Welcome to the #MEDSHED! Needing a brief, concise review of clinical pharmacotherapy and disease management? Direct links of reference to content discussed? Look no further than the #MEDSHED series based on infographics and carousel presentations!
💥 Atrial Fibrillation: Rate Control - #MEDSHED
💊 Metoprolol
MOA: Selective Beta-1 blocker
Dose 5 mg IV push every 5 minutes PRN x 3
Duration 4 hours | Half Life 4 hours
Metabolism Hepatic - CYP2D6
*Increased odds of achieving rate control when given with MgSO4 2 - 4 gm IV over 20 mins
Avoid in patients with decompensated HF
💊 Diltiazem
Dose: 0.25 mg/kg IV push. If rate control insufficient, repeat 0.35 mg/kg IV push. Transition to infusion at 5 - 15 mg/hr.
Mechanism Non-dihydropyridine CCB
Duration 1 hour | Half Life 4 hours
Metabolism Hepatic - CYP3A4
*Increased odds of achieving rate control when given with MgSO4 2 - 4 gm IV over 20 mins
Avoid in decompensated HF. Caution with hypotension.
💊 Digoxin
Dose: 250 - 500 mcg IV, then 250 mcg every 6 hours
Mechanism Inhibits NaKATPase pump, suppresses AV conduction
Duration 72 hours | Half Life 36 hours
Metabolism Urinary
*Consider in patients where BB or CCB are ineffective or contraindicated
Avoid in renal failure (reduced elimination, increased toxicities). Correct electrolyte abnormalities (hypokalemia, hypomagnesemia).
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