Pharm II (Anti Arrhythmic + Anesthesiology)
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What is the most serious side effect of Dofetilide, Idutilide, and Sotalol?
Tosades de pointes---a varient of Ventricular tachycardia
What are the Class IV drugs?
What is there effect?
What are they an Inappropriate treatment for?
They are Calcium Channel blockers
They decrease the conduction through the AV node and shorten the Plateau of the cardiac potential.
- Innapropriate for Heart failure (would want to increase contractility)
- They reduce the contractility of the heart.
What two drugs are in group IV?
What are they an important treatment for? What else?
Cerapamil and Diltiazem
- - Good for Supraventricular tachycardia
- - Can be used in Angina, and migrain prophylaxis.
What phase due they block?
- 1- Blocks Na channels and thus phase 0.
- 2- (Beta blockers) block phase 4
- 3- Blocks K channels, thus Phase 3
- 4- Blocks Ca channels, thus Phase 2
What is adenosine used for?
How does it work?
What is its major Adverse effect?
-It is the DOC for SVT
-It activates the K channels in the AV node (and SA node)--> reduces the Ca ++ currents
What is Digoxins effects?
What can it be used in?
Increases vagal activity via central action on the CNS--> decreasing the conduction through the AV node
- Used in SVT
What is Magnesium used in when acting as a Anti arrhythmic drug?
Used in Torsades de pointes and in Digoxin induced arrhythmia
What can treat it?
Atrial Flutter and fibrillation?
-Adenosine, CCB and BB
-Amiodarone, Lidocaine and BB
What are goals of Anesthetics?
- -Adequate Muscle relaxation
- -Adequate Ventilation
- -Pain Control
Name some Pre-Anesthetic drugs and their effects.
Antihistamines-- Prevent allergic reactions
Antiemetics--- Prevent nausea and vomiting
Opioids----- provide Analgesia
Atropine---- Prevent Bradycardia and secretion
What are the 4 Stages of Anesthesiology?
Which is the most dangerous?
- 1- Analgesia
- 2- Excitement, Combative behavior
- 3- Surgical anesthesia
- 4- Medullary paralysis
What do GA act on?
GABA-A and NMDA receptors
What are the twp types of Anesthetics?
Inhalational--- for maintenance
Intravenous- for induction and short precedures.
Name the Inhalational Anesthetics
Non halogenated----Nitrous oxide
Halogenated: Holothane, Isoflurane, Desflurane and Sevoflurane
What are the important characters that of inhalational anesthetics?
- 1- Solubility in the blood
- 2- Solubility in the fat
note if High lipid soluble= highly POTENT
What is the significance of Gas partition coefficient?
Low= Faster induction and recovery (what you want) (ex: NO)
High= Slow (Ex: Halothane)
What would you like to do?
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