Digitalis Lecture

50 %
50 %
Information about Digitalis Lecture

Published on February 23, 2008

Author: guest9bc2b8

Source: slideshare.net

Description

Digitalis Lecture

Drugs Used In the Treatment of Congestive Heart Failure

Prototype drugs to know for treatment of heart failure Inotropes – digoxin, inamrinone,dobutamine, dopamine Diuretics - hydrochlorothiazide, furosemide, amiloride, spironolactone ACE inhibitors – captopril, enalapril,lisinopril AII receptor blockers -valsartan,losartan Sympatholytics – propranolol, carvedilol Vasodilators – glyceryl trinitrate, hydralazine, sodium nitroprusside

Inotropes – digoxin, inamrinone,dobutamine, dopamine

Diuretics - hydrochlorothiazide, furosemide, amiloride, spironolactone

ACE inhibitors – captopril, enalapril,lisinopril

AII receptor blockers -valsartan,losartan

Sympatholytics – propranolol, carvedilol

Vasodilators – glyceryl trinitrate, hydralazine, sodium nitroprusside

 

 

DEFINITION “ The situation when the heart is incapable of maintaining a cardiac output adequate to accommodate metabolic requirements and the venous return. " E. Braunwald

 

 

EVOLUTION OF CLINICAL STAGES NORMAL Asymptomatic LV Dysfunction Compensated CHF Decompensated CHF No symptoms Normal exercise Normal LV fxn No symptoms Normal exercise Abnormal LV fxn No symptoms Exercise Abnormal LV fxn Symptoms Exercise Abnormal LV fxn Refractory CHF Symptoms not controlled with treatment Chronic Congestive Heart Failure

 

 

 

 

 

 

 

 

 

 

 

 

DIGOXIN NEUROHORMONAL EFFECTS Plasma Noradrenaline Peripheral nervous system activity RAAS activity Vagal tone Normalizes arterial baroreceptors

 

 

DIGOXIN TOXICITY CARDIAC MANIFESTATIONS ARRHYTHMIAS : - Ventricular (PVCs, VT, VF) - Supraventricular (PACs, SVT) BLOCKS: - S-A and A-V blocks CHF EXACERBATION

 

 

% WORSENING OF CHF p = 0.001 DIGOXIN: 0.125 - 0.5 mg /d (0.7 - 2.0 ng/ml) EF < 35% Class I-III (digoxin+diuretic+ACEI) Also significantly decreased exercise time and LVEF. DIGOXIN EFFECT ON CHF PROGRESSION RADIANCE N Engl J Med 1993;329:1 Placebo n=93 DIGOXIN Withdrawal DIGOXIN n=85 30 10 0 20 100 80 20 0 40 60 Days

Placebo n=3403 DIGOXIN n=3397 48 0 12 24 36 OVERALL MORTALITY % DIG N Engl J Med 1997;336:525 Months p = 0.8 50 40 30 20 10 0

 

Add a comment

Comments

Fifa Coins For Sale | 16/01/15
Oh, It's a nice post! Like you, Thanks! Excuse me, Please look at my username! Cheap Fifa Coins. Fifa Coins For Sale http://www.fifacoing.com/

Related presentations

Related pages

On digitalis a lecture delivered before the materia medica ...

James Stewart - On digitalis a lecture delivered before the materia medica class jetzt kaufen. Kundrezensionen und 0.0 Sterne. …
Read more

Lectures on Therapeutics — I. Digitalis — NEJM

Lecture from The New England Journal of Medicine — Lectures on Therapeutics — I. Digitalis
Read more

Digitalis - LECTURES ON HOMOEOPATHIC MATERIA MEDICA by ...

Main. LECTURES ON HOMŒOPATHIC MATERIA MEDICA by JAMES TYLER KENT, A.M., M.D. Late Professor of Materia Medica in Hering College, Chicago.
Read more

On digitalis : a lecture delivered before the materia ...

Get this from a library! On digitalis : a lecture delivered before the materia medica class, McGill University, Montreal, November, 1884. [James Stewart]
Read more

Cardiac glycoside - Wikipedia, the free encyclopedia

Binding of cardiac glycoside to Na-K ATPase is slow, and after binding, intracellular calcium increases gradually. Thus, the action of digitalis ...
Read more

www.aspet.org

www.aspet.org
Read more

Digitalis Homeopathic Materia Medica Lecture Dr Bashir ...

Skip navigation Upload. Sign in
Read more

Digitalis - homeopathic medicine | Kent's Lectures ...

Digitalis - homeopathic medicine from Kent's Lectures at Homeopathic Books - Homeopathic medicines from homeopathic books - materia medica & repertory at ...
Read more