TDM for cardiology Flashcards
what class is amiodarone
class 3 antiarrhythmic agent
why is monitoring of amiodarone important
may help differentiate treatment failure from poor adherence or suboptimal dosing
what class is disopyramide
Class 1a antiarrhythmic agent
why is monitoring of disopyramide important
complicated by varied protein binding
- widely useful in patients with renal impairment
what mode of action is warfarin
vitamin K antagonist
when does warfarin need to be monitored
frequently when changes in dose conducted or new medicines
- when dose is stable, every 12 weeks
what does international normalised ratio used to measure
Measures clotting
Describe how INR is measured
an electrochemical base of detection that detects the degree of coagulation
- place blood sample on the strip and allow thrombin to break down this compound
- thrombin breaks off the peptide and frees up phenyldiamine
- the electrons are proportional to the current which gives an indication of the efficacy of clotting
why is TDM conducted for digoxin
has a narrow therapeutic window
- above this dose, significant toxicity effects can be observed
what is a disadvantage of immunoassays
they have high variability
what are the advantages of immunoassays
they measure the free sample of the drug, highly selective and very sensitive
what should be monitored with the use of digoxin
plasma digoxin and potassium should be monitored
- endogenous substances may interfere with results
what is the mode of action of digoxin
inhibition of Na/K+ ATPase
Name possible digoxin assay interferences
- DLIS
- spironolactone
- potassium canrenoate
- Digibind and Digifab
- digitoxin
which digoxin assay interferent shows up on all of the immunoassay tests
spironolactone
