100 important drugs to know - part 1 Flashcards
Digoxin indication
- AF or flutter
- heart failure
Digoxin contra-indications
- constrictive pericarditis
- hypertrophic cardiomyopathy
- intermittent complete heart block
- myocarditis
- second degree AV block
- SVT arrhythmias eg WPW syndrome
= VF
Digoxin common or very common SE
- arrhythmia
- blurred/yellow vision
- d+v
- eosinophilia/ rash
Digoxin monitoring
Us/Es
Digoxin drug class
cardiac glycoside
Bendroflumethiazide indications
Oedema
Hypertension
Dose of Bendroflumethiazide for HTN
2.5 mg OD
Dose of Bendroflumethiazide for oedema
5-10 mg OD or alternate days
1-3/7 for maintenance
Contra-indications of Bendroflumethiazide
- addisons
- high Ca, urea
- low K, Na
Cautions with Bendroflumethiazide
- DM
- gout
- SLE
Monitoring for Bendroflumethiazide
Us/Es
Drug class of Bendroflumethiazide
thiazide diuretics
Furosemide mech of action
Loop diuretic; inhibits reabsorption
Furosemide indications
oedema
resistant oedema/ HTN
Dose of furosemide for oedema (non resistant)
start with 40 mg OD, maintain 20-40 mg OD
Dose of furosemide for resistant HTN
40-80 mg OD PO
Contra-indications of furosemide
renal failure
low Na or K
Main SE of furosemide
- hepatic impairment due to low K- could lead to encephalopathy and coma
- renal impairment
- tinnitus and deafness if rapidly administrated
Monitoring of furosemide
Us and Es
Spironolactone indications
- Oedema due to heart failure
- Ascites due to cirrhosis of liver
- nephrotic syndrome
- resistant HTN
Dose of spironolactone for oedema
100-400 mg OD
Dose of spironolactone for HTN
25 mg OD
Contra indications to spironolactone
Addisons
Anuria
High K
Monitoring of spironolactone
Plasma K levels- high risk of hyperkalaemia
Drug class of spironolactone
aldosterone antagonist
Indications of Co-amilofruse
oedema
What is co amilofruse made of
amiloride + furosemide
Amiloride indications
- oedema
- K conservation when used with other diuretics
Dose of amiloride for oedema
10 mg OD or 5mg BD
max daily =20mg
Monitoring of amiloride
monitor electrolytes (high risk of hyper K)
Adenosine indication
- rapid reversion to sinus rhythm from SVTs
- used in myocardial perfusion imaging in patients who cannot exercise adequately
Dose of adenosine for rapid reversion to sinus rhythm
- 6mg IV over 2secs,
- followed by a possible 2 more 12mg doses 1-2 min apart if required
Contra-indications of adenosine
- asthma, copd
- decompensated heart failure
- Long QT
- 2/3rd degree HB
- severe hypotension
Common SEs of adenosine
- angina (discontinue if)
- apprehension
- arrhythmia, AV block
- SOB
- nausea
- headache, dizziness
Monitoring for adenosine
ECG monitoring
resus facilities should be available
Amiadarone indication
- arrhythmias
- If Refractory to defib: ventricular fibrillation or pulseless ventricular tachycardia
Amiadarone dose
PO: 200 mg TDS 3days 1st wk, then 200mg BD for 2nd wk, then 20mg OD
IV: 5mg/Kg over 20-120 mins, max 1.2 g daily
Interactions of amiodarone
very long half life
interactions may occur several wks/months after taking
Common SEs of amiodarone
- Low HR
- high/low thyroid
- pulmonary toxicity
- jaundice, nausea/ vomiting
- grey skin discolouration, phototoxicity
- reversible corneal microdeposits
Monitoring of amiadarone
Every 6 mo: - TFT - LFTs Before start : - K, LFTs, TFT - CXR
Monitoring of iv amiadarone
ECG monitoring and resuscitation facilities must be available.
- plus liver transaminases
Concomitant use of which drugs and amiadarone should be avoided
Hep C anitretroviral rx:
sofosbuvir and daclatasvir, simeprevir and sofosbuvir, or sofosbuvir and ledipasvir
Why should avoid treating hep c and amiadarone at the same time
risk of severe bradycardia and HB
