Deutsche medizinische Wochenschrift
-
Analgesic drug therapy in kidney patients needs special expertise. Patients with kidney disease frequently have pain and they have chronic pain more than others. ⋯ When treating kidney patients with morphine, the accumulation kinetics of the M6 glucuronide must be observed. Otherwise, the risk increases for respiratory depression.
-
Dtsch. Med. Wochenschr. · Aug 2021
[Antiplatelet therapy and anticoagulation in patients with coronary heart disease].
Coronary heart disease (CHD) is a dynamic process with acute instable events and chronic periods leading to an increased mortality. Patients with CHD benefit from a differentiated antithrombotic therapy consisting of dual antiplatelet therapy in the acute phase and antiplatelet monotherapy or in combination with low dose anticoagulation (Xa-Inhibition) in the chronic phase. Current ESC-guidelines differentiate the acute coronary syndrome (ACS) and the chronic coronary syndrome (CCS). ⋯ In most scenarios in patients with ACS, the initial therapy will consist out of acetylsalicylic acid and a P2Y12-Inhibitor for 12 months followed by either a continuous monotherapy with acetylsalicylic acid (ASS), a prolonged dual antiplatelet therapy or a continuous dual antithrombotic therapy consisting of ASS and low dose rivaroxaban 2x daily. With atrial fibrillation as an underlying condition, an anticoagulant should be part of the therapy followed by anticoagulant monotherapy in the chronic phase of the disease (CCS). This article provides information about the different drugs and therapeutic algorithms based on the newest ESC-Guidelines and up to date studies.