LECTURE NO.

18 FEBRUARY 2023
2ND SEMESTER A.Y. 2022-2023

CLINICAL CHEMISTRY 2 CARDIOACTIVE DRUGS

CARDIOACTIVE DRUGS 4 CLASSIFICATIONS

 Treatment of congestive heart failure and  Class I

arrhythmias  Rapid sodium channel blockers
 Example: Quinidine, Procainamide,
Lidocaine
 Class II
 Beta receptor blockers
 Example: Propanolol
 Class III
 Potassium channel blocker
 Example: Amiodarone
 Class IV
 Calcium channel blocker
 Example: Verapamil

EXAMPLE ACTION ROUTE OF HALF ELIMINATION THERAPE PEAK

ADMINISTRATI LIFE UTIC SERUM
ON LEVEL LEVEL

DIGOXIN Lanoxin -treatment in Oral 38 Renal filtration 0.8-2 2-3 hours

Congestive Heart -Influenced hours of unbound mg/mL after given
Failure by dietary (time digoxin (1-2.6 dosage
-Type of Cardiac factors, present -Some product mmol/L)
glycoside gastrointesti in are metabolized
-Inhibits the Sodium- nal motility circula by the liver
Potassium ATPase and tion)
-Decrease in formulation
Potassium of the drug
-Increase
intracellular calcium
in cardiac myositis

QUINIDINE Quinidex -A naturally occuring Oral 6-8 Hepatic 2-5 ug/mL 2 hours
Extentabs drugs used to treat -As hours metabolism (sulfate)
Cardioquin arrhythmias gastrointesti
Quinora -Quinidine Sulfate nal 4 hours
(rapid absorption) absorption is (gluconate)
-Quinidine Gluconate complete

PROCAINAMIDE Procanbid Used to treat Oral 4 hours Renal filtration 4-8 ug/mL 1 hour post
Procan SR arrhythmias Hepatic dose
Pronestyl metabolism
-N-
acetylprocainami
de hepatic
metabolite

DISOPYRAMIDE Norpace Used to treat Oral 7 hours Renal filtration 3-7.5 1-2 hours
arrhythmias and ug/mL after given
cardiac abnormalities (8.8-22.1 dosage
-Quinidine substitute umol/L)
if ever the patient
has an adverse effect
on quinidine

LIDOCAINE Xylocaine Used to correct IV infusion Hepatic 1.5-4.0

ventricular (continuous) metabolism umol/L
arrhythmia -not given
orally due to
almost hepatic
removal of drug
in the liver

ARZEL S. VERAN 1
 TRANS: Module 18

-MEGX or
monoethyl
glycinexylidide
is the product
of hepatic
metabolism

PROPANOLOL -Beta receptor Oral 3-6 Renal filtration 50-100

blocker hours (in urine) ng/mL
-used to treat angina
pectoris and
cornonary artery
disease

AMIODARONE Cordarone -It blocks potassium Intravenous 5-8 Hepatic 1.0-2.5

channel blockers or IV days metabolism ug/mL
-Used to treat average biliary
ventricular excretion
arrhythmia

VERAPAMIL -Used to treat Orally Hepatic 80-400

angina, hypertension metabolism ng/mL
and supra ventricular (metabolize by
arrhythmia the liver)
-Excreted as a
metabolite in
urine and
feces/stool

ANTIBIOTICS

EXAMPLE ACTION ROUTE OF HALF LIFE TOXICITY THERAPEUTIC

ADMINISTRATION LEVEL

AMINOGLYCOSIDES Gentamycin -Used to treat Oral 2-3 hours (kapag lagpas

Tobramycin gram negative Intravenous or IV na sa preferred
Amikacin bacteria Intramuscular or dosage)
Kanamycin IM -Nephrotoxicity
(reversible)
-Ototoxicity
(hearing loss;
irreversible)

TEICOPLANIN -Bactericidal Oral 10-60 mg/L

antibiotic that is -As -for
effective against gastrointestinal endocarditis
gram positive (+) absorption is
bacilli and gram complete 20-60 mg/L
positive (+) cocci -for Staph.
-Treatment for infection
MRSD

VANCOMYCIN -Used to treat IV -Redman

against gram syndrome
positive (+) cocci
and bacilli

Erythemic
flushing of the
body
-Nephrotoxicity
-Ototoxicity

ARZEL S. VERAN 2