How do you counsel patients on amiodarone corneal deposits (1)
Does not normally affect vision but can cause night glare; which will effect driving.
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Why does amiodarone cause corneal deposits and hepatomegaly? (1)
Amiodarone is a lipophilic drug which is metabolised in the liver and excreted through the bile salts. It therefore accumulates in tissues and can lead to toxicity.
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Describe amiodarone's place in management of arrhytmia (3)
Used as pharmacological cardioversion in pts with evidence of structural heart disease. To reduce risk of Post-op AF.Used as LT maintence in pts with LV impariment or CHF
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What is the half life of amiodarone? (1)
~ 50 days
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What are the baseline tests needed for amiodarone? (5)
TFTs, LFTs, ECG,Potassium and CXR
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List some important amiodarone drug Ix
DO NOT TAKE GRAPEFRUIT JUICE, Warfarin (dose reduction), Phenytoin (dose reduction), Simvastatin max 20mg, beta blockers, digoxin (half dose), drugs that prolong QT
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STELL? (5)
S - Skin (Grey Slate) T- Thyroid (Thyrotoxicosis hypo/hyper) E -Eyes (Microdeposits) L-Liver (LFTs) L-Lungs (pulmonary toxicity)
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What is the oral dose of Digoxin? (1)
CHF: 62.5 - 125 micrograms AF: 125-250 micrograms
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What is digoxin's mechanism of action? (1)
Digoxin binds to a membrane sodium potassium ATPase inhibiting action and increasing intracellular calcium.
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