PHAR3816 Lecture Notes - Lecture 17: Atrial Tachycardia, Therapeutic Drug Monitoring, Ventricular Tachycardia
22 Jul 2018
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Document Summary
Therapeutic drug monitoring (tdm) is a multi-disciplinary clinical specialty aimed at improving patient care by individually adjusting the dose of drugs for which clinical experience or clinical trials have shown it improved outcome in the general or specific population. A posteriori measurement of blood concentrations of drugs (pharmacokinetic monitoring) and/or biomarkers (pharmacodynamics monitoring) By inhibiting the na+/k+-atpase, cardiac glycosides cause intracellular sodium concentration to increase. This then leads to an accumulation of intracellular calcium via the na+-ca++ exchange system. In the heart, increased intracellular calcium causes more calcium to be released by the sarcoplasmic reticulum, thereby making more calcium available to bind to troponin-c, which increases contractility (inotropy). Inhibition of the na+/k+-atpase in vascular smooth muscle causes depolarization, which causes smooth muscle contraction and vasoconstriction. Super ventricular tachycardia (svt) with av nodal re-entry: heart failure (harm-benefit ratio higher for heart failure) Common: anorexia, nausea, vomiting, diarrhea, blurred vision, visual disturbances, confusion, drowsiness, dizziness, nightmares, agitation, depression.
