๐SGLT2 inhibitors drug
โ๏ธCanagliflozin โ Canagliflozin is taken orally before the first meal of the day The initial dose is 100 mg once daily, and it can be increased to 300 mg daily to achieve glycemic goals. In patients with moderate kidney impairment (eGFR 30 to 59 mL/min/1.73 m2), the dose should not exceed 100 mg daily. Canagliflozin should not be given to patients with severe hepatic impairment.
โ No dose adjustment is needed in patients with mild or moderate hepatic impairment
โ๏ธDapagliflozin โ Dapagliflozin (10 mg once daily) can be taken any time of day with or without food. It is not recommended for use in patients with active bladder cancer
โ . For patients with severely reduced liver function, a starting dose of 5 mg is recommended. There is limited experience in patients with severe hepatic impairment
โ๏ธEmpagliflozin โ Empagliflozin is taken orally once daily in the morning with or without food
โ . The initial dose is 10 mg daily, and it can be increased to 25 mg once daily to achieve glycemic goals. In patients taking empagliflozin who have an eGFR 30 to 45 mL/min/1.73 m2, the dose should not exceed 10 mg.
โ Empagliflozin may be used in patients with hepatic impairment
#UpTodate2024
โ๏ธCanagliflozin โ Canagliflozin is taken orally before the first meal of the day The initial dose is 100 mg once daily, and it can be increased to 300 mg daily to achieve glycemic goals. In patients with moderate kidney impairment (eGFR 30 to 59 mL/min/1.73 m2), the dose should not exceed 100 mg daily. Canagliflozin should not be given to patients with severe hepatic impairment.
โ No dose adjustment is needed in patients with mild or moderate hepatic impairment
โ๏ธDapagliflozin โ Dapagliflozin (10 mg once daily) can be taken any time of day with or without food. It is not recommended for use in patients with active bladder cancer
โ . For patients with severely reduced liver function, a starting dose of 5 mg is recommended. There is limited experience in patients with severe hepatic impairment
โ๏ธEmpagliflozin โ Empagliflozin is taken orally once daily in the morning with or without food
โ . The initial dose is 10 mg daily, and it can be increased to 25 mg once daily to achieve glycemic goals. In patients taking empagliflozin who have an eGFR 30 to 45 mL/min/1.73 m2, the dose should not exceed 10 mg.
โ Empagliflozin may be used in patients with hepatic impairment
#UpTodate2024
๐ (SGLT2) inhibitors and blood pressure
โ reduction in both systolic and diastolic blood pressure (-4 to -6/-1 to -2 mm Hg) has been documented for SGLT2 inhibitors
#UpTodate2024
โ reduction in both systolic and diastolic blood pressure (-4 to -6/-1 to -2 mm Hg) has been documented for SGLT2 inhibitors
#UpTodate2024
๐SGLT2I inhibitors and magnesium
โ In practice, however, SGLT2 inhibitors have been observed to induce mild increases, ranging from 0.1 to 0.24 mg/dL in serum magnesium levels in patients with type 2 diabetes, and this appears to be a class effect
โ The mechanisms for this effect are not well understoo
โ (SGLT2) inhibitors have been reported to be quite effective in correcting refractory hypomagnesemia, with increases in serum magnesium ranging from 0.3 to 1 mg/dL
โ Remarkably, this beneficial effect has been observed in both patients with and without diabetes, in both renal and nonrenal hypomagnesemia, and is not consistently associated with reduction in magnesuria
#UpTodate2024
โ In practice, however, SGLT2 inhibitors have been observed to induce mild increases, ranging from 0.1 to 0.24 mg/dL in serum magnesium levels in patients with type 2 diabetes, and this appears to be a class effect
โ The mechanisms for this effect are not well understoo
โ (SGLT2) inhibitors have been reported to be quite effective in correcting refractory hypomagnesemia, with increases in serum magnesium ranging from 0.3 to 1 mg/dL
โ Remarkably, this beneficial effect has been observed in both patients with and without diabetes, in both renal and nonrenal hypomagnesemia, and is not consistently associated with reduction in magnesuria
#UpTodate2024
๐SGLT2 inhibitors and IgA nephropathy (IgAN)
โ Patients with IgAN and proteinuria should receive treatment with sodium-glucose cotransporter 2 (SGLT2) inhibitors. This approach is similar to that for other patients with CKD and proteinuria.
#UpTodate2024
โ ุจูุฐุง ูุฎุชู ุงูููู ูุฐุง ูุงู ุจุฑุนุงูุฉ ุงุฏููุฉ SGLT2I inhibitors ุงูุงุฏููุฉ ุงูุชู ุนู ูุช ุทูุฑู ุฎูุงู ุงุฎุฑ ุฎู ุณ ุณููุงุช ๐๐
โ Patients with IgAN and proteinuria should receive treatment with sodium-glucose cotransporter 2 (SGLT2) inhibitors. This approach is similar to that for other patients with CKD and proteinuria.
#UpTodate2024
โ ุจูุฐุง ูุฎุชู ุงูููู ูุฐุง ูุงู ุจุฑุนุงูุฉ ุงุฏููุฉ SGLT2I inhibitors ุงูุงุฏููุฉ ุงูุชู ุนู ูุช ุทูุฑู ุฎูุงู ุงุฎุฑ ุฎู ุณ ุณููุงุช ๐๐
ูู ุนูุฏ ุงูุงู
ุฅูู ูู ุฃู ูู ุบุฒุฉ ูููุณุทูู ุงูุญุฑุฉ ุงูุงุจูุฉ ูู ุนุงู ูุฃูุชู ูู ุฃูู ุฎูุฑ ููู ุนุงู ูุฃูุชู ุงูุฎูุฑ ุนูุฏูู ูุตุฑุง ุจุฅุฐู ุงููู
ูุงูุชู ู ู ุงูุฌุจุชูู ุฎูุฑ ุฑุฌุงู ูุฐุง ุงูุฒู ุงู ูู ู ุฑุจูุชูู ุงูู ุฌุงูุฏูู ุน ุงูุฌูุงุฏุ
ุซู ูู ุนุงู ูุงูุชู ุจุฎูุฑ ููู ุงู ุงูุงุช ุงูุนุงูู ุฃุฌู ุนูู ู ู ุจุนุฏูู.
ุฅูู ูู ุฃู ูู ุบุฒุฉ ูููุณุทูู ุงูุญุฑุฉ ุงูุงุจูุฉ ูู ุนุงู ูุฃูุชู ูู ุฃูู ุฎูุฑ ููู ุนุงู ูุฃูุชู ุงูุฎูุฑ ุนูุฏูู ูุตุฑุง ุจุฅุฐู ุงููู
ูุงูุชู ู ู ุงูุฌุจุชูู ุฎูุฑ ุฑุฌุงู ูุฐุง ุงูุฒู ุงู ูู ู ุฑุจูุชูู ุงูู ุฌุงูุฏูู ุน ุงูุฌูุงุฏุ
ุซู ูู ุนุงู ูุงูุชู ุจุฎูุฑ ููู ุงู ุงูุงุช ุงูุนุงูู ุฃุฌู ุนูู ู ู ุจุนุฏูู.
ุงูุณูุงู
ุนูููู
ู ุญุชุงุฌ ุงููุชุงุจ ุฐุง pdf ูู ุฃุฌุฏู ูู ุฃู ู ูุงูุ
ุนูู ู ู ูู ููู ุฃู ูุณุชุทูุน ุชูููุฑู ูุฑุณูู ูู ุน ุงูุฎุงุต
@m_rassam
ูุฃููู ูู ู ู ุงูุดุงูุฑูู
ู ุญุชุงุฌ ุงููุชุงุจ ุฐุง pdf ูู ุฃุฌุฏู ูู ุฃู ู ูุงูุ
ุนูู ู ู ูู ููู ุฃู ูุณุชุทูุน ุชูููุฑู ูุฑุณูู ูู ุน ุงูุฎุงุต
@m_rassam
ูุฃููู ูู ู ู ุงูุดุงูุฑูู
#remember
๐Aldosterone antagonists in ACS and diabetic patients
โ We recommend an aldosterone receptor blocker to all patients with diabetes who meet the following criteria, which were derived from the EPHESUS trial of patients 3 to 14 days after acute MI
โAre receiving an ACE inhibitor and a beta blocker
โHave a left ventricular ejection fraction โค40 percent
โHave a serum creatinine โค2.5 mg/dL (221 micromol/L) in men and โค2.0 mg/dL (177 micromol/L) in women
โHave a serum potassium โค5.0 mEq/L
#UpTodate2024
๐Aldosterone antagonists in ACS and diabetic patients
โ We recommend an aldosterone receptor blocker to all patients with diabetes who meet the following criteria, which were derived from the EPHESUS trial of patients 3 to 14 days after acute MI
โAre receiving an ACE inhibitor and a beta blocker
โHave a left ventricular ejection fraction โค40 percent
โHave a serum creatinine โค2.5 mg/dL (221 micromol/L) in men and โค2.0 mg/dL (177 micromol/L) in women
โHave a serum potassium โค5.0 mEq/L
#UpTodate2024
๐ุจูุณุจู ูู
ุนุงูุฌุฉ ุงู hypoglycemia ุงุฐุง ูุงู ุงูู
ุฑูุถ ุจูุนูู ููุงุฏุฑ ุนูู ุงูุงูู ูุงูุจูุน ุจูุนุทูู
โ 3 to 4 glucose tablets or a tube of gel with 15 grams, 4 to 6 oz fruit juice or non-diet soda, or a teaspoon of honey or table sugar
โ ููู ูู ุญุงูู ูุงู ูุณุชุฎุฏู ุงุฏููุฉ ุงูุณูุฑ ุงูุงุชูู
โ taking an alpha-glucosidase inhibitor (eg, acarbose, miglitol, voglibose
ููู ูุจูุท ุณูุฑู ุจูุนุทูู ููุท pure glucose (dextrose) ู ุงูุนุทูุฉ
other carbohydrates (eg, table sugar [sucrose])
ูุงูู ุฑุงุญ ูููู ูุถู ูุงู ุชุตุงุต ูุฐู ุงูุฃููุงุน ู ู ุงููุฑุจูููุฏุฑุงุช ูุชูุฌู ุชุงุซูุฑ ุงุฏููุฉ ุงูุณูุฑ ุงูู ุฐููุฑู
#UpTodate2024
โ 3 to 4 glucose tablets or a tube of gel with 15 grams, 4 to 6 oz fruit juice or non-diet soda, or a teaspoon of honey or table sugar
โ ููู ูู ุญุงูู ูุงู ูุณุชุฎุฏู ุงุฏููุฉ ุงูุณูุฑ ุงูุงุชูู
โ taking an alpha-glucosidase inhibitor (eg, acarbose, miglitol, voglibose
ููู ูุจูุท ุณูุฑู ุจูุนุทูู ููุท pure glucose (dextrose) ู ุงูุนุทูุฉ
other carbohydrates (eg, table sugar [sucrose])
ูุงูู ุฑุงุญ ูููู ูุถู ูุงู ุชุตุงุต ูุฐู ุงูุฃููุงุน ู ู ุงููุฑุจูููุฏุฑุงุช ูุชูุฌู ุชุงุซูุฑ ุงุฏููุฉ ุงูุณูุฑ ุงูู ุฐููุฑู
#UpTodate2024
Clinical Notes
๐ุจูุณุจู ูู
ุนุงูุฌุฉ ุงู hypoglycemia ุงุฐุง ูุงู ุงูู
ุฑูุถ ุจูุนูู ููุงุฏุฑ ุนูู ุงูุงูู ูุงูุจูุน ุจูุนุทูู โ
3 to 4 glucose tablets or a tube of gel with 15 grams, 4 to 6 oz fruit juice or non-diet soda, or a teaspoon of honey or table sugar โ
ููู ูู ุญุงูู ูุงู ูุณุชุฎุฏู
ุงุฏููุฉ ุงูุณูุฑ ุงูุงุชููโฆ
โ
If the patient is conscious and able to drink and swallow safely (ie, alert enough to do so and with gag reflex intact), administer a rapidly absorbed carbohydrate (eg, 3 to 4 glucose tablets or a tube of gel with 15 grams, 4 to 6 oz fruit juice or non-diet soda, or a teaspoon of honey or table sugar
โ Patients taking an alpha-glucosidase inhibitor (eg, acarbose, miglitol, voglibose) with symptomatic hypoglycemia should only receive pure glucose (dextrose) orally because digestion and absorption of other carbohydrates (eg, table sugar [sucrose]) will be delayed by these medications and will be less effective in raising blood glucose levels.
#UpTodate2024
โ Patients taking an alpha-glucosidase inhibitor (eg, acarbose, miglitol, voglibose) with symptomatic hypoglycemia should only receive pure glucose (dextrose) orally because digestion and absorption of other carbohydrates (eg, table sugar [sucrose]) will be delayed by these medications and will be less effective in raising blood glucose levels.
#UpTodate2024
Clinical Notes
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ูุชูุฏุฑ ู ูู ุชุฏุฎู
uptodate
#ู ูุงุญุธุฉ ุฅุฐุง ู ุง ุถูุฑ ูู ูู ุงูู ุนููู ุงุช ููุณ ุงูููุฏูู ุบูุฑ ุฅูู ุดูู ู ุชุตูุญ ูู ุจููุชุฑ ูู ุงูู ุชุตูุญ ููุณู ุจ ุฃุญุท ุตูุฑู ุจู ูู ุงูุชุนููู
#massoud
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ูุชุชุจุน ุจููู ุงูุชุนููู ุงุช ูู ุงูููุฏูู
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uptodate
#ู ูุงุญุธุฉ ุฅุฐุง ู ุง ุถูุฑ ูู ูู ุงูู ุนููู ุงุช ููุณ ุงูููุฏูู ุบูุฑ ุฅูู ุดูู ู ุชุตูุญ ูู ุจููุชุฑ ูู ุงูู ุชุตูุญ ููุณู ุจ ุฃุญุท ุตูุฑู ุจู ูู ุงูุชุนููู
#massoud
#remember
โ Domperidone may be associated with an increased risk of serious ventricular arrhythmias or sudden cardiac death, particularly with doses >30 mg.
#genebrandax
โ Domperidone may be associated with an increased risk of serious ventricular arrhythmias or sudden cardiac death, particularly with doses >30 mg.
#genebrandax
ูู ูุณุฎุชุฉ ุงูุณุงุจุนู ูุงูุญุฏูุซู
ุงูุฏููู ุงููุญูุฏ ููุจูุงูุงุช ุงูู ุฎุจุฑูุฉ ุงูุฐู ูุชุจู ุงูุตูุงุฏูุฉ ููุตูุงุฏูุฉ.
ูุชุงุจ ู ู ุงูุฌู ุนูุฉ ุงูุงู ุฑูููู ูุตูุฏูู ูุญุชูู
ุงูู ูุงุฑุงุช ุงูุฃุณุงุณูุฉ ูู ุชูุณูุฑ ุงูุจูุงูุงุช ุงูู ุฎุจุฑูุฉ ููู ุณุงุนุฏุฉ ูู ุชุดุฎูุต ุงูุฃู ุฑุงุถ ูุฎุงุตู ููุงุฏุฑ ุงูุตูุฏูู ุงูุณุฑูุฑูุฉ ูุงูุนุงู ุฉ..
ููุถุง ุชูุณูุฑ ุงููุญูุตุงุช ุงูู ุชุนููู ุจุงูุฏูุงุก ู ู ุญูุซ ุชุฃุซูุฑู ูู ุฑุงูุจุฉ ุงููุนุงููู ูุงูุฅุซุงุฑ ุงูุฌุงูุจู..
ูุงูุถุง ุงูุนูุงู ู ุงูู ุคุซุฑู ุนูู ุงููุญูุตุงุช..
ููู ููุงูุฉ ูู ุดุงุจุชุฑ ู ูุฎุต ู ุน ุญุงูุงุช ุจุณูุทู ู ุฃู ุซููุ
ูุชุงุจ ู ุฎุตุต ูุตูุฏูู ูุงูุตูุฏูุฉ ุงูุณุฑูุฑูู ูู ุงูู ูุงู ุงูุฃููุ
ูุงูุถุง ูุจููู ุงูุชุฎุตุตุงุช ุงูุทุจูู
#massoud
ุงูุฏููู ุงููุญูุฏ ููุจูุงูุงุช ุงูู ุฎุจุฑูุฉ ุงูุฐู ูุชุจู ุงูุตูุงุฏูุฉ ููุตูุงุฏูุฉ.
ูุชุงุจ ู ู ุงูุฌู ุนูุฉ ุงูุงู ุฑูููู ูุตูุฏูู ูุญุชูู
ุงูู ูุงุฑุงุช ุงูุฃุณุงุณูุฉ ูู ุชูุณูุฑ ุงูุจูุงูุงุช ุงูู ุฎุจุฑูุฉ ููู ุณุงุนุฏุฉ ูู ุชุดุฎูุต ุงูุฃู ุฑุงุถ ูุฎุงุตู ููุงุฏุฑ ุงูุตูุฏูู ุงูุณุฑูุฑูุฉ ูุงูุนุงู ุฉ..
ููุถุง ุชูุณูุฑ ุงููุญูุตุงุช ุงูู ุชุนููู ุจุงูุฏูุงุก ู ู ุญูุซ ุชุฃุซูุฑู ูู ุฑุงูุจุฉ ุงููุนุงููู ูุงูุฅุซุงุฑ ุงูุฌุงูุจู..
ูุงูุถุง ุงูุนูุงู ู ุงูู ุคุซุฑู ุนูู ุงููุญูุตุงุช..
ููู ููุงูุฉ ูู ุดุงุจุชุฑ ู ูุฎุต ู ุน ุญุงูุงุช ุจุณูุทู ู ุฃู ุซููุ
ูุชุงุจ ู ุฎุตุต ูุตูุฏูู ูุงูุตูุฏูุฉ ุงูุณุฑูุฑูู ูู ุงูู ูุงู ุงูุฃููุ
ูุงูุถุง ูุจููู ุงูุชุฎุตุตุงุช ุงูุทุจูู
#massoud
Clinical Notes
ูู ูุณุฎุชุฉ ุงูุณุงุจุนู ูุงูุญุฏูุซู ุงูุฏููู ุงููุญูุฏ ููุจูุงูุงุช ุงูู
ุฎุจุฑูุฉ ุงูุฐู ูุชุจู ุงูุตูุงุฏูุฉ ููุตูุงุฏูุฉ. ูุชุงุจ ู
ู ุงูุฌู
ุนูุฉ ุงูุงู
ุฑูููู ูุตูุฏูู ูุญุชูู ุงูู
ูุงุฑุงุช ุงูุฃุณุงุณูุฉ ูู ุชูุณูุฑ ุงูุจูุงูุงุช ุงูู
ุฎุจุฑูุฉ ููู
ุณุงุนุฏุฉ ูู ุชุดุฎูุต ุงูุฃู
ุฑุงุถ ูุฎุงุตู ููุงุฏุฑ ุงูุตูุฏูู ุงูุณุฑูุฑูุฉ ูุงูุนุงู
ุฉ.. ููุถุง ุชูุณูุฑ ุงููุญูุตุงุชโฆ
Basic_Skills_in_Interpreting_Laboratory_Data.pdf
24.4 MB
ูู
ุง ุชุนุทู Amoxicillin ูู
ุนุงูุฌุฉ Acute otitis media ูุทูู ุฃุฎุฐ ุฏูุงุก Amoxicillin ุฎูุงู ุซูุงุซูู ููู
ุงูู
ุงุถูุฉ ูุฃู ุณุจุจ
ุฑุฏู ูุนู ุงูุจูุชุฑูุง ุงูู ุณุจุจู
โ ุงูุณุจุจ ุฑุงุญ ูุญุตู ู ูุงูู ู ู Amoxicillin
ุงูุญู ูุนุทู Amoxicillin clavanic acid
#Salah
ุฑุฏู ูุนู ุงูุจูุชุฑูุง ุงูู ุณุจุจู
โ ุงูุณุจุจ ุฑุงุญ ูุญุตู ู ูุงูู ู ู Amoxicillin
ุงูุญู ูุนุทู Amoxicillin clavanic acid
#Salah
๐morphine in Acute coronary syndrome
โ Morphine occasionally produces bradycardia and hypotension (vagomimetic effect), which can be managed with atropine (0.5โ1.5 mg IV) if necessary
#Marinos ICU
โ Morphine occasionally produces bradycardia and hypotension (vagomimetic effect), which can be managed with atropine (0.5โ1.5 mg IV) if necessary
#Marinos ICU
๐ุฅุนุงุฏุฉ ูุดุฑ
ุทุจุนุง ููุช ุงููู ุงูู atropine
ูุนุงู ูู ุฌู ูุน ู ุฑุงุญู heart block ๐ค ูู ุญุงูู acute(unstable)
ููู ูุฑุงุช ุงูู ูุนุงู
ูู Ist degree
ููู 2nd degree (Mobize1)
ููุท
ููู ูู
2nd degree (Mobize2)
ุจุงูุนูุณ ูู parodixal effect in HR
ูุนูู ู ู ูู ููุทู HR๐ค
ุงู ุง ูู 3rd degree not effective in HR๐ฅฒ
#salah
ุทุจุนุง ููุช ุงููู ุงูู atropine
ูุนุงู ูู ุฌู ูุน ู ุฑุงุญู heart block ๐ค ูู ุญุงูู acute(unstable)
ููู ูุฑุงุช ุงูู ูุนุงู
ูู Ist degree
ููู 2nd degree (Mobize1)
ููุท
ููู ูู
2nd degree (Mobize2)
ุจุงูุนูุณ ูู parodixal effect in HR
ูุนูู ู ู ูู ููุทู HR๐ค
ุงู ุง ูู 3rd degree not effective in HR๐ฅฒ
#salah
๐ insulin in DM type 2
โ The initial dose for any basal insulin is 0.2 units per kg daily (minimum 10 units, up to 15 to 20 units).
โ If fasting glucose levels are very elevated (>250 mg/dL [13.9 mmol/L]), A1C is >8 percent, or insulin resistance is severe, initial doses of basal insulin in type 2 diabetes can be higher (eg, 0.3 units per kg or up to 25 to 30 units daily).
#Uptodate2024
โ The initial dose for any basal insulin is 0.2 units per kg daily (minimum 10 units, up to 15 to 20 units).
โ If fasting glucose levels are very elevated (>250 mg/dL [13.9 mmol/L]), A1C is >8 percent, or insulin resistance is severe, initial doses of basal insulin in type 2 diabetes can be higher (eg, 0.3 units per kg or up to 25 to 30 units daily).
#Uptodate2024