Anticoagulation

Anticoagulation therapy prevents and treats thromboembolism by inhibiting the coagulation cascade. Anticoagulants Class Mechanism Examples Nota bene Unfractionated heparin (UFH) Enhances the activity of antithrombin III → decreased thrombin and Xa activity Heparin Monitored with aPTT and Anti-Xa levels. It is…

Amiodarone

Overview Amiodarone is a very effective, but highly toxic, class III antiarrhythmic. Amiodarone-induced Hypothyroidism (AIH) The pathophysiology of hypothyroidism is due to the Wolff-Chaikoff effect – thyroxine formation is inhibited due to high levels of circulating iodine. Amiodarone-induced Thyrotoxicosis (AIT) AIT…

Digoxin and Digoxin Toxicity 

Digoxin Digoxin is a cardiac glycoside that is derived from the foxglove plant. Digoxin (Digitalis) Toxicity Syndrome The likelihood of digoxin toxicity increases at a concentration of 1.5 – 3 mcg In the past, loop diuretics would cause hypokalemia, which…

Potassium-Sparing Diuretics

Potassium-sparing diuretics increase fluid loss through urine while reducing the secretion of potassium. They are generally weak diuretics. Category Examples ENaC Blockers Amiloride and triamterene Mineralocorticoid receptor antagonists (MRAs) Spironolactone, eplerenone, and finerenone

Angiotensin II Receptor Blockers (ARBs)

Angiotensin II receptor blockers reduce the progression of renal disease in patients with diabetic nephropathy, and reduce cerebrovascular and ischaemic heart disease mortality in hypertensive patients. Category Examples Nota bene Angiotensin II receptor blockers Losartan, valsartan, and candesartan Hydrochlorothiazide (HCTZ) + Losartan is…

Positive Inotropes and Vasopressors

Inotropes and vasopressors are used critically ill patients with shock or severe hypotension in order to restore perfusion and maintain blood pressure. Category Function Examples Vasopressors Increase systemic vascular resistance (SVR) by vasoconstriction Noradrenaline, adrenaline, phenylephrine, vasopressin, and dopamine Inotropes Increase cardiac…

Beta-Blockers

Beta-blockers are adrenergic antagonists that are a staple in the inpatient and outpatient settings. outpatient settings. Classification of beta blockers Category Examples Nota bene Cardioselective beta-blockers (β-2 blockers) Atenolol, bisoprolol, esmolol, metoprolol, and nevibolol Preferred in patients with asthma or…