DI Ivabradine

Question 1

What is the mechanism of action of Ivabradine?

Answer 1

Impacts the ‘funny’ channel in SA node causing a reduced heart rate

Question 2

What are the two adverse effects of Ivabradine?

Answer 2

Bradycardia & Atrial fibrillation

Question 3

Is Ivabradine a morbidity reducing, mortality reducing, or morbidity & reducing drug?

Answer 3

Morbidity reducing drug

Question 4

When do you use Ivabradine in a HF patient?

Answer 4

NYHA II-III: resting HR>/= 70 beats/minute on maximally tolerated BB in sinus rhythm

Question 5

What should you monitor in a patient while they are taking ivabradine?

Answer 5

Heart rate and rhythm

Question 6

What are the pearls of Ivabradine?

Answer 6

Complicated dosing algorithm in guidelines

Question 7

True or False:

Ivabradine decreases HF hospitalizations and does NOT decrease mortality?

Answer 7

True

Question 8

What are contraindications of taking ivabradine?

Answer 8

Severe hepatic impairment, acute decompensated HF, clinically significant hypotension, sick sinus syndrome, sinoatrial block, or third-degree AV block

Question 11

What drug interactions does ivabradine have?

Answer 11

Major substrate of CYP3A4