pharmeducate cv

Question 1

amiodarone loading dose

Answer 1

200mg TDS 7 days
200mg BD 7 days
200mg OD as maintenance

Question 2

amiodarone s/e (eyes

Answer 2

eyes
corneal micro-deposits - night time glare when driving
optic neuropathy/ neuritis (blindness) - stop if impaired vision

Question 3

amiodarone s/e (skin

Answer 3

phototoxicity (burning, erythema)
slate-grey skin on light exposed areas
shield skin from light during trmxt, use high spf sunscreen for months after stopping

Question 4

amiodarone s/e nerve

Answer 4

peripheral neuropathy

numbness, tingling hands n feet, tremor

Question 5

amiodarone s/e lungs

Answer 5

pneumonitis, pulmonary fibrosis, SOB, dry couth

Question 6

amiodarone s/e liver

Answer 6

hepatotoxicity

jaundice, n+V, malaise, itching, burning, abd pain 3x raised liver transaminase

Question 7

amiodarone s/e thyroid dysfunction

Answer 7

(amiodarone contains iodine)
hyperthyroidism (weight loss, heat intolerace, tachycardia)
–> give carbimazole if necessary stop amiodarone
hypothyroidism (weight gain, cold intolerance, bradycardia
–> start levothyroxine without withdrawing amiodarone

Question 8

amiodarone monitoring

Answer 8

annual eye test, chest x-ray before, LFT every 6 months, monitor TSH, T3, T4 before trmxt n every 6 months
BP, ECG
serum potassium (hypokalaemia enhances arrhythogenic effect of amiodarone

Question 9

amiodarone long or short t1/2

Answer 9

long-

interaction can happen months after stopping

Question 10

amiodarone, enzyme inhibitor or inducer

Answer 10

inhibitor,

reduce dose of warfarin, phenytoin, digoxin

Question 11

what food does amiodarone interact with

Answer 11

grapefruit juice

Question 12

amiodarone risk with myopathy? interaction with which drug?

Answer 12

yes risk with myopathy- avoid with statin

Question 13

amiodarone cautions with other CV drug ?

Answer 13

BB, rate limiting CCB( verapamil, diltiazam)

- bradycardia, AV block n myocardial depression

Question 14

amiodarone QT prolongation? drug?

Answer 14

quinolones, macrolides, TCAs, SSRIs, lithium, quinine, hydroxychloroquine, antimalarials, (chloroquine, mefloquine), antipsychotics (sulpiride, pimozide, amisulpride)

Question 15

digoxin level

Answer 15

1-2mcg/L

Question 16

digoxin toxicity sign

Answer 16

slow and sick 
bradycardia/ heart block 
nvd abdominal pain 
**blurred/ yellow vision
confusion, delirium, 
rash

Question 17

digoxin affecting electrolytes ? consequence?

Answer 17

hypOK+, hypOMg, hypER Ca, hypoxia, renal impairment

- increase risk of digoxin toxicity

Question 18

trmxt for digoxin toxicity

Answer 18

withdraw- correct e- balance

digoxin-specific antibody- life threatening ventricular arrhythmias unresponsive to atropine