| Theme | Prescription of Therapeutics and Monitoring for the Dialysis Patients | |
|---|---|---|
| Title | Digitalis glycosides and antiarrhythmic drugs | |
| Publish Date | 1999/11 | |
| Author | Hiroyuki Tamura | Department of Blood Purification, Tokyo Medical and Dental University |
| Author | Takashi Akiba | Department of Blood Purification, Tokyo Medical and Dental University |
| Author | Haruki Ito | The Cardiovascular Institute |
| Author | Hiroyuki Iinuma | The Cardiovascular Institute |
| [ Summary ] | In the arrhythmias of dialysis patients, the ventricular extrasystole is a more important risk than the conduction disturbance. The causes of ventricular extrasystole are primary renal disease, secondary disease following renal failure, and radical changes in the internal environment due to dialysis. Arrhythmias of dialysis patients are treated by eliminating the underlying causes. When an arrhythmia forces us to suspend the dialysis therapy, a medicine should be prescribed to stop the arrhythmia. The therapeutic serum concentration range of antiarrhythmic drugs is narrow, and the therapeutic range is close to a toxic level. The absorption rate, metabolism, excretion, distribution, dialysis elimination, and drug interaction all influence the serum concentration of antiarrhythmic drugs. When administering an arrhythmic drug, the physician must check the drug side effects and maintain an adequate serum concentration. After starting administration experimentally, the serum concentration of the antiarrhythmic drug should be measured while maintaining a steady state. Based on the measured concentrations, the dosage of antiarrhythmic drug can be decided, and the serum concentration of the antiarrhythmic drug kept constant. |
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