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27 Cards in this Set
- Front
- Back
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What are primary prevention straegies for Atrial fibrillation
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Omega-3-fatty acids
Statins ACE/ARBs |
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What is the role RAAS in AF
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pathogeneis, atrial remodeling and structrual remodeling
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What are 2 strageis for treatment of AF
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rate control--which restore ventricular rate
rhythm control restores maintence of Sinus rhythm |
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Is there a difference in mortaiity between rate and rhythm control
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NO
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Rhythm control is better for younger pts, and rate control is bteeter for
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elderly pts
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When is Rhythm control given first
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1. First epidsode
2. Highly symptomatic 3. AF reversible 4. High chance of maintaining sustain rhythm |
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What do you choose rate control first
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1. Asymptomatic
2. Failed rhythm cotnrol 3. Adverse effects 4. Older |
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Amiodarone drug dosing
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typically 200mg qd
100-400mg/day |
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What is Dosing of Dofetilide
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CrCl >60 500 mcg BID
40-60 250 mcg BID 20-40 125 mcg BID |
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What is dosing of Flecainide
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200-300mg/day
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Amiodarone drug interactions
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Wafarin--decrease dose by 50%
Digoxin--decrase dose by 50% Cyclosporine Simvastatin--do not excee 20mg/day |
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What are Amiodarone monitoring parameters
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Basline Thyroid Fuction/pulmonary toxicity, and opthamic exams
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What are Drug interactions with Dofetilize
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HCTV
HCTZ, fursemide, trimethorpim, verapamil, Ketoconazole, Prochlorperzine, megestrol |
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What is Dofetilide mechansims of inetactions
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Tubular secetion inhbition
3A4 ineraction Electrolyte depletion |
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What drug is a prescriber program and providers must participate in the education program to be certified to prescribe--pharmacist must parcipate in the TIPS programs
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Dofetilide
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What are monitoring of Dofetilide
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EKG, Scr, QTC interval (like ibutilide)
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FLecainide and PRopafernon are contraindicated with
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Tipranavir
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What are monitoring of Flecaindie and Profarernone
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BP, HR, and LFTs
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Rate control drugs are Beta-blockers, Ca channel blcoker and Digoxin, monitoring
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Beta/Ca BP/HR
Digoxin HR, Ca/Mg, K |
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When do you check levels of Digoxin in LD is given
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12-24 hrs after
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When do you check level of digoxin if no loading dose is given
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3-5 days after starting therapy
or 5-7 after changing or staring or stops other drugs |
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What is CHADS2 Crieria
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C congestive HF
H Hypertension A Age >75 D Diabetes S Prior Stroke or TIA |
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What do CHADS2 citeria estimate
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stroke risk with atrial fibrillation
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What is recommended therapy with CHAD score 0
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ASA 81-325 mg/qd
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What is recomended therapy for CHAD score of 1
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ASA 81-325mg/dat or WARFARIN (WARFARIN recommended over ASA
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What is recommended therapy for CHAD score of 2 or more
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Warfarin
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Why is warfarin recommended of ASA in CHAD score 1
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wafarin has greater efficacy than ASA at prevneting stroke
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