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Related Concept Videos

Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists01:23

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Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Drugs for Treatment of Constipation-Predominant IBS01:21

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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

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 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
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Atherosclerosis III: Management01:26

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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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Propionyl-L-carnitine for intermittent claudication.

Victor Kamoen1, Robert Vander Stichele2, Laurence Campens3,4

  • 1Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.

The Cochrane Database of Systematic Reviews
|December 26, 2021
PubMed
Summary
This summary is machine-generated.

Propionyl-L-carnitine (PLC) moderately improved walking distance in peripheral arterial disease patients compared to placebo. Safety profiles were similar, but evidence comparing PLC to standard treatments is lacking.

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Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis.
  • Intermittent claudication, a symptom of PAD, causes leg pain during exercise.
  • Propionyl-L-carnitine (PLC) may alleviate PAD symptoms and improve exercise performance.

Purpose of the Study:

  • To evaluate the efficacy of propionyl-L-carnitine (PLC) versus placebo for intermittent claudication.
  • To assess PLC's impact on pain-free and maximum walking distances.
  • To compare PLC with other interventions like exercise, endovascular procedures, or surgery.

Main Methods:

  • Systematic review and meta-analysis of double-blind randomized controlled trials (RCTs).
  • Included studies compared PLC with placebo or L-carnitine in patients with stable intermittent claudication (Fontaine stage II).
  • Outcomes included walking performance (ICD, ACD), ankle-brachial index (ABI), quality of life, and adverse events.

Main Results:

  • PLC significantly improved maximal walking distance (ACD) by 50.86m and pain-free walking distance (ICD) by 32.98m compared to placebo.
  • Improvements in ABI and quality of life were also observed with PLC versus placebo.
  • No significant differences in disease progression or adverse events were noted between PLC and placebo. Limited data compared PLC to L-carnitine.

Conclusions:

  • Propionyl-L-carnitine (PLC) offers mild to moderate improvements in walking distance for intermittent claudication with a similar safety profile to placebo.
  • Current evidence does not support the use of PLC over standard treatments due to a lack of comparative RCTs.
  • PLC may be considered as an adjunct therapy when standard treatments are ineffective or contraindicated.