First Aid 245-268 Flashcards Preview

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Flashcards in First Aid 245-268 Deck (84)
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1
Q

Atropine is aka

A

bella donna
jimson weed
Muscarinic antagonist
can reverse lethal bradyarrythmias

2
Q

Muscarinic antagonists used in eye check ups to dilate

A

Atropine
Homatropine
Tropicamide

3
Q

“Park my Benz”

A

Parkinsons - use Benztropine (M1) to improve tremor/rigidity

4
Q

Hyoscamine
Dicyclomine
Uses

A

Antispasmodics for IBS

Antimuscarinics

5
Q

Tiotroprium is preferred over Ipratroprium for treatment of COPD and asthma because

A

Tiotroprium dissociates from M3 more slowly, provides longer bronchial relaxation;

Antimuscarinic

6
Q

M2 antagonist used to treat overactive bladder

A

Oxybutinin
Solifenacin
Tolterodine

7
Q
Hot as a hare (M3)
Mad as a Hatter
Dry as a Bone
Blind as a Bat
Red as a Beet
A

Antimuscarinic toxidrome ie atropine overdose

Can cause acute angle glaucoma

8
Q

Pralidoxime

A

reverses DUMBBELSS

no CNS penetration

9
Q

What receptors does Dobutamine act on?

A

B1> B2, alpha

direct sympathomimetic

10
Q

What receptors does dopamine act on?

A

D1 = D2 > beta > alpha

direct sympathomimetic

11
Q

What receptors does epinephrine act on?

A

Beta > alpha

direct sympathomimetic

12
Q

What receptor does Fenoldopam act on?

A

D1
post-op HTN (vasodilates)
direct sympathomimetic

13
Q

What receptors does isoproterenol act on?

A

beta 1 = beta 2
evaluation of tachyarrythmias
direct sympathomimetic

14
Q

What receptor does midodrine act on?

A

Alpha 1
tx of postural hypotension
direct sympathomimetic

15
Q

What receptors does norepinephrine act on?

A

alpha 1 > alpha 2 > beta 1

direct sympathomimetic

16
Q

What receptors does phenylephrine act on?

A

alpha 1 > alpha 2
tx hypotension, rhinitis, in ocular procedures to produce mydriasis
direct sympathomimetic

17
Q

Never give what if cocaine intoxication is suspected and why?

A

Beta blockers
Cocaine is a general (indirect) sympathomimetic agonist - blocking beta would cause unopposed alpha-1 activation and extreme HTN

18
Q

Amphetamine
Cocaine
Ephedrine
are all:

A

Indirect sympathomimetics

19
Q

Clonidine
Guanfacine
Uses

A

Alpha-2 sympatholytics - reduce sympathetic outflow - treat hypertensive emergency, ADHD, Tourette syndrome

20
Q

Name the non-selective alpha blockers and their applications

A

Phenoxybenzamine (irreversible) - Pheochromocytoma

Phentolamine - give to patients on MAO inhibitos who eat tyramine-rich foods

21
Q

Prazosin, Terazosin, Doxazosin, Tamsulosin - all used for unrinary symptoms of BPH. How do they work?

A

alpha-1-selective blocker - DECREASE vascular smooth muscle contraction and sphincter contraction

22
Q

What alpha blocker used in treatment of PTSD?

A

Prazosin

23
Q

MOA Mirtazapine

A

alpha-2 blocker

24
Q

What beta blockers are class II antiarrythmics indicated for SVT?

A

Metoprolol, Esmolol

reduce AV conduction velocity

25
Q

What beta blockers reduce mortality in patients with HF?

A

Bisoprolol
Carvedilol (**nonselective alpha and beta antagonist)
Metoprolol

26
Q

What beta blocker is used in the treatment of glaucoma by reducing secretion of aqueous humor?

A

Timolol

27
Q

Name the beta-1 selective agonists

A
Acebutolol (partial agonist)
Metoprolol
Atenolol
Betaxolol
Esmolol
(Selective agonists are mostly A through M)
28
Q

What poisoning is frequently misdiagnosed as a fish allergy?

A

Scombroid - bacteria in spoiled fish convert histadine to histamine

29
Q

Toxin: AChE inhibitors, organophosphates

Tx?

A

Atropine ? pralidoxime

30
Q

Toxin: Amphetamines (basic)

Tx?

A

Nh4Cl - acidify the urine

31
Q

Toxin: Antimuscarinic/anticholinergic agents

tx?

A

Physostigmine and control hyperthermia

32
Q

Toxin: Arsenic

Tx?

A

Dimercaprol, succimer

33
Q

Toxin: Benzodiazepines

Tx?

A

Flumazenil

34
Q

Toxin: Beta-blockers

Tx?

A

Saline, atropine, glucagon

35
Q

Toxin: Cyanide

Tx?

A

Nitrite + thiosulfate, hydroxycobalamin

36
Q

Toxin: Digitalis (digoxin)

Tx?

A

Anti-digitalis Fab fragments

37
Q

Toxin: Gold

Tx?

A

Penicillamine
Dimercaprol
succimer

38
Q

Toxin: Heparin

Tx?

A

Protamine sulfate

39
Q

Toxin: Iron

Tx?

A

Deferoxamine
Deferasirox
Deferiprone

40
Q

Toxin: Lead
Tx:

A

EDTA
Dimercaprol
Succimer
Penicillamine

41
Q

Toxin: Mercury

Tx?

A

Dimercaprol

Succimer

42
Q

Toxin: Methanol, ethylene glycol

Tx?

A

Fomepizole

43
Q

Toxin: Methemoglobin

Tx?

A

Methylene blue, vitamin C

44
Q

Toxin: Salicylates

Tx?

A

NaHCO3 (alkalinize urine), dialysis

45
Q

Toxin: TCAs

Tx?

A

NaHCO3

46
Q

Toxin: Warfarin

Tx?

A

Vitamin K (delayed effect), FFP (immediate)

47
Q

Ergonovine, an ergot alkaloid, is used to diagnose Prinzmetal’s angine because it does what?

A

Causes coronary vasospasm

48
Q

VANCE - what drugs cause cutaneous flushing?

A
Vancomycin
Adenosine
Niacin
Calcium channel blockers
Echinocandins
49
Q

What drug can be given with Doxorubicin or Daunorubicin to prevent the development of dilated cardiomyopathy?

A

Dexrazoxane

50
Q

ABCDE - drugs that cause torsades de pointes

A
AntiArrhthmics - class IA, III
AntiBiotics (macrolides)
AntiCychotics ie haloperidol
AntiDepressants ie TCAs
AntiEmetics ie ondansetron
51
Q

Embryonic structure: Truncus arteriosis

Gives rise to:

A

Ascending aorta and pulmonary trunk

52
Q

Embryonic structure: Bulbis cordis

Gives rise to:

A

Smooth parts of L and R ventricles

53
Q

Embryonic structure: Endocardial cushion

Gives rise to:

A

Atrial septum, membranous interventricular septum, AV and semilunar valves

54
Q

Embryonic structure: Primitive atrium

Gives rise to:

A

Trabeculated part of L and R atria

55
Q

Embryonic structure: Primitive ventricle

Gives rise to:

A

Trabeculated part of L and R ventricles

56
Q

Embryonic structure: Primitive pulmonary vein

Gives rise to:

A

Smooth part of LA

57
Q

Embryonic structure: Left horn of sinus venosus

Gives rise to:

A

Coronary sinus

58
Q

Embryonic structure: Right horn of sinus venosus

Gives rise to:

A

Smooth part of RA (sinus venarum)

59
Q

Embryonic structure: Right common cardinal vein and right anterior cardinal vein
Gives rise to:

A

SVC

60
Q

Where does erythropoesis occur in the fetus?

A

Yolk sac
Liver
Spleen
Bone marrow

61
Q

Where does erythropoesis occur on the adult?

A
Vertebrae
Sternum
Pelvis
Ribs
Cranial bones
Tibia and femur
62
Q

What divides the left and right atria in the developing fetus?

A

Septum primum and septum secondum

63
Q

Foramen ovale and ostium secundum: fx?

A

R to L shunting of blood to bypass pulmonary circulation (atrial development)

64
Q

VSD most commonly occurs in the

A

membranous septum

65
Q

How does fetal blood bypass the hepatic circulation?

A

Ductus venosus - goes umbilical vein –> IVC

66
Q

Closure of ductus arteriosus at birth from

A

increase in O2 –> decrease in prostaglandins

67
Q

Closure of foramen ovale at birth from

A

increase in LA pressure, decrease in pulmonary resistance

68
Q

Prostaglandins E1 and E2 keep what open?

A

PDA (pulmonary artery –> aorta)

69
Q

MediaN umbilical ligament used to be in the fetus:

A

AllaNtois –> urachus

70
Q

The nucleus pulposus used to be in the fetus

A

Notochord

71
Q

UmbiLical arteries become

A

MediaL umbilical ligaments

72
Q

Umbilican vein becomes

A

Ligamentum teres

73
Q

Why could a RCA infarct result in bradycardia or heart block?

A

Nodal dysfunction due to SA and AV nodes not being supplied by RCA

74
Q

What is right dominant circulation?

A

85% of the population

The Posterior descending artery arises from the RCA

75
Q

Coronary blood flow peaks in

A

early diastole

76
Q

MAP =

A

MAP = CO x TPR = 2/3DP + 1/3SP

77
Q

PP =

A

PP = SP - DP

78
Q

PP is inversely proportional to

A

arterial compliance

79
Q

Decreased afterload has what effect on SV?

A

Increases SV

80
Q

Nitroglycerin decreases

A

preload (venodilator)

81
Q

Hydralazine decreases

A

afterload (vasodilator)

82
Q

EF =

A

SV/EDV = EDV-ESV/EDV

83
Q

Ejection fraction is decreased in

A

systolic HF

84
Q

Ejection fraction is normal in what kind of HF?

A

Diastolic HF