-infective agents are a class of medications that are used to treat infections caused by various microorganisms such as bacteria, viruses, fungi, and parasites. These agents work by either killing the microorganism or inhibiting its growth, thereby helping to control the infection and alleviate symptoms.
There are several types of anti-infective agents, including:
1. Antibiotics: These are medications that are used to treat bacterial infections. They work by either killing bacteria (bactericidal) or inhibiting their growth (bacteriostatic).
2. Antivirals: These are medications that are used to treat viral infections. They work by interfering with the replication of the virus, preventing it from spreading and causing further damage.
3. Antifungals: These are medications that are used to treat fungal infections. They work by disrupting the cell membrane of the fungus, killing it or inhibiting its growth.
4. Antiparasitics: These are medications that are used to treat parasitic infections. They work by either killing the parasite or inhibiting its growth and reproduction.
It is important to note that anti-infective agents are not effective against all types of infections, and it is essential to use them appropriately to avoid the development of drug-resistant strains of microorganisms.
Fluoroquinolones are a class of antibiotics that are widely used to treat various types of bacterial infections. They work by interfering with the bacteria's ability to replicate its DNA, which ultimately leads to the death of the bacterial cells. Fluoroquinolones are known for their broad-spectrum activity against both gram-positive and gram-negative bacteria.
Some common fluoroquinolones include ciprofloxacin, levofloxacin, moxifloxacin, and ofloxacin. These antibiotics are often used to treat respiratory infections, urinary tract infections, skin infections, and gastrointestinal infections, among others.
While fluoroquinolones are generally well-tolerated, they can cause serious side effects in some people, including tendonitis, nerve damage, and changes in mood or behavior. As with all antibiotics, it's important to use fluoroquinolones only when necessary and under the guidance of a healthcare provider.
Microbial sensitivity tests, also known as antibiotic susceptibility tests (ASTs) or bacterial susceptibility tests, are laboratory procedures used to determine the effectiveness of various antimicrobial agents against specific microorganisms isolated from a patient's infection. These tests help healthcare providers identify which antibiotics will be most effective in treating an infection and which ones should be avoided due to resistance. The results of these tests can guide appropriate antibiotic therapy, minimize the potential for antibiotic resistance, improve clinical outcomes, and reduce unnecessary side effects or toxicity from ineffective antimicrobials.
There are several methods for performing microbial sensitivity tests, including:
1. Disk diffusion method (Kirby-Bauer test): A standardized paper disk containing a predetermined amount of an antibiotic is placed on an agar plate that has been inoculated with the isolated microorganism. After incubation, the zone of inhibition around the disk is measured to determine the susceptibility or resistance of the organism to that particular antibiotic.
2. Broth dilution method: A series of tubes or wells containing decreasing concentrations of an antimicrobial agent are inoculated with a standardized microbial suspension. After incubation, the minimum inhibitory concentration (MIC) is determined by observing the lowest concentration of the antibiotic that prevents visible growth of the organism.
3. Automated systems: These use sophisticated technology to perform both disk diffusion and broth dilution methods automatically, providing rapid and accurate results for a wide range of microorganisms and antimicrobial agents.
The interpretation of microbial sensitivity test results should be done cautiously, considering factors such as the site of infection, pharmacokinetics and pharmacodynamics of the antibiotic, potential toxicity, and local resistance patterns. Regular monitoring of susceptibility patterns and ongoing antimicrobial stewardship programs are essential to ensure optimal use of these tests and to minimize the development of antibiotic resistance.
Anti-bacterial agents, also known as antibiotics, are a type of medication used to treat infections caused by bacteria. These agents work by either killing the bacteria or inhibiting their growth and reproduction. There are several different classes of anti-bacterial agents, including penicillins, cephalosporins, fluoroquinolones, macrolides, and tetracyclines, among others. Each class of antibiotic has a specific mechanism of action and is used to treat certain types of bacterial infections. It's important to note that anti-bacterial agents are not effective against viral infections, such as the common cold or flu. Misuse and overuse of antibiotics can lead to antibiotic resistance, which is a significant global health concern.
Quinolones are a class of antibacterial agents that are widely used in medicine to treat various types of infections caused by susceptible bacteria. These synthetic drugs contain a chemical structure related to quinoline and have broad-spectrum activity against both Gram-positive and Gram-negative bacteria. Quinolones work by inhibiting the bacterial DNA gyrase or topoisomerase IV enzymes, which are essential for bacterial DNA replication, transcription, and repair.
The first quinolone antibiotic was nalidixic acid, discovered in 1962. Since then, several generations of quinolones have been developed, with each generation having improved antibacterial activity and a broader spectrum of action compared to the previous one. The various generations of quinolones include:
1. First-generation quinolones (e.g., nalidixic acid): Primarily used for treating urinary tract infections caused by Gram-negative bacteria.
2. Second-generation quinolones (e.g., ciprofloxacin, ofloxacin, norfloxacin): These drugs have improved activity against both Gram-positive and Gram-negative bacteria and are used to treat a wider range of infections, including respiratory, gastrointestinal, and skin infections.
3. Third-generation quinolones (e.g., levofloxacin, sparfloxacin, grepafloxacin): These drugs have enhanced activity against Gram-positive bacteria, including some anaerobes and atypical organisms like Legionella and Mycoplasma species.
4. Fourth-generation quinolones (e.g., moxifloxacin, gatifloxacin): These drugs have the broadest spectrum of activity, including enhanced activity against Gram-positive bacteria, anaerobes, and some methicillin-resistant Staphylococcus aureus (MRSA) strains.
Quinolones are generally well-tolerated, but like all medications, they can have side effects. Common adverse reactions include gastrointestinal symptoms (nausea, vomiting, diarrhea), headache, and dizziness. Serious side effects, such as tendinitis, tendon rupture, peripheral neuropathy, and QT interval prolongation, are less common but can occur, particularly in older patients or those with underlying medical conditions. The use of quinolones should be avoided or used cautiously in these populations.
Quinolone resistance has become an increasing concern due to the widespread use of these antibiotics. Bacteria can develop resistance through various mechanisms, including chromosomal mutations and the acquisition of plasmid-mediated quinolone resistance genes. The overuse and misuse of quinolones contribute to the emergence and spread of resistant strains, which can limit treatment options for severe infections caused by these bacteria. Therefore, it is essential to use quinolones judiciously and only when clinically indicated, to help preserve their effectiveness and prevent further resistance development.