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Metoprolol vs. Diltiazem for Rate Control of A-fib/flutter with RVR Metoprolol vs. Diltiazem for Rate Control of A-fib/flutter with RVR - Emergency Medicine Open Menu Back Close Menu Search for: Search Close Search Welcome Our Team Sections Education Alumni Research ECRC Journal Club Events Jermyn Lectures Open Search After discussing with your attending, your plan is for anticoagulation and rate control. But which agent to use for rate control? You know from prior rotations that some seem (...) to prefer metoprolol, but in your ED you have noticed that most attending use diltiazem almost exclusively. Wondering if there is a benefit to one agent over the other, you decide to do some digging and find a few relevant articles in the literature… PICO Question Population : Adult patients presenting to the emergency department in atrial fibrillation or atrial flutter with a rapid ventricular response without signs of hemodynamic compromise Intervention : Bolused intravenous diltiazem Comparison
Diltiazem Top results for diltiazem - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 (...) or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for diltiazem The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence
Topical Minoxidil Versus Topical Diltiazem for Chemical Sphincterotomy of Chronic Anal Fissure: A Prospective, Randomized, Double-Blind, Clinical Trial Anal fissure is a common anorectal problem causing severe pain and discomfort to the patients. Chemical sphincterotomy has emerged as a noninvasive alternative to the surgical methods of fissure treatment. The objective of this study was evaluation of the efficacy and the adverse effects of topically applied minoxidil in chemical sphincterotomy (...) of chronic anal fissure in comparison with topical diltiazem.A total of 88 patients with chronic anal fissure aged between 15 and 65 years were included in this double-blind, randomized clinical trial and were randomly assigned to either 0.5% minoxidil cream or 2% diltiazem cream twice daily for 2 weeks. The pain intensity, bleeding, wound healing, itching, headache, dizziness, significant drop in blood pressure, allergy and fissure relapse were assessed on a monthly basis for 2 months.Both diltiazem
Perioperative diltiazem or nitroglycerin in on-pump coronary artery bypass: A systematic review and network meta-analysis. Arterial graft spasm is a severe complication after coronary artery bypass graft (CABG). Among numerous potential antispasmodic agents, systemic application of diltiazem and nitroglycerin had been investigated most frequently over the past three decades. However, it remains inconclusive if either or both agents could improve patient outcomes by preventing graft spasm when (...) applied perioperatively, and, if so, which one would be a better choice. The current systematic review and network meta-analysis aims to summarize the data from all available randomized clinical trials of perioperative continuous intravenous infusion of diltiazem and/or nitroglycerin in patients undergoing on-pump CABG in order to define and compare their roles in graft spasm prevention and their impacts on perioperative outcomes.We searched Ovid Medline, PubMed, CINAHL, Google Scholar and Cochrane
Topical diltiazem ointment in post-hemorrhoidectomy pain relief: A meta-analysis of randomized controlled trials. Hemorrhoidectomy is commonly associated with postoperative pain. Calcium channel blockers are known to cause relaxation of gastrointestinal smooth muscle and oral diltiazem has also been shown to reduce the resting anal pressure.We attempted to analyze efficacy and side effects of topical diltiazem oint. in post-operative pain control.This is a meta-analysis of patients who (...) underwent hemorrhoidectomy using topical diltiazem oint. versus placebo (Vaseline) for pain control. Patients with third or fourth degree hemorrhoids undergoing traditional hemorrhoidectomy were included. Procedures took place in the colorectal division of a hospital in 5 countries. Five randomized control trials (RCTs) published between 2005 and 2016 including 227 patients were included our meta-analysis (Diltiazem (calcium channel block) group = 137; Placebo (Vaseline) group = 90). Pain assessment
Short-Term Effects of Verapamil and Diltiazem in the Treatment of No Reflow Phenomenon: A Meta-Analysis of Randomized Controlled Trials. Currently, there is still a lack of an optimal treatment for no reflow phenomenon (NRP). We analyzed the efficacy and safety of using nondihydropyridine calcium channel antagonists (NDHP, verapamil/diltiazem) in patients suffering from NRP. Eight RCTs with 494 participants were eligible for analysis. The pooling analysis showed that intracoronary verapamil (...) /diltiazem injection significantly decreased the occurrence of the coronary NRP (RR: 0.3, 95% CI: 0.16-0.57; P = 0.0002) and reduced corrected thrombolysis in myocardial infarction (TIMI) frame Count (WMD = -9.24, 95% CI -13.91-4.57; P = 0.0001) in patients with NRP. Moreover, verapamil/diltiazem treatment showed superiority in reducing wall motion index (WMI) compared to the control at day 1 (WMD = 0.11, 95% CI: 0.02-0.20; P = 0.02) (P < 0.05). There was also a significantly greater decline
Chronic anal fissure: 2% topical diltiazem hydrochloride Chronic anal fissure: 2% topical diltiazem Chronic anal fissure: 2% topical diltiazem h hy ydrochloride drochloride Evidence summary Published: 22 January 2013 nice.org.uk/guidance/esuom3 pathways K Ke ey points from the e y points from the evidence vidence The content of this evidence summary was up-to-date in January 2013. See summaries of product characteristics (SPCs), British national formulary (BNF), BNF for children (BNFc (...) ) or the MHRA or NICE websites for up-to-date information. Diltiazem hydrochloride is a calcium channel blocker and vasodilator. It increases blood flow to smooth muscles and relaxes muscle tone. Oral preparations of diltiazem hydrochloride are licensed in the UK to treat angina and hypertension. T opical diltiazem hydrochloride is not licensed in the UK for treating chronic anal fissure or any other indication. Therefore, its use for treating chronic anal fissure is unlicensed. An alternative topical
Intravenous diltiazem for the control of ventricular rate in patients with recent onset atrial fibrillation and left ventricular failure BestBets: Intravenous diltiazem for the control of ventricular rate in patients with recent onset atrial fibrillation and left ventricular failure Intravenous diltiazem for the control of ventricular rate in patients with recent onset atrial fibrillation and left ventricular failure Report By: Dr Richard Parris - Consultant in Emergency Medicine Search checked (...) by Dr Simon Clarke - Consultant in Emergency Medicine, Frimley Park Hospital, Camberley, UK Institution: Royal Bolton Hospital, Lancs Date Submitted: 12th January 2005 Date Completed: 11th August 2009 Last Modified: 11th August 2009 Status: Green (complete) Three Part Question In a patient with [recent onset atrial fibrillation and left ventricular failure], can [diltiazem] [control the ventricular rate without worsening left ventricular function]? Clinical Scenario A 72-year-old woman with a past
Intravenous diltiazem is superior to intravenous amiodarone or digoxin for achieving ventricular rate control in patients with acute uncomplicated atrial fibrillation To compare the clinical efficacy of intravenous diltiazem, digoxin, and amiodarone for acute ventricular rate (VR) control in patients with acute symptomatic atrial fibrillation (AF) necessitating hospitalization.Randomized control trial.Acute emergency medical admission unit in a regional teaching hospital in Hong Kong.One (...) hundred fifty adult patients with acute AF and rapid VR (>120 bpm).Patients were randomly assigned in 1:1:1 ratio to receive intravenous diltiazem, digoxin, or amiodarone for VR control.The primary end point was sustained VR control (<90 bpm) within 24 hours; the secondary end points included AF symptom improvement and length of hospitalization. At 24 hours, VR control was achieved in 119 of 150 patients (79%). The time to VR control was significantly shorter among patients in the diltiazem group (log
The efficacy of diltiazem and glyceryltrinitrate for the medical management of chronic anal fissure: a meta-analysis. The objective of this review is to systematically analyze the prospective randomized controlled trials on the effectiveness of diltiazem (DTZ) and glyceryltrinitrate (GTN) for the pharmacological management of chronic anal fissure (CAF).A systematic review of the literature was undertaken. Prospective randomized controlled trials on the effectiveness of DTZ for the management
Effects of ranolazine with atenolol, amlodipine, or diltiazem on exercise tolerance and angina frequency in patients with severe chronic angina: a randomized controlled trial. Many patients with chronic angina experience anginal episodes despite revascularization and antianginal medications. In a previous trial, antianginal monotherapy with ranolazine, a drug believed to partially inhibit fatty acid oxidation, increased treadmill exercise performance; however, its long-term efficacy and safety (...) have not been studied in combination with beta-blockers or calcium antagonists in a large patient population with severe chronic angina.To determine whether, at trough levels, ranolazine improves the total exercise time of patients who have symptoms of chronic angina and who experience angina and ischemia at low workloads despite taking standard doses of atenolol, amlodipine, or diltiazem and to determine times to angina onset and to electrocardiographic evidence of myocardial ischemia, effect
Diltiazem use in tacrolimus-treated renal transplant recipients Diltiazem use in tacrolimus-treated renal transplant recipients Diltiazem use in tacrolimus-treated renal transplant recipients Kothari J, Nash M, Zaltzman J, Prasad G V R Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability (...) of the study and the conclusions drawn. Health technology The effects of using diltiazem as a first-line antihypertensive agent in renal transplant patients who received tacrolimus-based immunosuppressive treatment were evaluated. The mean average daily dose of diltiazem was 213.95 mg/day. Type of intervention Other: Management care (post-transplant). Economic study type Cost-effectiveness analysis. Study population The study population comprised patients who underwent renal transplantation. Of those
Diltiazem co-treatment in renal transplant patients receiving microemulsion cyclosporin Diltiazem co-treatment in renal transplant patients receiving microemulsion cyclosporin Diltiazem co-treatment in renal transplant patients receiving microemulsion cyclosporin Kumana C R, Tong M K, Li C S, Lauder I J, Lee J S, Kou M, Walley T, Haycox A, Chan T M Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief (...) summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Diltiazem, an antihypertensive agent, was used as a co-treatment to reduce the use of cyclosporin (i.e. Neoral) in renal transplant recipients. Neoral was a relatively new microemulsified cyclosporin formulation. Diltiazem was administered at a dose of 30 mg twice daily in patients weighing less than 60 kg, and at 60 mg twice daily
Effect of amiodarone +/- diltiazem +/- beta blocker on frequency of atrial fibrillation, length of hospitalization, and hospital costs after coronary artery bypass grafting Effect of amiodarone +/- diltiazem +/- beta blocker on frequency of atrial fibrillation, length of hospitalization, and hospital costs after coronary artery bypass grafting Effect of amiodarone +/- diltiazem +/- beta blocker on frequency of atrial fibrillation, length of hospitalization, and hospital costs after coronary (...) fibrillation (AF) in patients who had undergone coronary artery bypass grafting (CABG) was examined. The pathway was based on the administration of oral amiodarone, rate and rhythm control, cardioversion, and anticoagulation. Rate control, if needed, was mainly achieved with intravenous diltiazem and less often with a beta-blocker. Type of intervention Secondary prevention. Economic study type Cost-effectiveness analysis. Study population The study population comprised patients who had CABG
Heart rate-lowering and -regulating effects of once-daily sustained-release diltiazem. Epidemiologic evidence suggests that an elevated heart rate (HR) is an adverse and independent prognostic factor in arterial hypertension and other cardiovascular diseases. Although diltiazem is characterized as an HR-lowering calcium antagonist, no studies have quantified the magnitude of HR changes in patients with angina or hypertension.The study was undertaken to explore the magnitude of proportional HR (...) reduction at varying levels of resting HR with the sustained-release formulation of diltiazem (SR diltiazem) at the usual clinical doses of 200 or 300 mg once daily.This meta-analysis was conducted on six comparative double-blind studies including 771 patients with angina or hypertension in which SR diltiazem 200-300 mg once daily was compared either with placebo or with other agents known not to influence HR (angiotensin-converting enzyme inhibitors, diuretics). Sustained-release diltiazem decreases
Diltiazem, nifedipine, nimodipine or verapamil for neuroleptic-induced tardive dyskinesia. Tardive dyskinesia (TD) is a potentially disfiguring movement disorder of the orofacial region often caused by use of neuroleptic drugs. A wide range of strategies have been used to help manage TD and, for those who are unable to have their antipsychotic medication stopped or substantially changed, the calcium-channel blocking group of drugs (diltiazem, nifedipine, nimodipine, verapamil) has been
Effects of diltiazem prophylaxis on the incidence and clinical outcome of atrial arrhythmias after thoracic surgery Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Diltiazem in acute myocardial infarction treated with thrombolytic agents: a randomised placebo-controlled trial. Incomplete Infarction Trial of European Research Collaborators Evaluating Prognosis post-Thrombolysis (INTERCEPT) Diltiazem reduces non-fatal reinfarction and refractory ischaemia after non-Q-wave myocardial infarction, an acute coronary syndrome similar to the incomplete infarction that occurs after successful reperfusion. We postulated that this agent would reduce cardiac events (...) in patients after acute myocardial infarction treated initially with thrombolytic agents-a clinical application previously unexplored with heart-rate-lowering calcium antagonists.A prospective, randomised, double-blind, sequential trial was done in 874 patients with acute myocardial infarction, but without congestive heart failure, who first received thrombolytic agents. Patients received either 300 mg oral diltiazem once daily, or placebo, initiated within 36-96 h of infarct onset, and given for up to 6
2000LancetControlled trial quality: predicted high
Randomised trial of effects of calcium antagonists compared with diuretics and beta-blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Calcium antagonists are a first-line treatment for hypertension. The effectiveness of diltiazem, a non-dihydropyridine calcium antagonist, in reducing cardiovascular morbidity or mortality is unclear. We compared the effects of diltiazem with that of diuretics, beta-blockers, or both on cardiovascular (...) morbidity and mortality in hypertensive patients.In a prospective, randomised, open, blinded endpoint study, we enrolled 10,881 patients, aged 50-74 years, at health centres in Norway and Sweden, who had diastolic blood pressure of 100 mm Hg or more. We randomly assigned patients diltiazem, or diuretics, beta-blockers, or both. The combined primary endpoint was fatal and non-fatal stroke, myocardial infarction, and other cardiovascular death. Analysis was done by intention to treat.Systolic
2000LancetControlled trial quality: predicted high