Drugs for the Heart [antikvár]

PrefaceCardiovascular pharmacology is a very active scene. A plethora of new agents are now offered to the clinicianto say nothing of the new indications that are being found for old agents. Every agent seems to have several actions that are often apparently unconnected. Confusion is rife.In this book, we hope to restore some order by examining six groups of drugs: beta-blockers, nitrates, calcium antagonists, antiarrhythmics, digitalis and sympathomimetics, and vasodilators. We will discuss what is known of their actions at both the cellular and the clinical levels. A knowledge of cellular mechanisms may help to avoid a serious hazard in polypharmacy. Information on clinical results will equally discourage adoption of the large number of drugs that should work but do not, or that have never been properly tested. We will speak often of "usual" or "average" or "maximum" doses, and some readers may protest that such terms are utterly not helpful. They are intended largely to allow some comparison of costs; it is not enough to know that one tablet is cheaper than another.The ready availability of so many agents means that the physician has great power for poor as well as for good results. Not all cardiac illness steadily progresses. Some patients with angina spontaneously improve. Cardiac failure may be temporarily worsened by intercurrent illness while post-infarct arrhythmias come and go. We must constantly be asking ourselves whether the therapy can be simplified or stopped; and, conversely, whether the time has come for one of the more vigorous regimens described in these articles.So, on to beta-blockers.vii