EIMED PAPDI PDF

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Eimed Papdi Pdf

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Download EIMED ecogenenergy.info DOWNLOAD PDF. Report this file. Description. Download EIMED ecogenenergy.info Free in pdf format. Sponsored Ads. Shop Related. View Essay - ecogenenergy.info from KEDOKTERAN 1 at Andalas University. INDONES. А. EIMED PAPDI. Kegawatdaruratan Penyakit Dalam. (Emergency in Internal Medicine). ESTE. Brest. BUKU 2. EIMED LANJUT. Bambang Setyohadi.

Digoxin improves the cardiac function and decreases the frequency of hospitalizations without delaying mortality.

The initial dosage, generally high and called loading dosage, is followed by a lower dosage, called maintenance dosage. It is advised to control the plasma level of digoxin to reach the best dosage. Adverse effects The majority of adverse effects of digoxin and other cardiac glycosides are doserelated. Moreover its adverse effects in women seem more marked increased mortality than in men, which does not encourage to prescribe digoxin to women with congestive heart failure.

The treatment of poisoning by cardiac glycoside involves first the ces sation of the glycoside, possibly the use of a drug able to reduce digitalis effects: potassium in case of hypokalemia, atropine in case of bradycardia, lidocaine, chelating agent of calcium, or electric stimulation. In severe overdose, digoxin-specific antibody fragments can be used to neutralize circulating free digoxin by binding to it. This neutralization induces a displacement of digoxin from tissues towards plasma where it is neutralized.

These relapses are seen in cas e of administration of an insufficient antibody dose. The administration of digoxin-specific antibody fragments can elicit allergic reactions. Decrease in their toxicity by potassium administration. Conversely hypokalemia, as observed with certain diuretics, increases digitalis toxicity.

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Increase in the concentration of digoxin by quinidine probably by inhibition of Pglycoprotein with increases the bioavailability of digitalis and itraconazole which slows down the metabolism of digoxin. Decrease of the concentration of digoxin by acceleration of its catabolism by enzyme inducers. But the interaction with rifampicin seems more related to the induction of the P-glycoprotein with reduction of the digestive absorption. Note: Among other drugs having a positive inotropic effect by mechanisms of action different from that of digoxin there are milrinone, inhibitor of phosphodiesterases, and sympathomimetics such as dobutamine and dopexamine.

One of their active compounds, digitalin, was obtained by the French pharmacist Nativelle one century later. The most frequently cardiac glycoside used today is digoxin. It consists of two alpha catalytic subunits and of two beta subunits.

It is an electrogenic pump which creates a potential difference between both sides of the c ytoplasmic membrane.

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