Doctor insights on:
Dihydropyridine Side Effects
Which dihydropyridine CCB is better for controlling Bp and has less side effects including pedal edema (amlodipine or lercanidipine) esp in ElderlyCkD?
Medications: Amlodipine tends to cause peripheral/pedal edema fairly regularly. Lercanidipine has the same effect on BP as amlodipine and has been shown to have less pedal edema. Both drugs are metabolized by the liver and should be okay for use in an elderly patient with CKD, Lercanidipine may even have protective kidney effects. ...Read more
What are the basic differences between dihydropyridines and non dihydropyridines ca channel blockers and also tell me their clinical importance ?
Great questions: All are in the category of Ca chnl blokers, dihydroperidines ( all if them end in --pine, eg. Amlodipine), have much more effect on lowering arterial vascular resistance, than an effect on the heart, therefore, excel. for reducing BP. The pyridines (diltiazem and verapamil) have more effect on heart muscle & conduction, and are therefore more useful in treating angina and certain rhythm disorders. ...Read more
Dihydropyridine: Dihydropyridines are calcium channel blockers that include nifedipine, amlodipine, Felodipine and nicardipine. They're preferred before resorting to Minoxidil which routinely causes reflex tachycardia and fluid retention and thus must be used in conjunction with a potent diuretic and betablocker. Minoxidil routinely causes facial hair (unacceptable for women) and can cause pericardial effusion. ...Read more
Difference of Verapamil & Diltiazem? Does Diltiazem cause more Vasodilation? "an intermediate class between phenylalkylamine and dihydropyridines"???
Too many individual: response variables; https://en.wikipedia.org/wiki/Calcium_channel_blocker offers reasonable overview. Yet, be aware: all the calcium channel blockers, except amlodipine (neutral), in observational databases, ?mortality. Best outcomes & lowest mortality rates: optimize NMR lipoproteins, HbA1c = 5.0%, ACE inhibitors (Aceon/Altace) or ARBs combined with carvedilol, carefully adjusted to responses. ...Read more
Same as any alcohol: Less likely to cause hangover, but causes the same liver inflammation, scarring and damage as any other form of alcohol, as well as damage to esophagus, stomach, pancreas. Also can be toxic to the heart, the immune system, the bone marrow (which makes our blood components), impairing our ability to fight infections and our general immune system. PLUS, it causes many kinds of cancers. ...Read more
CBT: Cbt is mostly free of side effects, but during the treatment you may well feel some anxiety. For instance, exposure and response prevention are part of cbt treatment for obsessive compulsive d/o. With ocd, the person is unconsciously using compulsive behaviors to bind anxiety -- and if prevented, will temporarily feel anxiety. The therapist will help you through this. ...Read more
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