Cardiovascular Drugs (See Digoxin)

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Subject: Cardiovascular Drugs (See Digoxin)

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Definition

  • Cardiovascular drugs include the antiarrhythmics, the anticoagulant warfarin, and antihypertensives, as well as the β-adrenergic antagonist propranolol and the drug digoxin.

  • Normal therapeutic values: see Table 16.15.

 
TABLE 16–15
Cardiovascular Drugs

Use

  • To treat arrhythmia, hypertension, blood clotting, and angina.

  • The majority of these drugs are not routinely monitored as clinical effects do not generally correlate with serum or plasma levels. Notable exceptions are digoxin and procainamide.

  • Where concentrations are required, specific gas chromatography and HPLC procedures have been developed (e.g., procainamide/N-acetylprocainamide [NAPA], quinidine, mexiletine, diltiazem, verapamil, amiodarone, and metabolite, warfarin). Limits of quantitation vary according to the drug and methodology.

  • Immunoassay tests (e.g., FPIA) are available for procainamide, quinidine.

  • In addition, lidocaine, diltiazem, verapamil, and quinidine are qualitatively detectable in urine with a simple alkaline liquid–liquid or solid-phase extraction followed by GC/MS analysis. Limits of detection range from 50 to 250 ng/mL.

Interpretation

Limitations

  • With procainamide, separate cells from plasma as soon as possible to prevent loss of drug during storage.

  • Hemolyzed samples are unacceptable.

 
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