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78. Diuretic Properties Diuretic agent Site of Action & Misc. Chlorothiazide PO/IV Distal Tubule Calcium Reabsorption Increased May transiently increase Lipids, BG and UA Hypomagnesemia (may complicate K+ correction) Severe Potassium Depletion – Creation of Combos ??? Pregnancy categories: B and C Hydrochlorothiazide Indapamide Metolazone (Mykrox) Furosemide Ascending Limb of Henle Ototoxocity (reversible and irreversible) Hypokalemia (supplement with K+) Pregnancy categories: B Torsemide Bumetanide Ethacrynic acid Amiloride Distal and Proximal tubule Impact Hyperkalemia and serum creatinine elevations Avoidance: BUN > 30 mg/dl or SCr > 1.5 mg/dl Triamterene Eplerenone Distal and Aldosterone receptor Impact Same as amiloride and triamterene – avoid K spare combos Spironolactone
suppress fast rhythms of the heart ( cardiac arrhythmias ), such as atrial fibrillation , atrial flutter , ventricular tachycardia , and ventricular fibrillation . It is important to stress that these medications do NOT cure the underlying cause of an arrhythmia Normal: depending on your age and physical conditioning 60-80 bpm Tachcarydia: 150-250 bpm Bradycardia: < 60 bpm Irregular heart beat due to extra beats or fibrillation
Antiarrhythmic drugs are grouped into 4 classes using the Vaughan Williams classification , introduced in 1970 Drugs are classfied based on its primary mechanism of its antiarrhythmic effect. However, one of the limitations of the VW classifcations, is that many antiarrhtmic agenst have MULTIPLE MOAs Arrythmias, hypertension, heart failure or myocardial infarctions
sodium, and magnesium levels. Low potassium and magnesium levels can lead to heart rhythm abnormalities, especially in patients already taking digoxin (Lanoxin). Please visit the digoxin (Lanoxin) site for further information.