地爾硫卓

用途

• Treatment of hypertrophic cardiomyopathy (Option A)
• Treatment of hypertrophic cardiomyopathy (Option B)
• Treatment of hypertrophic cardiomyopathy (Option C)
• Treatment of hypertrophic cardiomyopathy (Option D)
• Treatment of hypertrophic cardiomyopathy (Option E)
• Emergency treatment of supraventricular tachyarrhythmias
• Acute management of supraventricular tachyarrhythmias
• Chronic management of supraventricular tachyarrhythmias
• Emergency management of hypertension (when nitroprusside unavailable)
• Supraventricular tachyarrhythmias / Hypertrophic cardiomyopathy
• Supraventricular tachyarrhythmias / Hypertrophic cardiomyopathy
• Hypertrophic cardiomyopathy

給藥方式

可能的副作用

• Dogs: Bradycardia (most prominent)
• Cats: Vomiting (especially with 60 mg sustained-release pellets)
• Lethargy
• Anorexia / GI distress
• Hypotension
• Heart block or rhythm disturbances
• CNS effects
• Skin rashes
• Elevations in liver enzymes
• Bradycardia (most common in dogs)
• Vomiting (most common in cats)
• AV block

注意事項與禁忌

• Severe hypotension (<90 mm Hg systolic)
• Sick sinus syndrome (unless functioning pacemaker is in place)
• 2nd or 3rd degree AV block (unless functioning pacemaker is in place)
• Acute myocardial infarction
• Radiographically documented pulmonary congestion
• Hypersensitivity to diltiazem
• Second or third degree AV block
• Marked hypotension
• Sick sinus syndrome
• Acute or decompensated congestive heart failure (relative contraindication)
• > **Warning:** Use with extreme caution in geriatric patients, those with heart failure (especially if receiving beta-blockers), or patients with hepatic or renal impairment. * **IV Administration:** If giving direct IV push, administer slowly over at least two minutes to prevent acute hypotension or collapse. * **Pregnancy:** Potential teratogen at high doses (FDA Category C). Use only when benefits outweigh risks. * **Nursing:** Excreted in milk at concentrations approximating serum levels; use with caution.

藥物相互作用

• Anesthetics, General: May increase cardiac depressant effects of diltiazem.
• Benzodiazepines: Diltiazem may increase benzodiazepine levels.
• Beta-Blockers: May increase the likelihood of bradycardia, AV block, or CHF. Diltiazem may substantially increase the bioavailability of propranolol.
• Buspirone: Diltiazem may increase buspirone levels.
• Cisapride: Could potentially increase risk for increased QT intervals.
• Digoxin: Data conflicts regarding pharmacokinetic effects; diligent monitoring of digoxin serum concentrations is required.
• Cimetidine: May increase plasma diltiazem concentrations; increased monitoring warranted.
• Ranitidine: May affect diltiazem concentrations, but to a lesser extent than cimetidine.
• Cyclosporine: Diltiazem may increase cyclosporine serum concentrations; monitoring and dosage adjustments may be required.
• Rifampin: May decrease diltiazem levels.
• Quinidine: Diltiazem may increase quinidine serum concentrations; monitoring and dosage adjustments may be required.

常見問題