LAM Extra for General Practicioners

[ANTIHYPERTENSIVE THERAPY IN PATIENTS WITH COPD - THE SIGNIFICANCE OF NEBIVOLOL]

FARSANG Csaba

DECEMBER 15, 2011

LAM Extra for General Practicioners - 2011;3(05)

[The occurrence of hypertension associated with chronic obstructive pulmonary disease (COPD) is increasing. Recognising COPD is important in order to choose the appropriate antihypertensive drugs. Antihypertensive drugs that can be used to treat patients with hypertension and COPD include diuretics, ACE-inhibitors, angiotensine receptor blockers (AT1 receptor antagonists) and calcium antagonists, as well as cardioselective beta blockers, as these drugs decrease total and cardiovascular mortality. Of these agents, the importance of the most cardioselective one, nebivolol should be stressed, as this drug has no clinically significant effect on parameters of respiratory function, and, through its additional effects (namely by increasing the synthesis of NO), it has a beneficial effect on COPD-related deterioration of respiratory functions, haemodynamic alterations (cor pulmonale) and local factors that participate in the respiratory inflammation and endothelial dysfunction.]

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[The recognition of ECG artefacts is becoming increasingly important for physicians working in the field of internal medicine. At the same time, however, very little information about artefacts is published in either articles or textbooks. The authors provide a summary of the generation, types and recognition of ECG artefacts. The aim of the article is to draw the attention of clinicians to the dangers of this increasingly common phenomenon. Unrecognised artefacts can often prompt further (unnecessary) investigations and may result in establishing wrong diagnosis as well as erroneous treatment decisions.]

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[Metformin is currentlly the most commonly prescribed oral antidiabetic drug for the treatment of patients with type 2 diabetes mellitus. Its administration is limited by the contraindications and the possible gastrointestinal side effects. In Hungary, metformin is currently available in numerous forms, among which the extended-release tablets are distinguished because of their tolerability. The authors summarise the most recent data about the favourable features of metformin, help clinicians to choose the appropriate preparation of metformin, and highlight the administration procedures that help to avoid gastrointestinal side effects.]

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