Antiarrhythmic Medications

Cardiovascular Medications

• Amiodarone's potential adverse effect is pulmonary toxicity and/or corneal microdeposits.
• Adenosine's mechanism of action is blocking AV node conduction, leading to a brief period of asystole, which restores normal sinus rhythm.

Anticoagulants

• Aspirin's primary indication is for preventing stroke and myocardial infarction.
• Heparin's reversal agent is Protamine sulfate.
• Enoxaparin (Lovenox) has a specific effect of inhibiting factor Xa activity, preventing thrombus formation.

Amiodarone Interactions

• Amiodarone's potential adverse effect related to the endocrine system is thyroid dysfunction (hypo- or hyperthyroidism).
• In patients on amiodarone, monitor for interactions with other drugs, including warfarin, digoxin, and simvastatin.

Aspirin Effects

• Aspirin's effect on thromboxane A2 is irreversible inhibition, leading to reduced platelet aggregation.

Heparin Administration

• The primary route of administration for heparin in the treatment of an active clot is intravenous (IV).
• An important caution related to heparin use is the risk of bleeding and thrombocytopenia.
• The dosing frequency for the therapeutic dose of unfractionated heparin is every 4-6 hours, with monitoring of aPTT.

Warfarin Therapy

• The reversal agent for Warfarin (Coumadin) is Vitamin K.
• The target INR for Warfarin (Coumadin) therapy is 2-3.
• Warfarin's mechanism of action is inhibiting vitamin K-dependent clotting factors (II, VII, IX, and X).
• The primary factor affected by Warfarin (Coumadin) is the coagulation cascade.

Other Medications

• Apixaban (Eliquis) is indicated for stroke and systemic embolism prevention in non-valvular atrial fibrillation.
• Atorvastatin (Lipitor) has a potential side effect of dose-dependent, common myalgia (muscle pain).
• Andexxa is a reversal agent for apixaban and rivaroxaban, directly binding to and inhibiting the activity of these anticoagulants.
• When on Atorvastatin (Lipitor), monitor for liver function and myalgia.
• The main consideration when adjusting Atorvastatin (Lipitor) dosage peri-operatively or in critically ill patients is the risk of increased statin toxicity.