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Diltiazem has negative inotropic, chronotropic, and dromotropic effects. This means diltiazem causes a decrease in heart muscle contractility – how strong the beat is, lowering of heart rate – due to slowing of the sinoatrial node , and a slowing of conduction through the atrioventricular node – increasing the time needed for each beat.
Because of the role of both the liver and the kidneys in the elimination of flecainide, the dosing of flecainide may need to be adjusted in individuals who develop either liver failure or kidney failure. Because of the negative inotropic effects of flecainide, it should be used with caution in individuals with depressed ejection fraction, and ...
The negative chronotropic effects of CCBs make them a commonly used class of agents in individuals with atrial fibrillation or flutter in whom control of the heart rate is generally a goal. Negative chronotropy can be beneficial when treating a variety of disease processes because lower heart rates represent lower cardiac oxygen requirements.
“Kidney disease is a silent killer, so many do not have any signs of kidney disease until they are in the late stages of the disease,” she says. For this reason, nine in 10 people with chronic ...
The anti-proteinuria effect of non-dihydropyridine is due to better selectivity during glomerular filtration and/or a lower perfusion rate through the renal system. [ 11 ] Notable side effects of CCBs include edema, flushing in the face, headache, drowsiness, and dizziness.
People with chronic kidney disease, type 2 diabetes, or both of these conditions may have a higher cardiovascular disease (CVD) risk 8 to 28 years earlier than those without these conditions, a ...
The primary antihypertensive mechanism of beta blockers is unclear, but may involve reduction in cardiac output (due to negative chronotropic and inotropic effects). [73] It may also be due to reduction in renin release from the kidneys, and a central nervous system effect to reduce sympathetic activity (for those beta blockers that do cross ...
Loop diuretics may also precipitate kidney failure in patients concurrently taking an NSAID and an ACE inhibitor—the so-called "triple whammy" effect. [ 19 ] Because furosemide, torsemide and bumetanide are technically sulfa drugs, there is a theoretical risk that patients sensitive to sulfonamides may be sensitive to these loop diuretics.
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