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Positive inotropic drugs: Cardiac glycosides (digoxin)
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Drugs modifying cardiac rate and force
This 24-slide slide set provides an introduction at new learner to intermediate level to some of the most common drugs that are used clinically to modulate the rate and force of contraction of the heart. The specific drug classes presented include: agonists and antagonists of beta-adrenoceptors, an antagonist of muscarinic acetylcholine receptors (i.e. atropine), cardiotonic agents including cardiac glycosides (i.e. digoxin) and miscellaneous other agents.
efaccena - 10/07/2018 - 9:39am
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Arrhythmias
The normal heart beats regularly at 60–100 beats per min (bpm), which is controlled by the sinoatrial (SA) node located in the right atrium. Tachycardia describes a heart that beats more rapidly (>100 bpm). Bradycardia describes a situation where the heart beats more slowly (<60 bpm). Electrical signals generated in the SA node travel through a conduction pathway in the wall of the atria (causing atrial contraction) before reaching and depolarising the AV node.
efaccena - 15/03/2022 - 12:40pm
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Introduction to Drug Distribution
The process of transferring a drug from the bloodstream to tissues is referred to as distribution. The same principles that govern drug absorption (e.g. ionization of a drug, lipophilicity of a drug, size of a drug, pH of the environment, etc.) also govern the rate and extent that a drug will distribute to various tissues in the body. In addition, there are additional factors at play, particularly non-specific binding to proteins.
hbenson - 23/06/2015 - 2:55pm
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Role of inotropic drugs in treating congestive cardiac failure
This video is approximately 37 minutes long and discusses the role of inotropic drugs in treating congestive heart failure with the help of concept maps/diagrams and animations.This presentation starts with an overview of pathophysiological basis of treating congestive cardiac failure (CCF). Various drugs commonly used to treat CCF are listed to show how inotropic drugs fit in the larger picture. Then, a description of the mode of action, uses and side effects of inotropic agents and their role in CCF is given in greater detail. Finally, a summary is given.
efaccena - 05/10/2020 - 7:54am
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Drug interactions - Distribution
Distribution interactions occur when drugs are extensively protein-bound and the co-administration of a second can displace it to the non-bound active form. This increases the amount of (unbound) drug available to cause an effect. For example, diazepam displaces phenytoin from plasma proteins, resulting in an increased plasma concentration of free phenytoin and an increased risk of toxicity. The effects of protein displacement are usually short-lived because the metabolism of the affected drug usually increases in parallel with the increased free drug concentration.
smaxwell - 30/12/2015 - 10:31am
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Drug interactions - Excretion
Excretion interactions primarily involve changes in renal excretion. This might be due to drug-induced reduction in glomerular filtration rate (e.g. diuretic-induced dehydration, ACE inhibitors, NSAIDs). This can reduce the clearance and increase the plasma concentration of many drugs, including some with a low therapeutic index (e.g. digoxin, lithium, aminoglycoside antibiotics). Less commonly, interactions may be due to competition for a common tubular organic anion transporters (e.g. methotrexate excretion may be inhibited by competition with NSAIDs).
smaxwell - 30/12/2015 - 10:33am
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Herbal medicine
Herbal medicine has been practised for thousands of years and is based on the use of plants or plant extracts in the treatment or prevention of symptoms associated with many medical conditions. In Europe, herbal medicines are now generally used for minor or self-limiting conditions, without the need to be prescribed by a medical practitioner. Other longstanding herbal medicine traditions include traditional Chinese herbal medicine, Ayurvedic medicine (South-East Asia), and Kampo (Japan). Herbal medicines may contain a range of biologically active compounds in the same preparation, and some
smaxwell - 21/06/2016 - 9:35am
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Therapeutic index
When drugs are used in clinical practice, the prescriber is unable to construct a careful dose–response curve for each individual patient. Therefore, most drugs are licensed for use within a recommended dose range that is expected to be close to the top of the dose–response curve for most patients. This ensures that most patients will achieve a good clinical response without the need for frequent review and dose increases. However, this means that it is sometimes possible to achieve the desired therapeutic response at doses towards the lower end of the recommended range (or below).
efaccena - 20/11/2015 - 11:43am
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Anti-arrhythmic drugs
Antiarrhythmic drugs are a group of pharmaceuticals that are used to suppress abnormal rhythms of the heart (cardiac arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation.
Class I antiarrhythmics interfere with sodium channel function, and are subdivided by the effect they have on the action potential (AP)- see figure below
smaxwell - 10/10/2014 - 9:04am