Textbook of Cardiology

Cardiac Pharmacology: Difference between revisions

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Cardiac Pharmacology (view source)

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!Formula
!Formula
|-
|-
|Dose
!Dose
|Amount of active drug given to patient
|Amount of active drug given to patient
|mg (D)
|mg (D)
|Drug Specific (From clinical studies)
|Drug Specific (From clinical studies)
|-
|-
|Concentration
!Concentration
|Amount of drug in a given plasma volume
|Amount of drug in a given plasma volume
|µg/ml (C)
|µg/ml (C)
|= D / Vd
|= D / Vd
|-
|-
|EC50
!EC<sub>50</sub>
|The concentration of drug needed to elicit a response halfway between zero and maximal responses.
|The concentration of drug needed to elicit a response halfway between zero and maximal responses.
|µg/ml (EC50)
|µg/ml (EC50)
|   y=bottom+  (Top-Bottom)/(1+ [x/EC50]  Hill Coefficient)
|y=bottom+  (Top-Bottom)/(1+ [x/EC<sub>50</sub>]  Hill Coefficient)
|-
|-
|Volume of Distribution
!Volume of Distribution
|The theoretical volume the drug would occupy if distributed uniformly throughout the tissues to elicit the current plasma concentration.
|The theoretical volume the drug would occupy if distributed uniformly throughout the tissues to elicit the current plasma concentration.
|L (Vd)
|L (Vd)
|D / C
|D / C
|-
|-
|Elimination Constant (Rate)
!Elimination Constant (Rate)
|The rate at which the drug is removed from the body.
|The rate at which the drug is removed from the body.
|h-1 (Ke)
|h-1 (Ke)
|ln(2) / t1/2  or  CL / Vd
|ln(2) / t1/2  or  CL / Vd
|-
|-
|Bioavailability
!Bioavailability
|How much of the administered dose is available for actual use by the body.
|How much of the administered dose is available for actual use by the body.
|no units as expressing a fraction (f)
|no units as expressing a fraction (f)
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AUC = Area under curve  po = oral administration  iv = intravenous administration
AUC = Area under curve  po = oral administration  iv = intravenous administration
|-
|-
|Cmax or Cmin
!Cmax or Cmin
|The maximum (Cmax) /  minimum (Cmin) plasma drug concentration reached following drug administration
|The maximum (Cmax) /  minimum (Cmin) plasma drug concentration reached following drug administration
|µg/ml (Cmax or Cmin)
|µg/ml (Cmax or Cmin)
|Identified via direct measurement of plasma C
|Identified via direct measurement of plasma C
|-
|-
|tmax
!tmax
|The time it takes for a drug to reach Cmax following administration
|The time it takes for a drug to reach Cmax following administration
|h (tmax)
|h (tmax)
|Identified via direct measurement of plasma C over time
|Identified via direct measurement of plasma C over time
|-
|-
|Half-life
!Half-life
|The time it takes for a drug to reach half its original concentration
|The time it takes for a drug to reach half its original concentration
|h (t1/2)
|h (t1/2)
|ln(2) / Ke
|ln(2) / Ke
|-
|-
|Drug Clearance
!Drug Clearance
|The volume of plasma cleared of the drug over a set time
|The volume of plasma cleared of the drug over a set time
|l/h (CL)
|l/h (CL)
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!Side Effects (Prevalence %)
!Side Effects (Prevalence %)
|-
|-
|Anti-hypertensives
|colspan="6" bgcolor="#E6E6FA"|'''Anti-hypertensives'''
|
|-
|
|rowspan="2"|
|rowspan="2"|Diuretics
|rowspan="2"|Furosemide
|Oedema
|Oedema
|Furosemide: 20-40mg once daily
|Furosemide: 20-40mg once daily
|
|rowspan="2"|Mild gastro-intestinal disturbances, pancreatitis, hepatic encephalopathy, postural hypotension, temporary increase in serum-cholesterol and triglyceride concentration, hyperglycaemia, acute urinary retention, electrolyte disturbances, metabolic alkalosis, blood disorders, hyperuricaemia, visual disturbances, tinnitus and deafness, and hypersensitivity reactions (including rash, photosensitivity, and pruritus).<cite>Esc1</cite>
|-
|-
|
|Diuretics
|Furosemide
|Resistant Hypertension
|Resistant Hypertension
|Furosemide: 40-80mg once daily
|Furosemide: 40-80mg once daily
|Mild gastro-intestinal disturbances, pancreatitis, hepatic encephalopathy, postural hypotension, temporary increase in serum-cholesterol and triglyceride concentration, hyperglycaemia, acute urinary retention, electrolyte disturbances, metabolic alkalosis, blood disorders, hyperuricaemia, visual disturbances, tinnitus and deafness, and hypersensitivity reactions (including rash, photosensitivity, and pruritus).<cite>Esc1</cite>
|-
|-
|
|
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|
|
|-
|-
|Anti-Arrhythmics
|colspan="6" bgcolor="#E6E6FA"|'''Anti-Arrhythmics'''
|-
|
|Class I (sodium channel blockers)
|Class I (sodium channel blockers)
|Flecainide, Lidocaine, Procainamide
|Flecainide, Lidocaine, Procainamide
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|
|
|-
|-
|Anti-platelet Drugs
|colspan="6" bgcolor="#E6E6FA"|'''Anti-platelet Drugs'''
|-
|
|
|
|Aspirin
|Aspirin
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|Dyspnoea (13.8%), haemorrhage, bruising; nausea (4.3%), vomiting, diarrhoea (3.7%), hypertension (3.8%), hypotension (3.2%), back pain (3.6%), abdominal pain, dyspepsia, gastritis, dizziness (4.5%), chest pain (3.7%), headache (6.5%), cough (4.9%), rash, pruritus, fatigue (3.2%),  constipation, arrhythmias including atrial fibrillation (4.2%), paraesthesia, confusion, hyperuricaemia, raised serum creatinine (7.4%), vertigo.<cite>Esc37</cite><cite>Esc38</cite>
|Dyspnoea (13.8%), haemorrhage, bruising; nausea (4.3%), vomiting, diarrhoea (3.7%), hypertension (3.8%), hypotension (3.2%), back pain (3.6%), abdominal pain, dyspepsia, gastritis, dizziness (4.5%), chest pain (3.7%), headache (6.5%), cough (4.9%), rash, pruritus, fatigue (3.2%),  constipation, arrhythmias including atrial fibrillation (4.2%), paraesthesia, confusion, hyperuricaemia, raised serum creatinine (7.4%), vertigo.<cite>Esc37</cite><cite>Esc38</cite>
|-
|-
|Vitamin K Antagonists
|colspan="6" bgcolor="#E6E6FA"|'''Vitamin K Antagonists'''
|-
|
|
|
|Warfarin
|Warfarin
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|Haemorrhage, nausea, vomiting, diarrhoea, jaundice, hepatic dysfunction, pancreatitis, pyrexia, alopecia, purpura, rash, ‘purple toes’, skin necrosis (increased risk in patients with protein C or protein S deficiency)
|Haemorrhage, nausea, vomiting, diarrhoea, jaundice, hepatic dysfunction, pancreatitis, pyrexia, alopecia, purpura, rash, ‘purple toes’, skin necrosis (increased risk in patients with protein C or protein S deficiency)
|-
|-
|Lipid-Lowering Drugs
|colspan="6" bgcolor="#E6E6FA"|'''Lipid-Lowering Drugs'''
|-
|
|Statins
|Statins
|Simvastatin, Atorvastatin
|Simvastatin, Atorvastatin
NiloferT
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