Rx Note

Introduction The treatment approach for type 2 diabetes mellitus has undergo a shift from the traditional glucose-centric approach to the new cardiorenal-metabolic approach. This change emphasizes a comprehensive approach for reducing the risk of diabetes-related complications. As a result of this shift, sodium glucose co-transporter 2 (SGLT-2) inhibitors, such as canagliflozin, dapagliflozin and empagliflozin, have emerged as a key player for managing type 2 diabetes. Mechanism of Action The SGLT-2 inhibitors act by promoting the glucose excretion into the urine, thereby reducing the concentration of circulating glucose. The resulting glycosuria is associated with an osmotic diuresis and salt excretion. Furthermore, the osmotic diuretic effect and the caloric loss (from glucose in the urine) also leads to reduction in systolic blood pressure and body weight. Expected Benefits Lower blood glucose. 0.3-1.0% reduction in HbA1c Effect on both fasting and postprandial glucose concentratio...

Introduction Heart failure is not a single pathological diagnosis, but a clinical syndrome consisting of cardinal symptoms (e.g. breathlessness, ankle swelling and fatigue ) that may be accompanied by signs (e.g. elevated jugular venous pressure, pulmonary crackles, and peripheral oedema ). It is due to a structural and/or functional abnormality of the heart that results in elevated intracardiac pressures and/or inadequate cardiac output at rest and/or during exercise . The median survival following a diagnosis is around 3 to 5 years. A commonly used classification is by left ventricular ejection fraction (LVEF). HFrEF - Heart failure with reduced ventricular ejection fraction (i.e.≤ 40%) HFmrEF - Heart failure with mildly reduced ventricular ejection fraction (i.e. 41-49%) HFpEF - Heart failure with preserved ventricular ejection fraction (i.e. ≥50%) New York Heart Association (NYHA) Functional Classification The simplest terminology used to describe the severity of HF is the NYHA fun...