mjl1717
Forum Hero
Topics: 959
Posts: 5,467
|
What is the drug of choice for Recurrent ventricular tachycardia??
a)Digoxin
b)Adenosine
c)Amniodarone
d)Bretyllium
e)Procainamide
f)Phenytoin
g)Oubain
h)Nitroglycerin
i)Mexilitene
___________________
Smell the coffee! "Is That an Osler move??"
|
| dariush
Forum Elite
Topics: 20
Posts: 356
|
d)Bretyllium
only in ER setting
for long term "Intercardial Defibrillator" (ID)
Edited by dariush on 11/08/05 - 10:13 AM
___________________
Allah (God) is watching over us...
|
| mjl1717
Forum Hero
Topics: 959
Posts: 5,467
|
No
___________________
Smell the coffee! "Is That an Osler move??"
|
| mjl1717
Forum Hero
Topics: 959
Posts: 5,467
|
Cmon guys or docs!!!!???????????!!!!!!!!!!
(Maybe Ill get more results on the Paramedic or EMT forum??)
___________________
Smell the coffee! "Is That an Osler move??"
|
| usmlegr
Forum Junior
Topics: 6
Posts: 56
|
Amiodarone
or
ICD (according to SCD-HeFT, amio is useless however many heart failure experts deny this. Anyway, ICD is Class Ia in any patient with <35% now in the States)
|
| mjl1717
Forum Hero
Topics: 959
Posts: 5,467
|
No
___________________
Smell the coffee! "Is That an Osler move??"
|
| usmlegr
Forum Junior
Topics: 6
Posts: 56
|
mjl1717 wrote:
No
if your answer is Procainamide then i'd suggest either to get another book, or to read more in depth.
|
| mjl1717
Forum Hero
Topics: 959
Posts: 5,467
|
First--What Is ICD and SCDHefT
Procainamide (this dinosaur) is still the drug of choice for recurrent ventricular tachycardia.
Amniodarone is newer but using it is analagous to harnessing a wild horse:
It has numerous big time side effects: corneal deposits, blue skin, thyroid dysfunction, pulmonary fibrosis, just to name a few of MANY!! [ If you want to handle the risk good luck!!]
___________________
Smell the coffee! "Is That an Osler move??"
|
| usmlegr
Forum Junior
Topics: 6
Posts: 56
|
mjl1717 wrote:
First--What Is ICD and SCDHefT
Procainamide (this dinosaur) is still the drug of choice for recurrent ventricular tachycardia.
Amniodarone is newer but using it is analagous to harnessing a wild horse:
It has numerous big time side effects: corneal deposits, blue skin, thyroid dysfunction, pulmonary fibrosis, just to name a few of MANY!! [ If you want to handle the risk good luck!!]
Class Ia are no longer DOC for VT, dude where are you practicing medicine? In Afganistan? Honestly, read some new books....
Amiodarone is an excellent drug. Corneal deposits are rare and totally reversible, we've never seen blue skin (and we give tons of amio) and pulmonary fibrosis is rare and seen only after years of amio administration. I think you should stop trying to make up questions because you might get some people comfused here.What is the matter with you? In another thread you are asking what are b-blockers, and in another one what are ICDs? Where are you from?
Procainamide also causes numerous side effects: cardiotoxicity, arrhythmia, psychosis, pancytopenia, torsades, Lupus, allergy, fever, just to name a few.
Edited by usmlegr on 11/10/05 - 12:30 PM
|
| mjl1717
Forum Hero
Topics: 959
Posts: 5,467
|
1) Amniodarone is mentioned, but that must be monitored MUCH more, to keep out of trouble Im sticking with my guns and Ill stay with Procainamide!!
2)Also I never heard you or anyone distinctly define a beta blocker and you were given more then week!!!!
___________________
Smell the coffee! "Is That an Osler move??"
|
| mjl1717
Forum Hero
Topics: 959
Posts: 5,467
|
Ill leave it to the forum!!!!
The way to answer this is to ask is it stable or unstable v tach.
If stable Procainamide is still the drug of choice since its....1) more available 2)better side effect profile and 3) most importantly more cost effective..[This according to the American Heart Association!
For the boards both drugs would not be mentioned at the same time unless the dosage is incorrect.
Dariush -Bretylium was the drug of choice but the plant that it came from is no longer available. I will not even mention the Amniodarone side effect profile!!
___________________
Smell the coffee! "Is That an Osler move??"
|
| drsnq
Forum Elite
Topics: 24
Posts: 168
|
i will go with MEXILETINE..
it is a class 1b drug (lidocaine also include in it,which is actually the drug of choice for ventriculler arrhythmia.....but not present in the choices)
reason..it shortens the action potential by blocking fast plus slow Na channels..it also abolish the ventriculer reentry ...
what is the true ans..?
___________________
drsnq
|
| usmlegr
Forum Junior
Topics: 6
Posts: 56
|
mjl1717 wrote:
Ill leave it to the forum!!!!
The way to answer this is to ask is it stable or unstable v tach.
If the Vtach is UNstable, you don't ask, you don't breath, you don't think. You just Sync-Shock.
mjl1717 wrote:
If stable Procainamide is still the drug of choice since its....1) more available 2)better side effect profile and 3) most importantly more cost effective..[This according to the American Heart Association!
For the boards both drugs would not be mentioned at the same time unless the dosage is incorrect.
Dariush -Bretylium was the drug of choice but the plant that it came from is no longer available. I will not even mention the Amniodarone side effect profile!!
Ia drugs are more or less abandoned in VT for the much more effective III class drugs. Amio is an excellent and effective drug in the acute setting.
|
| monterusca2004
Forum Junior
Topics: 7
Posts: 42
|
I am sure also that this 2 drugs should not be in the same question, but I rather prefer Amio, since the use of procainamide have declined in the clinical setting due to adverse effects, as SLE and torsade, even though amio also causes some effects it is better tolerated.
|
| mjl1717
Forum Hero
Topics: 959
Posts: 5,467
|
Factually Amnio causes side effects too numerous to mention in about 75% of patients causing discontinuation in about 7-18% of patients. (And Im not just talking about a skin rash and pulmonary toxicity) Procainamide has side effects also. Once again concerning Amnio even in the U.S.(as carefree, spendfree, hitech and fortunate as you might think it is) one must think about 1)Whats available? and 2) $$ and cents 3) CLOSER monitoring of a relatively new drug. 4)Do I have a higher chaance of inviting a law suit using this relatively new and toxic med? And in places where Amnio is NOT used (and there are many) you WOULD be the pioneer with the Amnio!! Also with the adverse reaction part of the PDR Amnio was listed as "very commonly having adverse reaction" So I would not say its better tolerated.
Edited by mjl1717 on 11/21/05 - 04:09 PM
___________________
Smell the coffee! "Is That an Osler move??"
|
| usmlegr
Forum Junior
Topics: 6
Posts: 56
|
First, DO NOT judge drugs by their PDRs.
Secondly do not judge drugs by their cost. Just to remind you, in the US, where you count the last cent, and you are definately NOT spendfree, hitech and fortunate as you may think  , you start Rx of hypertension with chlorothiazide which is old, has noumerous side effects and extremely cheap (about $2-4 per month). We, in Europe, start with ARB's which are hell expensive ($40-60 per month), have almost NO side effects, and are extremely effective. My point is medicine is different than finance. Medicine is expensive and one must pay for it, not try to find ways not to.
I stick to my case that using AMIO makes you NO PIONEER, NOWHERE in the civilized world of year 2005, and that AMIO is an EXCELLENT DRUG in the ACUTE setting.
|
| sturge_weber
Forum Guru
Topics: 77
Posts: 1,042
|
i too go with amiodarone
|
| mjl1717
Forum Hero
Topics: 959
Posts: 5,467
|
1) I realize that the PDR is a major reference that legal authorities would refer to, but each person is different as far as the side effects go. 2)** I cant impress upon you enough that being cost effective especially in the U.S. IS a big deal!! (Especially with the power of these insurance companies) 3)Also as far as the USMLE is concerned--I never heard of them rewarding a guy for consciously or unconsciously spending money like its water.
Edited by mjl1717 on 11/27/05 - 01:38 PM
___________________
Smell the coffee! "Is That an Osler move??"
|
|
| |
| | | | | | | | | | | | | | | | | | |
Similar forum topics