Cardiac Pharmacology: Difference between revisions

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Cardiac Pharmacology (view source)

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|Angiotensin Receptor Blockers
|Angiotensin Receptor Blockers
|Losartan. Candesartan
|Losartan. Candesartan |Hypertension
|Hypertension
|Losartan: 50mg once daily
|Losartan: 50mg once daily
|ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
|ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
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|Drowsiness, hypotension (notably postural hypotension) (10-70% initially), syncope (1%), asthenia, dizziness, depression, headache (8-18%), dry mouth, gastro-intestinal disturbances, oedema, blurred vision (<5%), intra-operative floppy iris syndrome, rhinitis (<4%), erectile disorders (including priapism), tachycardia and palpitations (7-14%), gastrointestinal side-symptoms (4-5%), hypersensitivity reactions including rash, pruritus and angioedema.
|Drowsiness, hypotension (notably postural hypotension) (10-70% initially), syncope (1%), asthenia, dizziness, depression, headache (8-18%), dry mouth, gastro-intestinal disturbances, oedema, blurred vision (<5%), intra-operative floppy iris syndrome, rhinitis (<4%), erectile disorders (including priapism), tachycardia and palpitations (7-14%), gastrointestinal side-symptoms (4-5%), hypersensitivity reactions including rash, pruritus and angioedema.
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| Congestive Heart Failure Prazosin: 4-20mg daily
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Raynaud’s Syndrome Prazosin: 1-2mg daily
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Beta Blockers Atenolol, Propranolol Hypertension Atenolol: 25-50mg daily Gastro-intestinal disturbances (2-4%); bradycardia, heart failure, hypotension, conduction disorders, peripheral vasoconstriction, bronchospasm, dyspnoea; headache, fatigue, sleep disturbances (2-5%), paraesthesia, dizziness (2-5%), vertigo, psychoses; sexual dysfunction; purpura, thrombocytopenia; visual disturbances; exacerbation of psoriasis, alopecia; rarely rashes and dry eyes  
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Angina Atenolol: 100mg once/twice daily ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
|Congestive Heart Failure
|Prazosin: 4-20mg daily
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|Raynaud’s Syndrome
|Prazosin: 1-2mg daily
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|Beta Blockers
|Atenolol, Propranolol
|Hypertension
|Atenolol: 25-50mg daily
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|Gastro-intestinal disturbances (2-4%); bradycardia, heart failure, hypotension, conduction disorders, peripheral vasoconstriction, bronchospasm, dyspnoea; headache, fatigue, sleep disturbances (2-5%), paraesthesia, dizziness (2-5%), vertigo, psychoses; sexual dysfunction; purpura, thrombocytopenia; visual disturbances; exacerbation of psoriasis, alopecia; rarely rashes and dry eyes  
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|Angina
|Atenolol: 100mg once/twice daily
|ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
ACS: Class IIaB
ACS: Class IIaB


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doi:10.1093/eurheartj/ehs104):
doi:10.1093/eurheartj/ehs104):
Angina in symptomatic (NYHA class II-IV) HF and LVD: Class IA
Angina in symptomatic (NYHA class II-IV) HF and LVD: Class IA
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Arrhythmias Atenolol: 50-100mg daily ESC Guidelines (European Heart Journal (2012) 33, 2569–2619
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|Arrhythmias
|Atenolol: 50-100mg daily
|ESC Guidelines (European Heart Journal (2012) 33, 2569–2619
doi:10.1093/eurheartj/ehs215):  
doi:10.1093/eurheartj/ehs215):  


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AF (Stable flutter): Class IC
AF (Stable flutter): Class IC
Prophylaxis of SVT during pregnancy: Class IIaB
Prophylaxis of SVT during pregnancy: Class IIaB
Migraine Atenolol: 50-200mg daily
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Calcium Channel Blockers Nifedipine, Verapamil, Diltiazem Hypertension Nifedipine: 20-30mg once daily ESC Guidelines (European Heart Journal
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|Migraine
|Atenolol: 50-200mg daily
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|Calcium Channel Blockers
|Nifedipine, Verapamil, Diltiazem
|Hypertension
|Nifedipine: 20-30mg once daily
|ESC Guidelines (European Heart Journal
doi:10.1093/eurheartj/ehs104):
doi:10.1093/eurheartj/ehs104):
Hypertension in symptomatic (NYHA class II-IV) HF and LVD: Class IA gastro-intestinal disturbance (2-11%); hypotension (1-5%), oedema (7-29%), vasodilatation, palpitation; headache (7-35%), dizziness (3-27%), lethargy (4-6%), asthenia (10-12%); less commonly tachycardia (<1-7%), syncope (<1%), chills, nasal congestion, dyspnoea (<3%), anxiety, sleep disturbance (<2%), vertigo (<3%), migraine, paraesthesia, tremor (1-8%), polyuria, dysuria, nocturia, erectile dysfunction (<2%), epistaxis, myalgia, joint swelling, visual disturbance (<2%), sweating (<2%), hypersensitivity reactions (<1%); rarely anorexia, gum hyperplasia, mood disturbances, hyperglycaemia, male infertility, purpura (<1%), and photosensitivity reactions (<1%); also reported dysphagia, intestinal obstruction, intestinal ulcer, bezoar formation, gynaecomastia, agranulocytosis, and anaphylaxis;
Hypertension in symptomatic (NYHA class II-IV) HF and LVD: Class IA
Raynaud’s Syndrome Nifedipine: 5-20mg 3 times daily
|gastro-intestinal disturbance (2-11%); hypotension (1-5%), oedema (7-29%), vasodilatation, palpitation; headache (7-35%), dizziness (3-27%), lethargy (4-6%), asthenia (10-12%); less commonly tachycardia (<1-7%), syncope (<1%), chills, nasal congestion, dyspnoea (<3%), anxiety, sleep disturbance (<2%), vertigo (<3%), migraine, paraesthesia, tremor (1-8%), polyuria, dysuria, nocturia, erectile dysfunction (<2%), epistaxis, myalgia, joint swelling, visual disturbance (<2%), sweating (<2%), hypersensitivity reactions (<1%); rarely anorexia, gum hyperplasia, mood disturbances, hyperglycaemia, male infertility, purpura (<1%), and photosensitivity reactions (<1%); also reported dysphagia, intestinal obstruction, intestinal ulcer, bezoar formation, gynaecomastia, agranulocytosis, and anaphylaxis;
Angina (prophylaxis) Nifedipine: 5-20mg 3 times daily ESC Guidelines (European Heart Journal
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|Raynaud’s Syndrome
|Nifedipine: 5-20mg 3 times daily
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|Angina (prophylaxis)
|Nifedipine: 5-20mg 3 times daily
|ESC Guidelines (European Heart Journal
doi:10.1093/eurheartj/ehs104):
doi:10.1093/eurheartj/ehs104):
Angina in symptomatic (NYHA class II-IV) HF and LVD: Class IIaA
Angina in symptomatic (NYHA class II-IV) HF and LVD: Class IIaA
Anti-Arrhythmics Class I (sodium channel blockers) Flecainide, Lidocaine, Procainamide Ventricular Arrhythmias Flecainide: 50-100mg twice daily ESC Guidelines(European Heart Journal (2012) 33, 2569–2619
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|Anti-Arrhythmics
|Class I (sodium channel blockers)
|Flecainide, Lidocaine, Procainamide
|Ventricular Arrhythmias
|Flecainide: 50-100mg twice daily
|ESC Guidelines(European Heart Journal (2012) 33, 2569–2619
doi:10.1093/eurheartj/ehs215):  
doi:10.1093/eurheartj/ehs215):  
Sustained VT and VF: Class IIbC
Sustained VT and VF: Class IIbC
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Prophylactic therapy for AT: Class IIaC
Prophylactic therapy for AT: Class IIaC
AF (Stable flutter): Class IIbA
AF (Stable flutter): Class IIbA
Prophylaxis of SVT during pregnancy: Class IIbB Oedema, pro-arrhythmic effects (1-13%); dyspnoea; nervous-system side-effects including dizziness, asthenia, fatigue, fever; visual disturbances (13-28%); rarely pneumonitis, hallucinations, depression, confusion, amnesia, dyskinesia, convulsions, peripheral neuropathy; also reported gastro-intestinal disturbances (1-4%), anorexia, hepatic dysfunction, flushing, syncope, drowsiness, tremor, vertigo, headache, anxiety, insomnia, ataxia, paraesthesia, anaemia, leucopenia, thrombocytopenia, corneal deposits, tinnitus, increased antinuclear antibodies, hypersensitivity reactions (including rash, urticaria, and photosensitivity), increased sweating
Prophylaxis of SVT during pregnancy: Class IIbB
Class II (Beta blockers) (See above) (See above) (See above) (See above)
|Oedema, pro-arrhythmic effects (1-13%); dyspnoea; nervous-system side-effects including dizziness, asthenia, fatigue, fever; visual disturbances (13-28%); rarely pneumonitis, hallucinations, depression, confusion, amnesia, dyskinesia, convulsions, peripheral neuropathy; also reported gastro-intestinal disturbances (1-4%), anorexia, hepatic dysfunction, flushing, syncope, drowsiness, tremor, vertigo, headache, anxiety, insomnia, ataxia, paraesthesia, anaemia, leucopenia, thrombocytopenia, corneal deposits, tinnitus, increased antinuclear antibodies, hypersensitivity reactions (including rash, urticaria, and photosensitivity), increased sweating
Class III (Potassium channel blockers) Amiodarone,
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Sotalol Ventricular Arrhythmias Amiodarone: 200mg 2-3 times daily ESC Guidelines(European Heart Journal (2012) 33, 2569–2619
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|Class II (Beta blockers)
|(See above)
|(See above)
|(See above)
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|(See above)
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|Class III (Potassium channel blockers)
|Amiodarone,
Sotalol
|Ventricular  
Arrhythmias
|Amiodarone: 200mg 2-3 times daily
|ESC Guidelines(European Heart Journal (2012) 33, 2569–2619
doi:10.1093/eurheartj/ehs215):  
doi:10.1093/eurheartj/ehs215):  
Sustained VT and VF: Class IIaC
Sustained VT and VF: Class IIaC
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AF (Poorly tolerated): Class IIbC
AF (Poorly tolerated): Class IIbC
AF (Stable flutter): Class IIbC
AF (Stable flutter): Class IIbC
Prophylaxis of SVT during pregnancy: Class IIIC Gastro-intestinal disturbances (2-20%)), taste disturbances, hepatic disturbances (up to 50%); bradycardia; pulmonary toxicity (1-17%); tremor (9-59%), sleep disorders; hypothyroidism (5-10%), hyperthyroidism (5-10%); reversible corneal microdeposits (up to 98%); phototoxicity, persistent slate-grey skin discoloration (1-7%), injection-site reactions; less commonly onset or worsening of arrhythmia, conduction disturbances, peripheral neuropathy (1-105) and myopathy; very rarely sinus arrest, bronchospasm, ataxia (2-37%), benign intracranial hypertension, headache, vertigo, epididymo-orchitis, impotence, haemolytic or aplastic anaemia, thrombocytopenia, rash, hypersensitivity including photosensitivity (2-20%), anaphylaxis on rapid injection, hypotension (10-30%), respiratory distress syndrome, sweating, and hot flushes
Prophylaxis of SVT during pregnancy: Class IIIC |Gastro-intestinal disturbances (2-20%)), taste disturbances, hepatic disturbances (up to 50%); bradycardia; pulmonary toxicity (1-17%); tremor (9-59%), sleep disorders; hypothyroidism (5-10%), hyperthyroidism (5-10%); reversible corneal microdeposits (up to 98%); phototoxicity, persistent slate-grey skin discoloration (1-7%), injection-site reactions; less commonly onset or worsening of arrhythmia, conduction disturbances, peripheral neuropathy (1-105) and myopathy; very rarely sinus arrest, bronchospasm, ataxia (2-37%), benign intracranial hypertension, headache, vertigo, epididymo-orchitis, impotence, haemolytic or aplastic anaemia, thrombocytopenia, rash, hypersensitivity including photosensitivity (2-20%), anaphylaxis on rapid injection, hypotension (10-30%), respiratory distress syndrome, sweating, and hot flushes
Class IV (Calcium channel blockers) (See above) (See above) (See above) (See above)
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- Digoxin Supra-ventricular Arrhythmias Acute: 0.75-1.5mg over 24 hours
|Class IV (Calcium channel blockers)
Maintenance: 125-150µg daily ACC/AHA/ESC Guidelines (Blomström-Lundqvist and Scheinman et al. 2003):
|(See above)
|(See above)
|(See above)
|(See above)
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|Digoxin
|Supra-ventricular Arrhythmias |Acute: 0.75-1.5mg over 24 hours
Maintenance: 125-150µg daily |ACC/AHA/ESC Guidelines (Blomström-Lundqvist and Scheinman et al. 2003):
SVT: Class IIbC
SVT: Class IIbC
WPW Syndrome: Class IIIC
WPW Syndrome: Class IIIC
AVRT, poorly tolerated: Class IIIC
AVRT, poorly tolerated: Class IIIC
Since or infrequent AVRT episode(s): Class IIIC
Since or infrequent AVRT episode(s): Class IIIC
Prophylaxis of SVT during pregnancy: Class IC 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
Prophylaxis of SVT during pregnancy: Class IC |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
Heart Failure 62.5-125 µg daily ESC Guidelines (European Heart Journal
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|Heart Failure
|62.5-125 µg daily
|ESC Guidelines (European Heart Journal
doi:10.1093/eurheartj/ehs104):
doi:10.1093/eurheartj/ehs104):
Symptomatic (NYHA class II-IV) HF: Class IIbB
Symptomatic (NYHA class II-IV) HF: Class IIbB
ESC Guidelines Symptomatic (NYHA class II-IV) HF, LVD and AF: Class IB
ESC Guidelines Symptomatic (NYHA class II-IV) HF, LVD and AF: Class IB
Acute HF with AF and VT: Class IC
Acute HF with AF and VT: Class IC
Anti-platelet Drugs - Aspirin Prevention of thrombotic cerebro- or cardio-vascular disease 75mg once/day ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
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|Anti-platelet Drugs - |
|Aspirin
|Prevention of thrombotic cerebro- or cardio-vascular disease
|75mg once/day
|ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
Prevention in AF: Class IC
Prevention in AF: Class IC
Prevention in diabetic patients: IIaB
Prevention in diabetic patients: IIaB
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doi:10.1093/eurheartj/ehs092):
doi:10.1093/eurheartj/ehs092):
Post-MI: Class Ia
Post-MI: Class Ia
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%).
|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%).
Pain / pyrexia 300-600mg every 4-6 hours as necessary
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- Clopidogrel Prevention of thrombotic events (esp. when warfarin not tolerated) 75mg once/day ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
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|Pain / pyrexia
|300-600mg every 4-6 hours as necessary
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|Clopidogrel
|Prevention of thrombotic events (esp. when warfarin not tolerated) |75mg once/day
|ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
Prevention in diabetic patients: IIaB
Prevention in diabetic patients: IIaB
Primary and secondary prevention of stroke: Class IB
Primary and secondary prevention of stroke: Class IB
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doi:10.1093/eurheartj/ehs092):
doi:10.1093/eurheartj/ehs092):
Acute phase of coronary artery syndrome: Class IB
Acute phase of coronary artery syndrome: Class IB
Non-cardioembolic cerebral ischaemic events: Class IA Dyspepsia (5.2%), abdominal pain (5.6%), diarrhoea (4.5%); bleeding disorders including gastro-intestinal (2.0%) and intracranial (0.4%), nausea (3.4%), vomiting, gastritis, flatulence, constipation, gastric and duodenal ulcers, headache (7.6%), epistaxis (2.9%), dizziness (6.2%), paraesthesia, leucopenia, decreased platelets (very rarely severe thrombocytopenia), eosinophilia, rash (4.2%), pruritus (3.3%), vertigo, colitis, pancreatitis, hepatitis (<1%), acute liver failure, hypertension (4.3%), chest pain (8.3%), oedema (4.1%), vasculitis, confusion, hallucinations, taste disturbance, cough (3.9%), fatigue (4.8%) stomatitis, bronchospasm, interstitial pneumonitis, pyrexia (2.2%), blood disorders including thrombocytopenic purpura (5.3%), agranulocytosis, neutropenia (0.04%) and pancytopenia and hypersensitivity-like reactions (<0.1%)including fever, glomerulonephritis, arthralgia, Stevens-Johnson syndrome, toxic epidermal necrolysis, lichen planus
Non-cardioembolic cerebral ischaemic events: Class IA
Acute myocardial infarction 300mg daily initially then 75mg once/day ESC Guidelines(European Heart Journal (2012) 33, 2569–2619
|Dyspepsia (5.2%), abdominal pain (5.6%), diarrhoea (4.5%); bleeding disorders including gastro-intestinal (2.0%) and intracranial (0.4%), nausea (3.4%), vomiting, gastritis, flatulence, constipation, gastric and duodenal ulcers, headache (7.6%), epistaxis (2.9%), dizziness (6.2%), paraesthesia, leucopenia, decreased platelets (very rarely severe thrombocytopenia), eosinophilia, rash (4.2%), pruritus (3.3%), vertigo, colitis, pancreatitis, hepatitis (<1%), acute liver failure, hypertension (4.3%), chest pain (8.3%), oedema (4.1%), vasculitis, confusion, hallucinations, taste disturbance, cough (3.9%), fatigue (4.8%) stomatitis, bronchospasm, interstitial pneumonitis, pyrexia (2.2%), blood disorders including thrombocytopenic purpura (5.3%), agranulocytosis, neutropenia (0.04%) and pancytopenia and hypersensitivity-like reactions (<0.1%)including fever, glomerulonephritis, arthralgia, Stevens-Johnson syndrome, toxic epidermal necrolysis, lichen planus
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|Acute myocardial infarction |300mg daily initially then 75mg once/day
|ESC Guidelines(European Heart Journal (2012) 33, 2569–2619
doi:10.1093/eurheartj/ehs215):  
doi:10.1093/eurheartj/ehs215):  
Post STEMI: Class IA
Post STEMI: Class IA
Acute coronary syndrome 300mg daily initially then 75mg once/day ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
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ACS: Class IIaC
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- Prasugrel Prevention of thrombotic events. 60mg bolus then 5-10mg once daily ESC Guidelines (European Heart Journal
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|Acute coronary syndrome |300mg daily initially then 75mg once/day
|ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
ACS: Class IIaC
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|Prasugrel
|Prevention of thrombotic events. |60mg bolus then 5-10mg once daily
|ESC Guidelines (European Heart Journal
doi:10.1093/eurheartj/ehs104):
doi:10.1093/eurheartj/ehs104):
Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA
Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA
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doi:10.1093/eurheartj/ehs092):
doi:10.1093/eurheartj/ehs092):
Acute phase of coronary artery syndrome: Class IB
Acute phase of coronary artery syndrome: Class IB
Haemorrhage (11.3%) (including gastro-intestinal (1.5%) and intracranial), haematoma, haematuria, hypertension (7.5%), hypotension (3.9%), headache (5.5%), back pain (5.0%), dyspnoea (4.9%), nausea (4.6%), dizziness (4.1%), cough (3.9%), fatigue (3.7%), chest pain (3.1%), arrhythmias including atrial fibrillation (2.9%) and bradycardia (2.9%), rash (2.8%), pyrexia (2.7%), oedema (2.7%), diarrhoea (2.3%), hypercholesterolaemia/hyperlipidaemia (7.5%), anaemia, rash,hypersensitivity reactions including angioedema (0.06%), thrombocytopenia (0.06%), thrombotic thrombocytopenic purpura
|Haemorrhage (11.3%) (including gastro-intestinal (1.5%) and intracranial), haematoma, haematuria, hypertension (7.5%), hypotension (3.9%), headache (5.5%), back pain (5.0%), dyspnoea (4.9%), nausea (4.6%), dizziness (4.1%), cough (3.9%), fatigue (3.7%), chest pain (3.1%), arrhythmias including atrial fibrillation (2.9%) and bradycardia (2.9%), rash (2.8%), pyrexia (2.7%), oedema (2.7%), diarrhoea (2.3%), hypercholesterolaemia/hyperlipidaemia (7.5%), anaemia, rash,hypersensitivity reactions including angioedema (0.06%), thrombocytopenia (0.06%), thrombotic thrombocytopenic purpura
- Ticragelor Prevention of thrombotic events. 180mg bolus then 90mg twice daily ESC Guidelines (European Heart Journal
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|Ticragelor
|Prevention of thrombotic events. |180mg bolus then 90mg twice daily
|ESC Guidelines (European Heart Journal
doi:10.1093/eurheartj/ehs104):
doi:10.1093/eurheartj/ehs104):
Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA
Prevention in Symptomatic (NYHA class II-IV) HF and AF: Class IIA
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doi:10.1093/eurheartj/ehs092):
doi:10.1093/eurheartj/ehs092):
Acute phase of coronary artery syndrome: Class IB
Acute phase of coronary artery syndrome: Class IB
 
|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
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
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Vitamin K Antagonists - Warfarin Prevention of thrombotic/ embolic events (esp. after prosthetic valve insertion) 5-10mg initially then tailored to individual (usually 3-9mg once daily at the same time) 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)
|Vitamin K Antagonists
- Acenocoumarol Prevention of thrombotic/ embolic events (esp. after prosthetic valve insertion) 4mg initially, followed by 1-8mg daily 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)
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Lipid-Lowering Drugs Statins Simvastatin, Atorvastatin Primary hyper-cholesterolaemia, combined hyperlipidaemia Simvastatin: 10-20mg once daily ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
|Warfarin
|Prevention of thrombotic/ embolic events (esp. after prosthetic valve insertion)
|5-10mg initially then tailored to individual (usually 3-9mg once daily at the same time)
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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)
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|Acenocoumarol
|Prevention of thrombotic/ embolic events (esp. after prosthetic valve insertion)
|4mg initially, followed by 1-8mg daily
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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)
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|Lipid-Lowering Drugs |Statins
|Simvastatin, Atorvastatin Primary hyper-cholesterolaemia, combined hyperlipidaemia Simvastatin: 10-20mg once daily ESC and EASD Guidelines (European Heart Journal doi: 10.1093/eurheart/ehl261)
Dyslipidaemia: Class IA
Dyslipidaemia: Class IA
Low HDL-C: Class IIbB
Low HDL-C: Class IIbB
NiloferT
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