Titrating cardiovascular drugs

Titrating cardiovascular drugs is important to ensure efficacy and to minimize the risk of toxicity. A serum assay is extremely useful to guide digoxin therapy. Assessment of the effect of warfarin on blood clotting should be used to adjust dose. Serum cholesterol and lipid measurements guide therapy with antilipemic agents. The antihypertensive drugs, beta blockers, calcium channel blockers, and vasodilators can be assessed by their clinical effects. There is no strict relation between serum concentration of antiarrhythmic drugs and their effects, nor is it clear that the long-term efficacy of these drugs can be assessed by surrogate end points.

Post-transplant hyperlipidemia: mechanisms and management.

Hyperlipidemia is common after renal transplantation. In recent years, much progress has been made in understanding the causes and treatment of lipid abnormalities in renal transplant patients. Recently, short-term studies have shown that newer antilipemic agents appear to be safe and effective in treating hyperlipidemia in this population. Despite the absence of large, controlled clinical trials examining the effect of lipid-lowering strategies on cardiovascular disease and chronic renal allograft rejection, therapy appears to be warranted in renal transplant patients with an atherogenic lipid profile and multiple risk factors.