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Amiodarone cardiac stimulants cardiac treating

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Unformatted text preview: ed vision , night blindness CNS – headache • Most Toxic: – low BP – respiratory depression, respiratory arrest – low temperature Contraindications or Cautions Contraindications • • • • complete A-V block cardiac failure allergy to drug or idiosyncracy due to anticholinergic properties – caution glaucoma, urinary retention • Serum potassium must be normal – hypokalemia decreases drug effectiveness – hyperkalemia increases it Other Antiarrhythmics Other • You should know: – – – – Quinidine Lidocaine Beta Blockers Calcium channel blockers • Others will not be tested: 5 Mexiletine 7 Flecanide 10 Amiodarone Cardiac Stimulants Cardiac Treating Arrhythmias that are slow • Therapy is only a temporary measure – heart starts – electrical pacemaker fitted (overcome A-V block) • Mechanism of Action – Adrenergic Agents - Stimulates β activity of heart • Epinephrine (α & β agonist) • Isoproterenol (β agonist) - can be given orally or sublingually – Anticholinergic Agents – • blocks muscarinic slowing Therapeutic Uses Therapeutic Cardiac Stimulants – For most therapeutic uses try adrenergic agonist • • • • Cardiac arrest Hypotensive crisis A-V block Bradycardia – For bradycardia, chiefly use anticholinergic agent Side Effects Side Cardiac Stimulants • Not crucial - drug used acutely Toxic Effects Toxic Cardiac Stimulants • Heart – palpitations, tachycardia, ventricular arrhythmias • CN S – headache, fear, anxiety, restlessness • BP – may rise alarmingly Contraindications Contraindications Cardiac Stimulants • Not for chronic use – makes heart work too hard and increases its O2 use • Congestive heart failure • Angina pectoris • High blood pressure …Unless cardiac arrest Angina Pectoris: Angina Treating Heart Pain Heart Pain caused by mismatch of oxygen supply vs. oxygen demand • Often think of coronary arteries… Why? Chen, H.S. V. et al. N Engl J Med 2003;349:1e No Caption Found Angina Pectoris: Angina Heart Pain caused by mismatch of oxygen supply vs. oxygen demand • Causes related to oxygen supply – Atherosclerosis – Spasms of coronary arteries (Prinzmetal’s variant angina) – Anemia • Causes related to oxygen demand – Hypertension – Pulmonary hypertension – Heart valve disease • Note: When severe these conditions may also affect supply • Attacks precipitated by exercise or strong emotion If Condition Progresses If Could lead to Myocar...
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