index after cardiac surgery 132 anticoagulation for 138 in heart failure 65, 82, 89, 97, 106 in mitral stenosis in palpitations 112

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1 index 325 index A ACE inhibitors 282 in cardiomyopathy in children 76, 228 in diabetes in HIV nephropathy 149 in hypertension 213, , 228 in isolated right sided heart failure , congenital heart disease in kidney failure , 154, 158, 216 aminophyilline , 283 amitriptyline 280, in diabetic peripheral neuropathy 192 in palliative care 23, 26, 162 amlodipine 282 in children in pregnancy 235 in kidney failure 228 anemia as etiology of cardiomyopathy 72, 105 as part of differential diagnosis of dyspnea 258, 261 in kidney failure aspirin 138, 282 after cardiac surgery 127, 129, 136 in diabetes 191 in hypertension 203 in mitral stenosis 89, 91 in peripartum cardiomyopathy asthma 4, 58, 77, , , 304, 315 atenolol , 297, 282, , 297 after cardiac surgery 132 in cardiomyopathy in children 76, in heart failure , 226 in kidney failure 216, 217 in mitral stenosis in palpitations 112 in pregnancy 235 after cardiac surgery 132 anticoagulation for 138 in heart failure 65, 82, 89, 97, 106 in mitral stenosis in palpitations 112 B beclomethasone inhaler , 283, 294, 304 beta-blockers 282 after cardiac surgery 132 in cardiomyopathy in children 76, , 74 in heart failure 68, , 226

2 326 chronic care integration for endemic non-communicable diseases, 88 in kidney failure 216, 217 in mitral stenosis in palpitations 112 in pregnancy 235 bronchiectasis 271 C captopril 282 in cardiomyopathy in children 76, 96, 224, in hypertension 205, 213, 214, 215 in hypertensive emergency 205, 215, in kidney failure 193, 216, 228 congenital heart disease 96 cardiomyopathy carvedilol in cardiomyopathy in children 76 chronic kidney disease stages 151 chronic obstructive pulmonary disease (COPD) creatinine and ACE inhibitor use 80,, 95, 96, 104, 105 failure and digoxin 90 and kidney failure screening 148 and management of diabetes 175, 177, 178, 180, 181, 192, 193 and management of kidney failure and potassium 107 and spironolactone use 97, 104 availability 279 cost , in heart failure 59, 65 67, 93, 100, 104, 105 in hypertension 148, , , 228 indicators for monitoring and evaluation 297, 300, 303 D dexamethasone in palliative care 28 diabetes 4, , 283, 2, , , 315 diabetes and hypertension 207, diabetic nephropathy diabetic neuropathy 22 diabetic retinopathy nutritional support in 37 E electrocardiogram (ECG) 40, , 112, 159, 279 echocardiography 43, 45 46, 49 52, 54 55, 57, 279 ejection fraction 46 endocarditis , 246 erythromycin 244, 247, 282 F family planning 37 38, 82 83, 89, 91, 97, 106, 142, 194 fever in patients with prosthetic heart valves

3 index 327 G glibenclamide (daonil) 174, , 283, , 301 in pregnancy , 228 H haloperidol 281 in palliative care 25, 28, 30 in chronic kidney disease HbA1c 39, 170, , 279, 291, 301 affect of hemoglobinopathies on 176 goals 188, 194 hydralazine 282, 2, 292 in cardiomyopathy 79 80, 82 in children 76, 224 in hypertension 235 in hypertensive emergency 215 in kidney failure in pregnancy 229 side effects 214 hyperkalemia 107, and ACE inhibitor use 80, 88, 95, 105, 228 and spironolactone 95, 104, 105 hypertension as etiology of renal failure 147 as risk factor for diabetes 169 cost model for 2, in heart failure 46, 47, 59, 64, 67, 84, 87 indicators for monitoring and evaluation 303 screening for renal failure in 148 hypertensive heart disease 44, 46, 47, 59, 61, I insulin 173, , 283 storage in the community 185 cost isosorbide dinitrate 282, 2 in cardiomyopathy 75, 76, K kidney failure L lisinopril 282, 2, , 297, 300 in cardiomyopathy 75 76, 78 in diabetes , , 88 congenital heart disease 96 M magnesium sulfate 229, , 314 metformin , , 283, , 301 in pregnancy 194 methyldopa 282, 292 in hypertension , in preeclampsia mitral stenosis morphine 280, , 304 in diarrhea 30 in heart failure 113 in kidney disease 161 in pain ladder 23 24, N naloxone 281 for constipation 29

4 328 chronic care integration for endemic non-communicable diseases nausea 21, 28 in chronic kidney disease in hyperglycemia 172 in hypoglycemia 175 side effect of digoxin 161 side effect of opioids 25 steroid therapy for 27 nifedipine 282, 292 in children 224 in hypertension 213, 215 in hypertension and pregnancy 229, in hypertensive emergency 205 P palliative care in heart failure in chronic kidney disease palpitations as symptom of hypoglycemia 174 Partners In Health history of involvement in Rwanda 1 2 housing assistance program 36 charts for women as measure of asthma attack severity 260 in initial management of chronic lung disease at integrated chronic care clinics 263 as essential equipment 279 penicillin 282 as secondary prophylaxis for rheumatic fever 89, 91, 96 97, 136, as treatment for endocarditis 165, 167 as primary prophylaxis for rheumatic fever 240, , 276 as treatment for rheumatic fever pericardial effusion 56, 102 in tamponade 131 echocardiographic image of 57 preeclampsia pregnancy and diabetes 168, 176, 180, and hypertension and chronic disease in heart failure 65, 73, 83, 91, 105 as consideration in type of valve replacement 129 and warfarin , 142 drug safety in prosthetic heart valve 129 fever in choice of type of 127 anticoagulation for 138 proteinuria in diabetes 193 in HIV 149 in hypertension 148, 210, 215 in preeclampsia urine dipstick pulmonary hypertension 98, 99, 105, 119 as cause of chronic dyspnea 261 R rheumatic heart disease antibiotic prophylaxis 131 cardiac surgery mitral stenosis other rheumatic valvular disease prevention right sided heart failure

5 index 329 S salbutamol inhaler , , , 283, 294, 304 spironolactone (aldactone) 283, 1 as diuretic 71 in cardiomyopathy 75, 77, in hyperkalemia management 159 congenital heart disease in right-sided heart failure 101, steroid therapy 280, 283 for pain relief 23, 27 as treatment for cholestasis 31 as treatment for tuberculous pericarditis 103 as treatment for rheumatic carditis 246 as treatment for severe asthma 263, 266, sulfonylureas , 283, , 301 in pregnancy 194 T tamponade (pericardial) 131 tuberculous pericarditis W warfarin (coumadin) , 283, 287, 289 interactions with antibiotics 133, 135

6 the pih guide to Chronic Care Integration for Endemic Non-Communicable Diseases Partners In Health is a 501(c)3 nonprofit corporation based in Boston, Massachusetts. Established in 1987, PIH is committed to making a preferential option for the poor by working with sister organizations to improve the health and well-being of people living in poor communities. To this end, PIH provides technical and financial assistance, medical supplies, and administrative support to partner projects in Haiti, Peru, Russia, Rwanda, Lesotho, Malawi, Mexico, Guatemala, Burundi, Kazakhstan, the Dominican Republic, and the United States. The goal of these partnerships is neither charity nor development but rather pragmatic solidarity a commitment to struggle alongside the destitute sick and against the economic and political structures that cause and perpetuate poverty and ill health. Partners In Health is affiliated with the Department of Global Health and Social Medicine at Harvard Medical School and the Division of Global Health Equity at the Brigham and Women s Hospital. the pih guide to Chronic Care Integration for Endemic Non-Communicable Diseases rwanda edition cardiac, renal, diabetes, pulmonary, and palliative care s66666 More information on Partners In Health can be found at our web site: rwanda edition Partners In Health Harvard Medical School Department of Global Health and Social Medicine Program in Global Non-Communicable Disease and Social Change Brigham and Women s Hospital Division of Global Health Equity