by:

Dr. Bagheri

Adenosine

Antiarrhythmic actions: Slows conduction time through the AV node,

interrupting the re-entry pathways through the AV node, restoring normal sinus

rhythm

Myocardial perfusion scintigraphy: coronary vasodilation and increases blood

flow in normal coronary arteries with little to no increase in stenotic coronary

arteries.

LRرس با 14: پایذاری هحلل رلیك شذه در سزنگ NSیا D5Wرس پایذار با 16

Pharmacologic Category:

- Antiarrhythmic Agent, Miscellaneous

-Diagnostic Agent

>10%:

Cardiovascular: Transient new arrhythmia (eg, atrial premature contractions,

atrial fibrillation) after cardioversion (55%), facial flushing (18% to 44%)

Central nervous system: Headache (2% to 18%), dizziness (2% to 12%)

Gastrointestinal: GI discomfort (13%)

Neuromuscular & skeletal: Discomfort of neck, throat, jaw (<1% to 15%)

Respiratory: Chest pressure/discomfort (7% to 40%), dyspnea (12% to

28%).......... Emphysema, bronchitis

etc…..

دی پیرادامول

کاربامازپین

Amiodarone

Inhibits adrenergic stimulation: (alpha-beta-blocking properties)

Affects sodium, potassium, and calcium channels: prolongs the action

potential and refractory period in myocardial tissue

Decreases AV conduction and sinus node function

Pharmacologic Category:

- Antiarrhythmic Agent

D5Wپایذاری در -

جذب سطحی ...... PVCساعت در ظزف 2ساعت در ظزف شیشو ای فمط 24-

PVCپیزی اس دس پیشنيادی استفاده اس تجيیشات ......

>10%:

Cardiovascular: Hypotension (I.V. 16%, refractory in rare cases)

Central nervous system (3% to 40%): dizziness, fatigue, headache, malaise,

impaired memory, involuntary movement, insomnia, poor coordination,

peripheral neuropathy, sleep disturbances, tremor

Dermatologic: Photosensitivity (10% to 75%) , pigmentation.

Endocrine & Metabolic: Hypothyroidism (1% to 22%) / hyperthyroidism

Gastrointestinal: Nausea, vomiting, anorexia, and constipation (10% to 33%)

Hepatic: AST or ALT level >2x normal (15% to 50%)

Ocular: Corneal microdeposits (>90%; causes visual disturbance in <10%)

فلکبیىید، پريکبئیه آمید ي کیىیدیهسرعت تصفی کجدی یب کلیی ثرخی داريبی ضد آریتمی کبش*

پريپبفىن، کیىیدیه، پريکبئیه آمیددر مصرف مسمبن ثب ثرخی داريبی ضد آریتمی مثل torsade depointامکبن ثريز آریتمی *

افت فشبر خن در مصرف مسمبن ثب سبیر داريبی کبىد فشبر خن تشدید*

بCCBثالکرب ي Bدر مصرف مسمبن ثب AVثیش از حد عملکرد قلت ي کبش دایت گر سرکة*

سطح سرمی دیگکسیه% 70-100 فسایشا*

خدداری از تجیس مسمبن..... ي کبش سطح سرمی ي ویم عمر ثب کلستیرامیه سبیمتیدیهغلظت سرمی آمیدارين ثب افسایش*

متتریکسبتي تئفیلیه ،دکستريمترفبن، سیکلسپریه غلظت افسایش*

فىی تئیهمتبثلیسم کبش*

تبثیر داريبی ضد اوعقبد خراکی ي امکبن ثريز خوریسی مىجر ث مرگ افسایش*

غلظت سرمی آمیدارين ثب فىی تئیه کبش*

فىتبویلثريز بیپتبوسین، ثرادی کبردی ي کبش ثرين د قلجی در مصرف مسمبن ثب *

ث عىان ثی حس کىىد مضعیلیديکبئیه در تجیس مسمبن ثب IVثريز یک مرد ثرادی کبردی سیىسی ي تشىج ثب ديز زیبد *

مهار کننده قوی آنسیم های کبدی

Verapamil

Inhibits calcium ion from entering the “slow channels” or

select voltage-sensitive areas of vascular smooth muscle and

myocardium during depolarization;

produces relaxation of coronary vascular smooth muscle

vasodilation

increases myocardial oxygen delivery in patients with angina

slows automaticity and conduction of AV node

Pharmacologic Category:

-Antianginal Agent

-Antiarrhythmic Agent

-Calcium Channel Blocker

>10%:

CNS: Headache (1% to 12%)

GI: Gingival hyperplasia (≤19%), constipation (7% to 12%)

1% to 10%:

Cardiovascular: Peripheral edema (1% to 4%), hypotension (3%),

CHF/pulmonary edema (2%), AV block (1% to 2%), bradycardia (HR <50 bpm: 1%),

CNS: Fatigue (2% to 5%), dizziness (1% to 5%), lethargy (3%), pain (2%), sleep

disturbance (1%)

Dermatologic: Rash (1% to 2%)

Lidocaine:

Pharmacologic Category :

-Antiarrhythmic Agent, Class Ib;

-Local Anesthetic

.پایذار است 24hدر دهای اتاق حذالل تا %DWSهحلل رلیك شذه با

سذین بی کزبنات........................... pH= 3-6بیشتزین پایذاری در

*increasing electrical stimulation threshold of ventricle, His-Purkinje system, and

spontaneous depolarization of the ventricles during diastole by a direct action on

the tissues.

*blocks both the initiation and conduction of nerve impulses by decreasing the

neuronal membrane's permeability to sodium ions.

Cardiovascular: Arrhythmia, bradycardia, arterial spasms, cardiovascular collapse,

edema, flushing, heart block, hypotension, sinus node supression

CNS: Agitation, anxiety, apprehension, coma, confusion, headache, hyperesthesia,

hypoesthesia, lethargy, lightheadedness, nervousness,

Gastrointestinal: Metallic taste, nausea, vomiting

Local: Thrombophlebitis

Neuromuscular & skeletal: Paresthesia, tremor, weakness

Otic: Tinnitus

Dobutamine

Stimulates beta1-adrenergic receptors; causing increased contractility and

heart rate, with little effect on beta2- or alpha-receptors

Pharmacologic Category:

-Adrenergic Agonist Agent

.ساعت هصزف شد هابمی در ریختو شد 24هحلل رلیك شذه بایستی تا -

اکسیذاسین.... تغییز رنگ **

Cardiovascular: Increased heart rate, increased blood pressure, increased

ventricular ectopic activity, hypotension, premature ventricular beats (5%, dose

related), anginal pain (1% to 3%), nonspecific chest pain (1% to 3%), palpitation

(1% to 3%)

CNS: Fever (1% to 3%), headache (1% to 3%), paresthesia

Endocrine & metabolic: Slight decrease in serum potassium

Gastrointestinal: Nausea (1% to 3%)

Hematologic: Thrombocytopenia

Local: Phlebitis, local inflammatory changes and pain from infiltration, cutaneous

necrosis (isolated cases)

Neuromuscular & skeletal: Mild leg cramps

Respiratory: Dyspnea (1% to 3%)

Dopamine

Stimulates both adrenergic and dopaminergic receptors:

-lower doses are mainly dopaminergic stimulating and produce renal and

mesenteric vasodilation

-higher doses also are both dopaminergic and beta1-adrenergic stimulating and

produce cardiac stimulation and renal vasodilation

-large doses stimulate alpha-adrenergic receptors (vasoconstriction)

Pharmacologic Category:

- Adrenergic Agonist Agent

.ساعت در دهای اتاق لابل نگيذاری است 24هحلل رلیك شذه تا -

عذم هصزف..... اکسیذاسین ( .... للیایی pH) تغییز رنگ**

*Most frequent:

Cardiovascular: Anginal pain, ectopic beats, hypotension, palpitation, tachycardia,

vasoconstriction

Central nervous system: Headache

Gastrointestinal: Nausea and vomiting

Respiratory: Dyspnea

Concurrent use with MAOIs: prolong hypertension

Use with extreme caution

Potassium chloride; KCl Pharmacologic Category: Electrolyte Supplement

Heart failure: Inhibition of the sodium/potassium ATPase pump in myocardial cells

Supraventricular arrhythmias: Direct suppression of the AV node conduction

Dermatologic: Rash

Endocrine & metabolic: Hyperkalemia

Gastrointestinal: Abdominal pain/discomfort, diarrhea, flatulence, nausea, vomiting

.ساعت هرد استفاده لزار بگیزد 24هحلل رلیك شذه فزآرده بایستی در طی

**Drug interaction:

ACE Inhibitors

Angiotensin II Receptor Blockers

Potassium-Sparing Diuretics

enhance the hyperkalemic effect

Disease/drug-related concerns:

• Acid/base disorder

• Cardiovascular disease: (eg, heart failure, cardiac arrhythmias)

life-threatening cardiac effects

• Renal impairment

• Digitalis: life-threatening cardiac effects

• Potassium-altering therapies: ACEI, potassium-sparing diuretics, potassium

containing salt substitutes

Nitroglycerin (TNG) Pharmacologic Category:

-Antianginal Agent

-Vasodilator

.رس در یخچال پایذار است 7 در دهای اتاق تا 48hدر ظزف شیشو ای تا %DWSیا N/Sهحلل رلیك شذه با *

PVC* :24 رس در یخچال 14ساعت در دهای اتاق

(سزعت انفسین، غلظت هحلل، طل ست انفسین)جذب سطحی

لزص ىای نیتزگلیسیزین*

Produces a vasodilator effect on the peripheral veins and arteries with more

prominent effects on the veins.

Cardiovascular: Flushing, hypotension, orthostatic hypotension, peripheral edema,

syncope, tachycardia

CNS: Headache (common), dizziness, lightheadedness

Gastrointestinal: Nausea, vomiting, xerostomia

Neuromuscular & skeletal: Paresthesia, weakness

Respiratory: Dyspnea, pharyngitis, rhinitis

• PDE-5 inhibitors: sildenafil, tadalafil, vardenafil

Enoxaparin: Clexan®

Pharmacologic Category:

-Low Molecular Weight Heparin

1% to 10%:

CNS: Fever (5% to 8%), confusion, pain

Dermatologic: Erythema, bruising

Gastrointestinal: Nausea (3%), diarrhea

Hematologic: Hemorrhage (major, <1% to 4%; includes cases of intracranial,

retroperitoneal, or intraocular hemorrhage

Local: Injection site hematoma (9%), local reactions

Renal: Hematuria (<2%)

Octreotide:

Pharmacologic Category:

-Antidiarrheal

-Antidote

-Somatostatin Analog

*Inhibiting serotonin release, and the secretion of gastrin, VIP, insulin, glucagon,

secretin, motilin, and pancreatic polypeptide.

*Decreases growth hormone and IGF-1 in acromegaly.

>16%: Cardiovascular: Sinus bradycardia (19% to 25%), chest pain (≤20%; non-depot

formulations)

CNS: Fatigue (1% to 32%), headache (6% to 30%), malaise (16% to 20%), fever (16% to

20%), dizziness (5% to 20%)

Dermatologic: Pruritus (≤18%)

Endocrine & metabolic: Hyperglycemia (2% to 27%)

Gastrointestinal: Abdominal pain (5% to 61%), loose stools (5% to 61%), nausea (5% to

61%), diarrhea (34% to 61%), flatulence (≤38%), cholelithiasis (13% to 38%; length of therapy

dependent)

Local: Injection site pain

Neuromuscular & skeletal: Back pain (1% to 27%), arthropathy (8% to 19%), myalgia

(≤18%)

Respiratory: Upper respiratory infection (10% to 23%), dyspnea (≤20%; non-depot

formulations)

Pantoprazole:

Pharmacologic Category:

-Proton Pump Inhibitor

-Suppresses gastric acid secretion by inhibiting the parietal cell H+/K+ ATP pump

ساعت پس اس آهساده سساسی 6هحلل آهاده ساسی شذه هی بایست حذاکثز -

.رلیك گزدد

سساعت پس اس آهساده سساسی 24هحلل رلیك شذه هسی بایسست حسذاکثز تسا -

.استفاده شد

>10%:

CNS: Headache (adults 12%; children >4%)

1% to 10%:

Cardiovascular: Facial edema (≤4%), generalized edema (≤2%)

CNS: Dizziness (≤4%), vertigo (≤4%), depression (≤2%), fever (adults ≤2%; children

>4%)

Dermatologic: Rash (adults ≤2%; children >4%), urticaria (≤4%), photosensitivity

(≤2%), pruritus (≤2%)

Endocrine & metabolic: Triglycerides increased (≤4%)

GI: Diarrhea (≤9%), abdominal pain (children >4%), vomiting (≥4%), constipation

(≤4%), flatulence (children ≤4%), nausea (children ≤4%), xerostomia (≤2%)

Hematologic: Leukopenia (≤2%), thrombocytopenia (≤2%)

Hepatic: Liver function tests abnormal (≤4%), hepatitis (≤2%)

Stereptokinase:

-Converts plasminogen to the enzyme plasmin

Pharmacologic Category:

-thrombolytic

ساعت در یخچال قابل نگهذاری 24ساعت در دمای کنترل شذه محیط و تا 8محلىل آماده سازی شذه فراورده تا - .است

Cardiovascular: Hypotension (sometimes severe)

Hematologic: Bleeding (major and minor)

Respiratory: Respiratory depression