Streptokinase

Introduction Dose 1.5 MU diluted in 100 mL normal saline, given over 1 hour Notes: Make sure no bubble in the solution Contraindications Notes • Streptokinase should not be given again between 3 days – 12 months after initial treatment with streptokinase • Streptokinase is antigenic; it’s is a bacterial product which promotes production of […]

Paracetamol / Acetaminophen

Introduction Brand name Panadol (tablet); Perfalgan (IV) Mechanism of action / Effects • Analgesic effect • Antipyretic effect • Anti-inflammatory activity (weak) Route of administration • Oral ( / syrup) • IV• Rectal Pharmacokinetics Onset • Oral: <1 hour• IV: 5 – 10 minutes (analgesia); within 30 minutes (antipyretic) Peak of action • Oral: 30 […]

Amlodipine

Introduction A dihydropyridine calcium channel blocker Pharmacokinetics • Onset: • Duration of action: 24 hours Dose Related Posts Calcium channel blocker (CCB) References MIMS Malaysia

Digoxin

Introduction • Digoxin competes with potassium to bind to potassium binding sites then inhibits sodium-potassium pump in cardiac myocytes→ affects cardiac contraction force, rate and rhythm Precaution 🚪 Is the patient hypokalaemic? Clinical Use • Supraventricular arrhythmias (especially atrial fibrillation / atrial flutter) Dose Rapid digitalization — Intravenous• Initial loading dose: 0.25 – 0.5 mg […]

Fentanyl

Onset IV: less than 60 seconds, up to 2 – 3 minutes Duration of Action 30 – 60 minutes Dose Adverse Effects • Muscle wall rigidity• Respiratory distress• Hypotension Related Posts Further Reading

Atropine

Preparation IV: 1 mg/mL Mechanism of action Competitive, reversible Uses • Bradycardia • To reduce salivation / bronchial secretion• Antidote for organophosphorous poisoning Doses Side effects • Hypersensitivity• Lack of sweating•Blurred vision• Dry mouth• Tachycardia Q&A Reference https://www.rxlist.com/atropine-side-effects-drug-center.htmhttps://www.ncbi.nlm.nih.gov/books/NBK470551/

Glyceryl Trinitrate (GTN)

Sublingual GTN Dilution Protocol for IVI GTN Dilution mcg/min to mL/hr

Alpha-Blockers

Types • Specific VS (e.g. phentolamine, phenoxybenzamine) Mechanism of Action • Reduces peripheral resistance → lowers BP• Doses Related Posts Adrenoceptors [open]

Renin-Angiotensin-System (RAS) Blockers — ACEi & ARB

Ace Inhibitors (ACEIs) Benefits • Can lower cardiovascular risk• Can prevent coronary artery disease in patients with HTN• Can reduce mortality & morbidity in patients with congestive heart failure • No adverse effect on lipid & glucose metabolism Adverse effects • Dry cough • Angioedema (rare) • Doses Precautions • Check baseline before starting • […]

Calcium Channel Blockers (CCB)

Mechanism of action Dihydropyridine• Vasodilatation → decreased peripheral resistance Non-dihydropyridine• Negative inotropic effect Classification • vs Calcium channel blockers in hypertension Related Posts

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Index