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Cardiac Medications

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Cardiac Medications
Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Inotropes
Inotropes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class Participation Question #1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class Participation Question #1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiac Glycosides ,[object Object]
Digoxin MOA
Digoxin (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class Participation Question 2: ,[object Object]
Class Participation Question 2: ,[object Object],[object Object],[object Object]
Class Participation Question 2: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class Participation Question 2: ,[object Object],[object Object],[object Object]
Latest News on Digoxin ,[object Object],[object Object]
Digitalis Toxicity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chronotropes
Chronotropes ,[object Object],[object Object],[object Object]
Chronotropes (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Positive Chronotrope ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Atropine (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Atropine Dosing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anti-anginal Drugs
Antianginal Drugs ,[object Object],[object Object],[object Object]
Symptoms of Angina
Nitrites/Nitrates ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class Participation Question #3: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class Participation Question #3: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Drug (Trade Name) Common Dosage Onset Duration Amyl nitrate (Vaporole ® ) 0.3 ml inhalation 30-60 sec 10 min ISDN (Isordil ® ) 2.5 - 10 mg SL 5 - 30 mg po qid 2-5 min 2 - 4 hr Nitroglycerin ( Nitro-bid ® ) 2% ointment 15 min 4 - 8 hr ( Nitrostat ® ) 0.3 - 0.6 mg SL 1-3 min 10 - 45 min ( Nitrogard ® ) 1,2,3 mg XR tab 30 min 8 - 12 hr ( Transderm-Nitro ® ) 2.5 - 15 mg/day Transdermal patch 30-60 min 24 hr
 
Nitroglycerin (NG) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NG (cont’d) ,[object Object],[object Object],[object Object],[object Object]
NG (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Antidysrhythmics/Antiarrhythmics
What are Arrhythmias? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Antidysrhythmics/Antiarrhythmics ,[object Object],[object Object],[object Object]
Antidysrhythmics/Antiarrhythmics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiac Action Potential ,[object Object],[object Object],[object Object],[object Object],[object Object]
Class Participation Question #4: ,[object Object],[object Object]
Class Participation Question #4: ,[object Object],[object Object],[object Object]
The Catch 22 with Antiarrhythmics ,[object Object],[object Object],[object Object]
Antiarrthymics: Class I ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class I A ,[object Object],[object Object],[object Object]
Class 1A – Quinidine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class 1A – Quinidine (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class I B ,[object Object],[object Object],[object Object],[object Object]
Lidocaine – Class IB ,[object Object],[object Object],[object Object]
Dosage ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lidocaine – Class IB (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lidocaine (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class I C ,[object Object],[object Object]
Flecainide – Class IC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Flecainide – Class IC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class II – Beta Blockers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Propranolol Warning ,[object Object],[object Object],[object Object],[object Object]
Class III ,[object Object],[object Object],[object Object],[object Object],[object Object]
Amiodarone – Class III ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vfib Amiodarone Dosage ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Amiodarone – Adverse Reactions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Amiodarone – Class III (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class IV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sympathomimetics
Sympathomimetics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epinephrine ,[object Object],[object Object],[object Object],[object Object],[object Object]
Epinephrine MOA
Epinephrine (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epinephrine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vasopressors
Vasopressors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vasoconstrictor ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vasopressin ,[object Object],[object Object],[object Object],[object Object]
Vasopressin (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vasopressin (cont’d) ,[object Object],[object Object],[object Object],[object Object]
Vasopressin (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diuretics
Diuretics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
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
Diuretics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Furosemide – Edema Dosage ,[object Object],[object Object]
Furosemide ,[object Object],[object Object],[object Object]
Furosemide (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anticoagulants
Antiplatelets/Anticoagulants ,[object Object],[object Object],[object Object]
Types of Antiplatelets/Anticoagulants ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Antiplatelets/Anticoagulants ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Heparin Recall in 2008 ,[object Object]
Coagulation Cascade
Warfarin – Oral Anticoagulant ,[object Object]
Warfarin (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Warfarin Warnings ,[object Object],[object Object],[object Object]
Warfarin (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
[object Object],[object Object]
Fibrinolytic Enzymes
Fibrinolytic Enzymes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Streptokinase (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Streptokinase (cont’d) ,[object Object],[object Object],[object Object],[object Object]
Streptokinase (cont’d)
Beta Blockers
Beta Blockers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Beta Blockers (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Propranolol ,[object Object],[object Object],[object Object],[object Object],[object Object]
Propranolol (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Propranolol (cont’d) ,[object Object],[object Object],[object Object]
Calcium Channel Blockers
Calcium Channel Blockers (CCBs) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CCBs (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Amlodipine ,[object Object],[object Object],[object Object],[object Object],[object Object]
Amlodipine http://online.factsandcomparisons.com/MonoDisp.aspx?monoID=fandc-hcp10122&inProdGen=true&quick=Amlodipine&search=Amlodipine
Amlodipine ,[object Object],[object Object],[object Object],[object Object]
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Cardiac Medications

Notes de l'éditeur

  1. 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
  2. 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
  3. 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.
  4. .