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First Aid 245-268 Flashcards

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1
Q

Atropine is aka

A

bella donna
jimson weed
Muscarinic antagonist
can reverse lethal bradyarrythmias

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2
Q

Muscarinic antagonists used in eye check ups to dilate

A

Atropine
Homatropine
Tropicamide

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3
Q

“Park my Benz”

A

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

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4
Q

Hyoscamine
Dicyclomine
Uses

A

Antispasmodics for IBS

Antimuscarinics

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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

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6
Q

M2 antagonist used to treat overactive bladder

A

Oxybutinin
Solifenacin
Tolterodine

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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

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8
Q

Pralidoxime

A

reverses DUMBBELSS

no CNS penetration

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9
Q

What receptors does Dobutamine act on?

A

B1> B2, alpha

direct sympathomimetic

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10
Q

What receptors does dopamine act on?

A

D1 = D2 > beta > alpha

direct sympathomimetic

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11
Q

What receptors does epinephrine act on?

A

Beta > alpha

direct sympathomimetic

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12
Q

What receptor does Fenoldopam act on?

A

D1
post-op HTN (vasodilates)
direct sympathomimetic

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13
Q

What receptors does isoproterenol act on?

A

beta 1 = beta 2
evaluation of tachyarrythmias
direct sympathomimetic

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14
Q

What receptor does midodrine act on?

A

Alpha 1
tx of postural hypotension
direct sympathomimetic

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15
Q

What receptors does norepinephrine act on?

A

alpha 1 > alpha 2 > beta 1

direct sympathomimetic

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16
Q

What receptors does phenylephrine act on?

A

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

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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

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18
Q

Amphetamine
Cocaine
Ephedrine
are all:

A

Indirect sympathomimetics

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19
Q

Clonidine
Guanfacine
Uses

A

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

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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

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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

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22
Q

What alpha blocker used in treatment of PTSD?

A

Prazosin

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23
Q

MOA Mirtazapine

A

alpha-2 blocker

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24
Q

What beta blockers are class II antiarrythmics indicated for SVT?

A

Metoprolol, Esmolol

reduce AV conduction velocity

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25
What beta blockers reduce mortality in patients with HF?
Bisoprolol Carvedilol (**nonselective alpha and beta antagonist) Metoprolol
26
What beta blocker is used in the treatment of glaucoma by reducing secretion of aqueous humor?
Timolol
27
Name the beta-1 selective agonists
``` Acebutolol (partial agonist) Metoprolol Atenolol Betaxolol Esmolol (Selective agonists are mostly A through M) ```
28
What poisoning is frequently misdiagnosed as a fish allergy?
Scombroid - bacteria in spoiled fish convert histadine to histamine
29
Toxin: AChE inhibitors, organophosphates | Tx?
Atropine ? pralidoxime
30
Toxin: Amphetamines (basic) | Tx?
Nh4Cl - acidify the urine
31
Toxin: Antimuscarinic/anticholinergic agents | tx?
Physostigmine and control hyperthermia
32
Toxin: Arsenic | Tx?
Dimercaprol, succimer
33
Toxin: Benzodiazepines | Tx?
Flumazenil
34
Toxin: Beta-blockers | Tx?
Saline, atropine, glucagon
35
Toxin: Cyanide | Tx?
Nitrite + thiosulfate, hydroxycobalamin
36
Toxin: Digitalis (digoxin) | Tx?
Anti-digitalis Fab fragments
37
Toxin: Gold | Tx?
Penicillamine Dimercaprol succimer
38
Toxin: Heparin | Tx?
Protamine sulfate
39
Toxin: Iron | Tx?
Deferoxamine Deferasirox Deferiprone
40
Toxin: Lead Tx:
EDTA Dimercaprol Succimer Penicillamine
41
Toxin: Mercury | Tx?
Dimercaprol | Succimer
42
Toxin: Methanol, ethylene glycol | Tx?
Fomepizole
43
Toxin: Methemoglobin | Tx?
Methylene blue, vitamin C
44
Toxin: Salicylates | Tx?
NaHCO3 (alkalinize urine), dialysis
45
Toxin: TCAs | Tx?
NaHCO3
46
Toxin: Warfarin | Tx?
Vitamin K (delayed effect), FFP (immediate)
47
Ergonovine, an ergot alkaloid, is used to diagnose Prinzmetal's angine because it does what?
Causes coronary vasospasm
48
VANCE - what drugs cause cutaneous flushing?
``` Vancomycin Adenosine Niacin Calcium channel blockers Echinocandins ```
49
What drug can be given with Doxorubicin or Daunorubicin to prevent the development of dilated cardiomyopathy?
Dexrazoxane
50
ABCDE - drugs that cause torsades de pointes
``` AntiArrhthmics - class IA, III AntiBiotics (macrolides) AntiCychotics ie haloperidol AntiDepressants ie TCAs AntiEmetics ie ondansetron ```
51
Embryonic structure: Truncus arteriosis | Gives rise to:
Ascending aorta and pulmonary trunk
52
Embryonic structure: Bulbis cordis | Gives rise to:
Smooth parts of L and R ventricles
53
Embryonic structure: Endocardial cushion | Gives rise to:
Atrial septum, membranous interventricular septum, AV and semilunar valves
54
Embryonic structure: Primitive atrium | Gives rise to:
Trabeculated part of L and R atria
55
Embryonic structure: Primitive ventricle | Gives rise to:
Trabeculated part of L and R ventricles
56
Embryonic structure: Primitive pulmonary vein | Gives rise to:
Smooth part of LA
57
Embryonic structure: Left horn of sinus venosus | Gives rise to:
Coronary sinus
58
Embryonic structure: Right horn of sinus venosus | Gives rise to:
Smooth part of RA (sinus venarum)
59
Embryonic structure: Right common cardinal vein and right anterior cardinal vein Gives rise to:
SVC
60
Where does erythropoesis occur in the fetus?
Yolk sac Liver Spleen Bone marrow
61
Where does erythropoesis occur on the adult?
``` Vertebrae Sternum Pelvis Ribs Cranial bones Tibia and femur ```
62
What divides the left and right atria in the developing fetus?
Septum primum and septum secondum
63
Foramen ovale and ostium secundum: fx?
R to L shunting of blood to bypass pulmonary circulation (atrial development)
64
VSD most commonly occurs in the
membranous septum
65
How does fetal blood bypass the hepatic circulation?
Ductus venosus - goes umbilical vein --> IVC
66
Closure of ductus arteriosus at birth from
increase in O2 --> decrease in prostaglandins
67
Closure of foramen ovale at birth from
increase in LA pressure, decrease in pulmonary resistance
68
Prostaglandins E1 and E2 keep what open?
PDA (pulmonary artery --> aorta)
69
MediaN umbilical ligament used to be in the fetus:
AllaNtois --> urachus
70
The nucleus pulposus used to be in the fetus
Notochord
71
UmbiLical arteries become
MediaL umbilical ligaments
72
Umbilican vein becomes
Ligamentum teres
73
Why could a RCA infarct result in bradycardia or heart block?
Nodal dysfunction due to SA and AV nodes not being supplied by RCA
74
What is right dominant circulation?
85% of the population | The Posterior descending artery arises from the RCA
75
Coronary blood flow peaks in
early diastole
76
MAP =
MAP = CO x TPR = 2/3DP + 1/3SP
77
PP =
PP = SP - DP
78
PP is inversely proportional to
arterial compliance
79
Decreased afterload has what effect on SV?
Increases SV
80
Nitroglycerin decreases
preload (venodilator)
81
Hydralazine decreases
afterload (vasodilator)
82
EF =
SV/EDV = EDV-ESV/EDV
83
Ejection fraction is decreased in
systolic HF
84
Ejection fraction is normal in what kind of HF?
Diastolic HF

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