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Cardiac Pharmacology: Difference between revisions
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|Class III (Potassium channel blockers) | |Class III (Potassium channel blockers) | ||
|Amiodarone, | | | ||
Sotalol | *Amiodarone, | ||
|Ventricular | *Sotalol | ||
Arrhythmias | | | ||
*Ventricular | |||
*Arrhythmias | |||
|Amiodarone: 200mg 2-3 times daily | |Amiodarone: 200mg 2-3 times daily | ||
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|Digoxin | |Digoxin | ||
|Supra-ventricular Arrhythmias | |Supra-ventricular Arrhythmias | ||
|Acute: 0.75-1.5mg over 24 hours | | | ||
Maintenance: 125-150µg daily | *Acute: 0.75-1.5mg over 24 hours | ||
| | *Maintenance: 125-150µg daily | ||
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|Gastro-intestinal disturbances (vomiting, diarrhoea, anorexia, abdominal pain) (25%); arrhythmias (up to 50%), AV conduction disturbances (50%); nervous system disturbances (dizziness, apathy, confusion, headache, fatigue, weakness) (25%); blurred or yellow vision; rash, eosinophilia, depression, anorexia, intestinal ischaemia and necrosis, psychosis, gynaecomastia on long-term use, and thrombocytopenia.<cite>Acc23</cite> | |||
|Gastro-intestinal disturbances (vomiting, diarrhoea, anorexia, abdominal pain) (25%); arrhythmias (up to 50%), AV conduction disturbances (50%); nervous system disturbances (dizziness, apathy, confusion, headache, fatigue, weakness) (25%); blurred or yellow vision; rash, eosinophilia, depression, anorexia, intestinal ischaemia and necrosis, psychosis, gynaecomastia on long-term use, and thrombocytopenia | |||
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|Heart Failure | |Heart Failure | ||
|62.5-125 µg daily | |62.5-125 µg daily<cite>Esc24</cite><cite>Esc25</cite> | ||
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|Aspirin | |Aspirin | ||
|Prevention of thrombotic cerebro- or cardio-vascular disease | |Prevention of thrombotic cerebro- or cardio-vascular disease | ||
|75mg once/day | |75mg once/day | ||
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|Bronchospasm (10-30% in asthmatics); gastro-intestinal irritation (up to 83%), gastro-intestinal haemorrhage (occasionally major), also other haemorrhage (e.g. intracranial (0.5%), subconjunctival), chest pain (8.3%), oedema (4.5%), hypertension (4.3%).<cite>Esc26</cite><cite>Esc27</cite><cite>Esc28</cite><cite>Esc29</cite> | |||
|Bronchospasm (10-30% in asthmatics); gastro-intestinal irritation (up to 83%), gastro-intestinal haemorrhage (occasionally major), also other haemorrhage (e.g. intracranial (0.5%), subconjunctival), chest pain (8.3%), oedema (4.5%), hypertension (4.3%). | |||
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#Esc21 ESC Guidelines (European Heart Journal doi:10.1093/eurheartj/ehs104): Management of VA in HF: Class IA; Prevention of VA in HF: Class IIbB | #Esc21 ESC Guidelines (European Heart Journal doi:10.1093/eurheartj/ehs104): Management of VA in HF: Class IA; Prevention of VA in HF: Class IIbB | ||
#Acc22 ACC/AHA/ESC Guidelines (Blomström-Lundqvist and Scheinman et al. 2003): SVT: Class IIBC; Wide QRS-complex tachycardia of unknown origin: Class IB; Wide QRS-complex tachycardia of unknown origin with LVD: Class IB; Recurrent AVNRT unresponsive to beta blocker or calcium-channel blocker and patient not desiring RF ablation: Class IIbC; Focal junction tachycardia: Class IIaC; WPW Syndrome: IIaC; AVRT, poorly tolerated: Class IIaC; Since or infrequent AVRT episode(s): Class IIbB; Acute treatment of Focal Atrial Tachycardia: Class IIaC; Prophylactic therapy for AT: Class IIaC; AF (Poorly tolerated): Class IIbC; AF (Stable flutter): Class IIbC; Prophylaxis of SVT during pregnancy: Class IIIC | #Acc22 ACC/AHA/ESC Guidelines (Blomström-Lundqvist and Scheinman et al. 2003): SVT: Class IIBC; Wide QRS-complex tachycardia of unknown origin: Class IB; Wide QRS-complex tachycardia of unknown origin with LVD: Class IB; Recurrent AVNRT unresponsive to beta blocker or calcium-channel blocker and patient not desiring RF ablation: Class IIbC; Focal junction tachycardia: Class IIaC; WPW Syndrome: IIaC; AVRT, poorly tolerated: Class IIaC; Since or infrequent AVRT episode(s): Class IIbB; Acute treatment of Focal Atrial Tachycardia: Class IIaC; Prophylactic therapy for AT: Class IIaC; AF (Poorly tolerated): Class IIbC; AF (Stable flutter): Class IIbC; Prophylaxis of SVT during pregnancy: Class IIIC | ||
#Acc23 ACC/AHA/ESC Guidelines (Blomström-Lundqvist and Scheinman et al. 2003): SVT: Class IIbC; WPW Syndrome: Class IIIC; AVRT, poorly tolerated: Class IIIC; Since or infrequent AVRT episode(s): Class IIIC; Prophylaxis of SVT during pregnancy: Class IC | |||
#Esc24 ESC Guidelines (European Heart Journal doi:10.1093/eurheartj/ehs104): Symptomatic (NYHA class II-IV) HF: Class IIbB | |||
#Esc25 ESC Guidelines Symptomatic (NYHA class II-IV) HF, LVD and AF: Class IB; Acute HF with AF and VT: Class IC | |||
#Esc26 ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261): Prevention in AF: Class IC; Prevention in diabetic patients: IIaB | |||
#Esc27 ESC Guidelines (European Heart Journal doi:10.1093/eurheartj/ehs104): Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA | |||
#Esc28 ESC Guidelines: (European Heart Journal doi:10.1093/eurheartj/ehs092): Prevention in hypertensive patients with CV events: Class IA; Prevention in hypertensive patients without CV history but with reduced renal function/high risk: Class IIbA | |||
#Esc29 ESC Guidelines: (European Heart Journal doi:10.1093/eurheartj/ehs092): Post-MI: Class Ia | |||