j_rjc_2021_31_2_311_tab_001
| Dabigatran | CrCl>30mL/min-150mg b.d | CrCl=30–49mL/min-110mg b.d | CrCl=15–30mL/min-75 mg b.d | CrCl<15mL/min-Avoid |
| Apixaban | CrCl>15mL/min-5mg b.d | Any 2 (>80yrs, <60kg, SCr>1,5mg/dl)-2,5mg b.d | CrCl<15mL/min-Avoid | |
| Rivaroxaban | CrCl>50mL/min-20mg o.d | CrCl=15-50mL/min-15mg o.dzx | CrCl<15mL/min-Avoid | |
| Edoxaban | CrCl>50mL/min-60mg o.d | CrCl=30–49mL/min-30mg o.d | CrCl=15–30mL/min 30mg o.d | CrCl<15mL/min-Avoid |
j_rjc_2021_31_2_311_tab_002
| Class | Mechanism | Drug name | Indications | Adult Dose | Side Effects & Warnings |
|---|---|---|---|---|---|
| Ib | Net effect: Depress conduction with NO change in or shortened APD (repolarization) | Lidocaine | Approved: VF, VT | 1–1.5 mg/kg IV/IO x1; 0.5–0.75 mg/kg IV repeat in 3–5 min (max 3 mg/kg) | SE: Hypotension; neuro (↓ CNS, dizziness, drowsiness and seizures at high levels). Warnings: prophylactic use in AMI; (Warning: reduce maintenance dose if liver disease or left ventricular dysfunction); Adam-Stokes Syndrome. |
| II | Net effect: | Esmolol & other β-blockers | Approved: VT, AFib, AFlutter, Intraoperative HTN | Doses vary based on indication. Please see prescribing recommendations. | SE: Bradycaerdia, hypotension, exacerbation of heart failure, bronchospasm Warning: Asthma (especially moderate to severe), decompensated HF |
| III | Net effect: Prolong repolarization (recovery) by effective refractory period and APD. | Amiodarone | Approved: VT, VF | Inj: Pulseless VT/VF: 300 mg IV/IO push in 20 cc ; Other VT/VF: 150 mg IV × 10 min, then 360 mg IV × 6h, then 540 mg × 18h | Note: Can be used in patients with impaired left ventricular dysfunction and WPW. |
| Net effect: ↓ chronotropy & inotropy; MOA: ↓ SA & AV nodal conduction of Ca+ through a blockade of voltage gated Ca+ channels | Diltiazem | Approved: AFib, AFlutter | 15–20 mg IV × 2 min; Repeat in 15 min at 20–25 mg | SE: Bradycardia, HB, worsening of HF, ↓ BP | |
| Verapamil | Approved: Angina, AFib, AFlutter | 2.5–5 mg IV over 2 min; then 5–10 mg (if needed) q15–30min (max dose 20mg). | |||
| Other | Net effect: ↓ chronotropy & ↓ inotropy; MOA: PNS; ↑ gK & ↑ gCa | Digoxin | Approved: AFib, Aflutter | 0.4–0.6 mg IV over ≥5 min; may repeat 0.1–0.3 mg IV over ≥5 min | SE: Arrhythmias, N/V |