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Prolongs QT
Torsades de pointes
Slows phase 0 of cardiac cells
Displaces digoxin making digoxin more toxic
Blocks K, incr effective refractory period
Quinidine - Class IA
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Lupus
Bad for slow acetylator
Torsades de pointes
Agranulocytosis
Slows/prolongs phase 0 of cardiac cells
Procainamide - Class IA
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Lidocaine -CNS effects
Mexiletine
- Class IB
- Prolnogs phase 0 cardiac cells
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Flecainide
- Class 1C
- Prolongs phase 0 cardiac cells
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Class II antiarrythmias
- Beta blockers
- Slows/decr phase IV of pacemakers
- Decr SA/AV activity
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Amiodarone
Sotalol
Dofetilide
ibutilide
- Class III - K channel blockers
- Incr effective refractory period
- Prolongs phase III cardiac cells
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Prolongs QT
- -azoles
- Sotalol
- Quinidine
- Amiodarone
- Hypocalcemia
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Pulmonary toxicity
- Amiodarone (fibrosis)
- Bleomycin
- Mitomycin
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Class IV
- Ca channel blockers
- Verapamil - can lead to CHF
- Diltiazem
- Decr phase 0 and phase 4
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Drugs causing torsades
- K channel blockers (class IA and III)
- Antipsychotics (thioridazine)
- TCA
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Unclassified antiarrythmia
Decr SA and AV activity
Can be antagonized by methylxanthines (theophylline and caffeine)
Adenosine
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Unclassified antiarrythmia
Treats torsades
Magnesium
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Hydralazine
- Vasodilator acting thru NO
- SLE syndrome in slow acetylators
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Toxicity of nitroprusside
- Reflex tachycardia
- Cyanide toxicity
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Drugs causing SLE in slow acetylators
- Hydralazine
- Isoniazide
- Procainamide
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Ca channel blockers
- Verapamil (constipation)
- Diltiazem
- -dipines (gingival hyperplasa, reflex tachycardia)
- Dihydropyridine
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P450 inducers
- Quinidine
- Barbiturates
- St Johns Wort
- Phenytoin
- Rifampin
- Griseofulvin
- Carbamazepine
- Chronic alcoholism
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P450 inhibitors
- Sulfa
- Isoniazid
- Cimetidine
- Ketoconazole
- Erythromycin
- Grapefruit
- Acute alcohol
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Digoxin
- Inhibits cardiac Na/K ATPase --> more intracell Na
- Incr contractile force
- Incr vagal tone
- Prolongs PR interval
- Bradycardia
- Hyperkalemia
- Not used in A Fib
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Wolff Parkinson white syndrome
- Treat w/ class IA or III
- Don't use digoxin, beta blocker, Ca channel blocker or adenosine
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-dipines
Ca channel blockers w/ special use for Raynaud's
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Carbonic anhydrase inhibitors
- Acetazolamide
- Dorzalamide
- Causes metabolic acidosis --> hyperventilation can be used to treat acute mountain sickness
- Treats alkalosis and glaucoma
- Works on PCT
- Causes renal stones
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Hypokalemia
Hypocalcemia
Hypouricemia
Sulfa hypersensitivity
- Loop diuretics
- Sulfa hypersensitivity only w/ Furosemide
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Side effects:
sulfa hypersensitivity
Hypokalemia
Hypercalcemia
Hyperlipidemia
Can be used to treat hypertension, CHF, calcium stones, nephrogenic diabetes insipidus
- Thiazides
- Avoid use w/ digoxin. Avoid in diabetic pts
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Side effects of flushing, pruritus, rashes, hepatotoxicity, incr HDL
Niacin/Vit B3
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Side effects of Gemfibrozil
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Drug used for weight loss
Inhibits pancreatic lipase
Decr TGA breakdown in intestines
Side effects: steatorrhea, diarrhea, decr absorption of lipid soluable vitamins
Orlistat
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