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84 Cards in this Set

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M3 receptors
smooth muscle contraction and gland secretion; eg endothelial cells --> EDRF/NO --> dec BP; bronchoconstriction; saliva release; NO effect on HR
nonspecific beta agonist
nicotinic ganglionic blocker --> blocks peripheral ganglia, prevents baroreceptor response
parasympathetic tone in BV
absent (muscarinic receptors are not parasympathetically innervated)
M2 receptors
cardiac tissue: slowed SA depol, decreased conduction vel --> dec HR
tx of Varicella (VZV)
acyclovir possible, but not as good as it is for HSF. FAMCICLOVIR and VALACYCLOVIR are preferred
tx CMV retinitis when gancyclovir fails; viral DNA pol inhibitor (pyroFOSphate analog)
beta blockers with intrinsic sympathomimetic activity
acebutolol, pindilol (not recommended for angina)
ACEi effects on K
metoprolol side effects (2)
bradychardia / varying degrees of AV block; dyslipidemia
CCBs a/w cardiac block
Diltiazem and Verapamil (not felodipine or __________)
K+ sparing diuretic -- blocks ENaC
Anti-hypertensives in pts with Diabetic Nephopathy?
ACEi, eg. Captopril
direct vasodilator; profound s/e: hypertrichosis (exceess hair), pericardial effusion, tachycardia, angina --> rarely used as initial tx for HTN
epinephrine reversal
epi (large doses) causes vasoconstriction --> inc BP; if anti-alpha agent administered (eg phentolamine), only beta effects left --> vasodilation --> *decreased* BP
antihypertensive in adult polycystic kidney disease
ACEi; hypretension usu caused by decreased glomerular perfusion --> RAA;
drug to decrease conduction rate thru AV node
digoxin; used to tx afib, aflutter, and CHF; indirect vagomimetic action (??)
lidocaine in arrythmias
class IB anti-arrythmic; used to tx ventricular arrythmias
atropine's cardiac conduction effects
increases conduction thru AV node (anticholinergic) --> used for AV block
class IA anti-arrythmic; both supraventricular and ventricular arrythmias
afib/flutter, but exerts indirect anticholinergic effect --> decrease vagal tone --> increase AV conduction
1st tx in hypertrophic cardiomyopathy
beta-blockers --> prevent dyspnea, angina, arrythmias; CCBs also useful
tx for HACEK endocarditis
ceftriaxone (haemophilus, actinobacillus, cardiobacterium, elkenella, kingella kingae)
clinical signs of infective endocarditis
OSLER nodules (purplish/red subq nodules on fingers/toes); JANEWAY lesions (hemorrhagic painless plaques on palms/soles); PETECHIAE; SPLINTER hemorrhages
PGE1 analog (like misoprostol), used to maintain PDA
atropine's effects on blood pressure
NO EFFECT; atropine blocks muscaranic receptors, but BV have no vagal tone (muscarinic receptors are not innervated); atropine will increase HR (blocks M2 receptors in SA node)
which tetracycline is bad for pregnancy
doxycycline ('dox bad for the (baby in the) box')
dilated CHF ('plop as blood fills into blood-filled chamber'?)
hypertrophic cardiomyopathy (atrial kick into thickened heart)
nitroprusside use, s/e
vasodilator, used for HTN; can cause cyanide toxicity (releases CN)
methyldopa use, s/e
sympathoplegic used for HTN; can result in positive Coombs test
reserpine mech, use, s/e
mech: blocks VMAT, depletes NE; use: HTN; s/e: sedation, depression
hydralazine mech, use, s/e
MECH: vasodilator (decreases afterload); USE: HTN and CHF; S/E: lupus-like syndrome
CCBs, targets of action, tox
Nifedipine (vasculature); Verapamil/Diltiazem (heart); TOX: flushing, constipation, cardiac depression, edema
captopril s/e
CAPTOPRIL (Cough, Angioedema, Proteinuria, Taste Changes from electrolyte shifts, hypOtension, Pregnancy problems, Rash, Increased K/Renin, Lower ATII)
Nitroglycerin, isosorbide dinitrate: mech, use s/e
mech: NO --> cGMP -> VENODILATE, dec preload; s/e: "Monday disease" -- tolearnce develops over week, lost over weekend --> tachycardia, hypotension, headache
digoxin/digitalis toxicity
arrhythmia (AV block?), changes in color vision (think Van Gogh)
what potentiates digoxin/digitalis tox? (3)
1) renal disease: impaires excretion; 2) hypokalemia: potentiates action; 3) quinidine: displaces digoxin from tissue binding sites, decreases clearance
1' tx of lung abscess in alcoholic
clindamycin (cover anaerobes)
tx of choice for paroxysmal SVT
adenosine (rapid acting, slows conduction thru AV node)
uses of amiodarone
"broad spectrum anti-arrhtymic:" SVT and PSVT
uses of lidocaine
ventricular arrhythmias
drug of choice for mucor and its toxicity
Amphotericin B; tox: RENAL -- hypoK, hypoMG --> can casue arrhythmias
amphotericin B tox
renal damage --> electrolyte imbalanace
milrinone: class, mechanism
inodilator; PDE III inhibitor --> increased cAMP --> vasodilation + positive inotropy
cause of angioedema in ACEi
increased levels of bradykinin --> itchy swelling of face and hands
most common side effect of nitrates (nitroglycerine and isosorbide)
throbbing headaches (because of vasodilation)
treatment for nephrogenic DI
most use-dependent subclass of Class I anti-arrhythmics
Class IB: lidocaine, mexiletine, tocainide
s/e of verapamil
flushing, constipation, av block (CCBs are anti-arrhythmic because they slow conduction)
diuretics with mortality benefits
ACEi, spironolactone
amiodarone tox
"check LFTs, PFTs, TFTs": hepatotox, pulm fibrosis, hyper- or hypothyroidism, photosensitivity, NO TPD (for some reason, minimal TPD risk even tho QT interval is prolonged)
foscarnet use/tox
use: CMV retinitis not treatable by gancyclovir; tox: hypoCa/hypoMg (foscarnet is a pyrophosphate --> chelates cations)
gancyclovir tox
s/e of protease inhibitors
fat redistribution, insulin resistance, hypertriglyceridemia
potassium levels in digoxin tox
elevated (causes hyperkalemia)
use of thiazides vs ACEi
Thiazides are first line for essential hypertension in absence of CHF / diabetes. If CHF or diabetes, give ACEi (mortality benefit and nephroprotective)
potassium effects of ACEi/HCTZ
ACEi retain potassium, HCTZ waste potassium
which part of action potential does QRS correspond to?
"phase 0," i.e. NA influx (depolarization)
sulfa-derived diuretics
acetazolamide, furosemide (NOT ethacrynic acid), HCTZ
indications for mannitol
increased intracranial pressure, shock, drug OD
contraindications for mannitol
anuria, CHF (can rapidly pull water out of cells --> pulmonary edema, exacerbating CHF)
indications for acetazolamide
glaucoma, need for urinary alkalinization (eg secrete weak acids like salicylate tox), metabolic acidosis
furosemide toxicity
ototox and nephrotox (like aminoglycosides and cilastin); also: hypokalemia, gout, sulfa allergy, dehydration
ethacrynic acid
like furosemide minus the sulfa tox
HCTZ use
idiopathic hypercalciuria (stones risk), nephrogenic DI, HTN, CHF (though prefer ACEi in CHF)
HCTZ tox
hyperGLUC (glucose, lipids, uricemia, calcemia), sulfatox
cyclosporine tox and prevention
predispose to viral infec/lymphoma; nephrotoxicity (preventable by mannitol diuresis)
Name the nitrosourea ending and the exception
"-mustin" (carmustine, lomustine, semustine) and Streptozocin
cyclosporine vs tacrolimus (FK506)
both inhibit calcineurin, both used for organ transplant, both cause nephrotocity; cyclosporine predisposes to lymphoma/viral infections, tacrolimus causes peripheral neuropathy, pleural effusions, and hyperglycemia
AZA use, tox, what drug precipitates
USE: kidney transplant, AI disorders (GN, hemolytic anemia; TOX: bone marrow suppression; precipitated by allopurinol (prevents breakdown of active metabolite 6-MP)
IL-2, used for RCC and metastatic melanoma
gamma interferon used to tx
chronic granulomatous disease (CGD)
IL-11; tx thrombocytopenia
Tx for RA
3 prong: Anti-Inflammatories (Salicylates, NSAIDs), Bridging therapies (Corticosteroids), and DMARDs [Methotrexate (anti-metabolite, --| purine synth), Etanercept/Infliximab/adalimumab (anti-TNFalpha), sulfasalazine, hydroxychloroquine]
Acute tx for gout
NSAIDs (eg indomethacin), followed by colchicine; corticosteroids often added for immediate symptomatic relief, or if NSAIDS/colchicine contraindicated (eg renal failure)
Chronic tx for gout
Uricosuric agents (eg probenecid), Allopurinol
Methotrexate tox
Stomatitis, hepatotox (macrovesicular fatty change)
digoxin vs digitalis
digoxin: renal clearance, shorter halflife; digitalis: hepatic clearance, longer half life (longer name)
muscle weakness and cramping suggests
Tetracycline in pregnancy can cause what
growth retardation and discolored teeth (because of cation chelation, specifically calcium)
loop diuretic like furosemide
toxicity of herpes treatments (3 tx)
foscarnet + IV acylovir: nephrotox + neurotox (seizures, delirium); gancyclovir: nephrotox + neurotox + BM-tox
tx of lyme dz
penicillin type Abx, esp ceftriaxone or doxycycline