Case 1

نبدوا بال 3) drugs used in heart failure💫

الشيت كلامه واجد بس تلقو معظمه مكرر و أهم جزئية هي digoxin

قبل ما نبدوا في الdrugs لازم نفهموا الpathophysiology للHF و هذا فيديو لفوده تلقو فيه الشرح~ ☝️

أحتمال يجن إكسبلاين أو شورت نوت~

❕list drugs used to reduce preload afterload and myocardial contractility in CHF vs AHF? ⭐
▫️CHF
(preload): loop - ACEI ARBs - nitrates
(after load): ACEI ARBs - hydralazine
(contractility): Digoxin

▫️AHF
(preload): loop - nitrates - nitroprusside
(afterload): nitroprusside
(contractility): dopamine - dobutamine - inamrinone

❕advantages of ACEI in HF? ⭐⭐⭐
▫️improve exercise tolerance & congestive symptoms
▫️decrease mortality in HF
▫️renoprotective
▫️do not induce reflex tachycardia

⭐⭐⭐❕Explain advantages of ARBs?
▫️no bradykinin production
▫️antagonize Ag II formed by ACE
▫️avoid hormonal escape
▫️increase activity of AT2 → ↑VD

❕List precautions when using nitroprusside?
▫️give slow IV
▫️freshly prepared in saline with opaque foil
▫️frequent monitoring of BP
▫️avoid prolonged administration to prevent cyanide toxicity

⭐❕Explain the beneficial effects of spironolactone in reducing mortality in HF?

❕beneficial effects of beta bl. in reducing mortality in HF ⭐⭐⭐
▫️نزله سلايد

❕CI of digoxin? ⭐⭐

❕Explain why digoxin CI with AF+WPW? ⭐
▫️b/c blocks AVN → ↑conduction in accessory tract

❕Explain why digoxin CI with erythromycin?
▫️b/c decrease inactivation of digitalis by killing GIT flora lead to increase absorption and toxicity

❕Explain digitilization? ⭐⭐⭐
(مهم مهم جدا الدكتورة عاودتها كم مرة)
▫️to achieve therapeutic bl. lvl & to avoid toxicity
▫️low dose 0.125-0.25 mg/d (Css reached in one week)

❕TTT of digitalis toxicity? ⭐⭐

❕Order of therapy in CHF? ⭐