Introduction: Preventive therapy is recommended in patients with migraines frequent and/or severe enough to interfere with daily life, and/or with an inadequate response to acute therapy (26-43% of patients with migraine in a recent US survey). Preventive treatments include beta blockers, amitriptyline, and antiepileptics (sodium valproate, gabapentin), but these may have significant adverse effects and are contraindicated in some patients. Topiramate is an antiepileptic recently approved for prevention of migraine.
Effective control of serum phosphate and Ca × P product to within K/DOQI target range Clear Sevelamer is as effective as calcium salts Absence of hypercalcemia Clear Reduced incidence of hypercalcemia with sevelamer compared with calcium salts Reduction in serum LDL cholesterol and total cholesterol Clear Sevelamer is more effective than calcium salts May have beneficial effects on cardiovascular morbidity and mortality Reduction in vascular calcification Substantial Attenuated progression with sevelamer compared with calcium salts May have beneficial effects on cardiovascular morbidity and mortality Metabolic acidosis Moderate Sevelamer may be more likely than calcium salts to induce metabolic acidosis Preservation of trabecular bone mineral density Limited Better preservation with sevelamer than with calcium salts May improve morbidity due to bone disease Patient-oriented evidence Improvement in cardiovascular morbidity and mortality Limited Reduced risk of cardiac mortality and morbidity with sevelamer compared with calcium salts continued overleaf… Reduction in serum uric acid concentration Moderate Greater reduction with sevelamer than with calcium salts
Introduction: Heart failure is a frequent complication after acute myocardial infarction (MI) and carries a poor prognosis. Current treatments inhibit the renin-angiotensin-aldosterone system but suppression of aldosterone may be incomplete. The aldosterone antagonist spironolactone has been shown to improve survival in patients with chronic, severe heart failure. Eplerenone is a selective aldosterone antagonist expected to have a lower incidence of hormonal side effects than spironolactone.
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