PHRM3011 Lecture Notes - Lecture 13: Hepatotoxicity, Cyp2D6, Orthopnea
Document Summary
Decrease pulse, decrease bp, decrease contractility = decreased myocardial. Do not stop abruptly (withdraw over 2 weeks) Dilate arteries and veins = decreased myocardial o2 demand. Verapamil and diltiazem also decreased pulse and contractility. Avoid nifedipine on its own due to reflex tachycardia decrease bp too much and hr increases to counteract caustion with other dihydropyridines on their own as can increae sympathetic tone (increase pulse) Se"s headaches and flushing inititally, faiting, orthostatic hypotension, palpitations. Glycerol trinitrate spray or sub-lingual tablets and patches. Bb + verapamil avoid decreasing pulse and contractility. Statins decrease death and major coronary events. Acei decrease death, mi and stroke. Ses headache, nausea, vomiting, dizziness, malaise. Start low dose 5mg d or bd. Perhexiline increase glucose and lactate utilization in myocardium metabolic effect. Effective as mono or add on therapy. Dose 200 300 mg for 5 days -> 100 200mg d. Dis cyp2d6 potential interactions ssris. Result of a cardiac abnormality or insult to heart.
