Dyspnea Associated with Ticagrelor

Ticagrelor is an antiplatelet medication that is commonly used for a number of cardiovascular conditions.  Its mechanism is similar to that of antiplatelet medications clopidogrel and prasugrel in that it inhibits P2Y12 ADP receptors on platelets, preventing platelet activation and aggregation.  Ticagrelor is different from clopidogrel and prasugrel in that it binds reversibly to the receptor and, importantly, it is administered as the active compound.  This contrasts with clopidogrel and prasugrel which require metabolic activation by CYP450 enzymes and are therefore susceptible to drug interactions and altered activation in those with polymorphic CYP450 phenotypes (clopidogrel requires two CYP450 enzyme steps for

Thiamine deficiency and supplementation in heart failure

Thiamine is a water-soluble vitamin that is an important coenzyme for various metabolic processes in the body.  These include the regulation of glucose metabolism, the Krebs cycle (generates ATP), the pentose shunt (generates NADPH), and maintenance of sodium/potassium gradients in the brain (necessary for conducting nerve impulses).  Thiamine is mostly obtained from dietary intake with absorption occurring in the jejunum and ileum. After traveling to the liver, thiamine spends a relatively short amount of time in the blood before distributing to tissues throughout