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40 Cards in this Set

  • Front
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Site of action
Side effect of hydrochlorothiazides
(5)
Works on distal tubule to inhibit resorption of Na+ and Cl-.
SE - hyperuricemia, hypercalcemia, hyperglycemia, hypokalemia, slight hyperlipidemia
Loop diuretics
SE (4)
Inhibit the Na K 2Cl cotransporter.
SE - K+ wasting, metabolic alkalosis, HoTN, Ototoxicity.
Clonidine
alpha 2 agonist
SE dry mouth, sedation, rebound HTN
Methyldopa
alpha2 agonist
SE sedation, positive Coombs test
Hemamethonium
NicAch rec antag (blocks reflex bradycardia caused by NE)
severe orthostatic HTN, blurred vision, sexual dysfx
Reserpine
prevents DA into vesicles to become NE - depletes NE
sedation
Guanethidine
decr NE concentrations
othrostatic and exercise HTN
Prasozin
alpha 1 block.
1st dose orthostatic HTN
Hydralazine
vasodilator - arterioles
lupus like syndrome
Incr cGMP -> smooth muscle relaxation.
incr K+ eflux and decr Ca influx
reflex tach,
Minoxidil
vasodilator
hirsuitism
incr K+ eflux and decr Ca influx
hypertrichosis, pericardial effusion, reflex tach
Trimethaphan
NicAch rec blocker
used during surg to decr BP to minimize blood loss
SE of ACEi
ACE cough, angioedema, hyperkalemia, fetal renal damage, taste funny, Rash, Incr Renin
Losartan
ARB
fetal renal tox, hyperkalemia
Ca channel blockers
vasc vs cardio
Block voltage dependent L-type Ca++ channels of cardiac and smooth muscle.
vasc smooth muscle nifedipine>diltiazem>verapamil
cardio verapamil>diltiazem>nifedipine.
Mondays Dz
industrial nitro exposure.
Vasodilation during the work week. Loss of tolerance over the weekend leads to tach, dizzyness, and HA
Cardiac Glycoside effect
Effects, use
Toxicity and contraindication
Vagal response -
Positive inotropy, Incr PR, decr QT, scooping of ST segment, Twave inversion.
Use - CHF (incr contractility), A-fib (decr conduction through AV node)
SE - blurry yellow vision
SE exacerbated by renal failure, hypokalemia, and quinidine (decr dig clearance, displaces dig from tiss binding sites)
Antidote cardiac glycosides
Slowly normalize K+, lidocaine, cardiac pacer, anti-Dig Fab fragment.
Class I A antiarrythmics

SE
Quinidine, Amiodorone, Procainamide, Disopyramide
Incr AP duration
incr ERP
Incr QT interval
used for both atrial and vent arrhythmias
Cinchonism (thrombocytopenia, torsades from incr QT interval)- quinidine
SLE like syndrome - procainide
Class I B
Lidocaine, mexilitine, tocainide
decr AP duration
Used in acute ventricular arrhythmias (esp post MI) and digitalis induced arrhythmias
Class I C
flecainide, encainide, propafenone
No effect an AP duration
used in Vtach that progress to VF and intractable SVT
LAST RESORT in tachyarrhythmias
Class III antiarrhythmics
SE
Solatol, Ibutilide, Bretylium, Amiodorone
Used when other antiarrhythmics fail
K+ channel blockers
Incr AP duration
Incr ERP
Incr QT interval
SE - ibutilide + solatol Torsades,
bretylium - HoTN, new arrhythmias
Amiodorone: pulm fibrosis, hepatotoxicity, hypo/hyperthrydoid
Type IV antiarrhythmics
Ca channel blockers
Verapamil and diltiazem
Used in prevention of Nodal Arrhythmias (SVT)
primarily nodal cells effected.
Decr Conduction velocity
Incr ERP
Incr PR interval
Adenosine
good for abolishing and diagnosing AV nodal arrhythmias
K+
depresses ectopic pacemakers esp in Dig tox
Embryo
Smooth parts of ventricles and atria
Trabeculated parts of ventricles and atria
Smooth parts of ventricles derive from the bulbis cortis while the trabeculated parts arise from the primitive ventricle.
Smooth part of Atria come from sinus venosus while the trabeculated part comes from the primitive ventricle
Epinephrine reversal
after giving phentolamine (alpha blockade) BLOOD pressure drops when Epi is given. This happens because epi now preferentially binds beta 2 receptors which act to vasodilate the vasculature.
Findings In ASD
prominent RV cardiac impulse
mid systolic ejection murmur in the pulmonic area
Fixed split S2
ACE inhibitor electrolyte imbalances
Hyperkalemia especially in renally deficient pts.
Mild hyponatremia
Neutropenia, anaphylaxis, angioedema etc.
Major criteria for dx CHF
Paroxysmal Nocturnal Dyspnea
Neck Vein Distention
Rales
cardiomegaly
S3 gallop
Incr Venous Pres
Pos hepatojugular reflex
use ACEi
Arterial vs Venous Thrombous vs post mortem
Arterial: alternating layers of dark gray platelets and lighter areas of fibrin. lines of zahn,
venous: dark red due to higher RBC content, little to no lines of Zahn.
Post mortem: not true thrombi bc no attachment to vessel wall. 2 layered - current jelly RBC rich lower layer, chicken fat cell poor upper layer
Pulmonary embolus
pulmonary infarction, hemorrhagic pulm infaction results. Characteristically wedge shaped.
Paradoxical emboli
Due to patent foramen ovale or ASD
Treatment of choice for HACEK endocarditis
cephtriaxone
Treatment of choice for HTN in APCKD
ACEi
beta 1 selective antagonist
Acebutolol
Betaxolol
Esmolol
Atenolol
Metoprolol
beta blockers with intrinsic sympathomimetic activity
don't use with angina
Acebutolol and Pindolol
Riluozole
Acts on nervous system - extends survival of ALS pts
Baclofen
GABA-B agonist
tx for spascticity in ALS
Tizanidine
alpha 2 agonist in CNS
good for spasticity in ALS
Anecdote for organosphosphates poisoning.
Organophosphates inhibit anticholinesterase
PRALIDOXIME binds to the organosphosphate reactivating the AchE