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ู…ู„ุฎุตุงุช ุณู†ุฉ ุซุงู„ุซุฉ ุจุดุฑูŠ~ ๐ŸŒธ
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ุงู„ุณู„ุงูŠุฏุงุช ุงู„ู„ูŠ ู‚ุงู„ุช ุนู„ูŠู‡ุง ุงู„ุฏูƒุชูˆุฑุฉ ุงู† ู†ุฑูƒุฒูˆุง ุนู„ูŠู‡ ู…ู‡ู…ุงุช ุฌุฏุง๐Ÿ“
๐Ÿ‘2
ู†ู‚ุงุท ู…ู‡ู…ุฉ mcq ๐Ÿ“Œ

โญโ–ซ๏ธbeta bl only used in HF (carvedilol - bisoprolol - metoprolol) ู…ู‡ู…ุฉ

โ–ซ๏ธnitroprusside not used in chronic only acute

โ–ซ๏ธnitrates + hydralazin used together in HF

โ–ซ๏ธACEI prevent myocardial hypertrophy & remodeling & lower BP w/o reflex tachy

โ–ซ๏ธcaptopril contain SH + rapid onset + short duration

โ–ซ๏ธACEI used in early MI with aspirin + fibrinolytics + beta bl


โญโ–ซ๏ธACEI CI with bilateral renal artery stenosis (ู…ู‡ู…ุฉ) Explain
b/c GFR is maintained by VC of the efferent arteriole by AgII

โ”because they โ†“ Ang-II โ†’ โ†“ VC of the efferent arterioles โ†’ โ†“ GFP and โ†“ GFR โ†’lead to aggravation of renal failure in both kidneys and hyperkalemia

โ–ซ๏ธdiuretics give for fluid control โ†’ โ†“pulmonary congestion + โ†“peripheral ankle edema

โญโ–ซ๏ธdiuretics 1st choice in refractory pulmonary edema

โญโ–ซ๏ธdrugs that lower mortality: (ACEl ARBs - beta bl - spironolactone)

โ–ซ๏ธdigoxin inhibits Na/K ATPase

โ–ซ๏ธdigoxin increase contractility

โ–ซ๏ธdigoxin can cause arrhythmia

โ–ซ๏ธdigoxin cause vagal stim. at (therapeutic dose) & sympathetic stim. at (toxic dose)

โญโ–ซ๏ธit inhibits SAN โ†’โ†“HR (indicate optimal digitalization) + AVN block and increase ERP (ู…ู‡ู…ุฉ)

โญโ–ซ๏ธdigoxin drug of choice for HF + AF

โ–ซ๏ธit has narrow safety margin and give yellow green coloured vision

โญโ–ซ๏ธdigibind is first choice for TTT of digitalis toxicity

โ–ซ๏ธdopamine given in AHF + cardiogenic shock

โ–ซ๏ธMilrinone - Inamrinone are inodilators inhibit phosphodiesterase III

โญโ–ซ๏ธSacubitril-Valsartan are inhibitor of neprilysin enzyme

โญโ–ซ๏ธIvabradine TTT stable angina + CHF with ejection fraction less than 35%
โ–ซ๏ธit selectively inhibit hyperpolar. of cyclic nucleotide channel (funny channels) on SAN
โค2
ุงู„ุญู‚ ุตุงุฑู„ูŠ ุดูˆูŠุฉ ุฅุญุจุงุท ู…ู† ุฃุฎุจุงุฑ ุงู„ูŠูˆู… ุจุณ ุญู†ุฒู„ ุงู„ุจุงู‚ูŠ ุจูŠุด ู†ุณุชููŠุฏูˆุง ูƒู„ู†ุง~
ู†ุนุฑูุด ู†ู‚ูˆู„ ูƒู„ุงู… ู…ุญูุฒ ๐Ÿ˜‚ ุจุณ ู†ุฏูŠุฑูˆุง ุงู„ู„ูŠ ุนู„ูŠู†ุง ูˆ ุงู† ุดุงุก ุงู„ู„ู‡ ุงู„ุชุนุจ ู…ุด ุญูŠุนุฏูŠ ุนุงู„ูุงุถูŠ ู†ุชูˆูƒู„ูˆุง ุนู„ู‰ ุงู„ู„ู‡ ุจุณ ูˆ ูƒู„ู†ุง ู†ุทู„ุนูˆุง ู…ู†ู‡ุง ุฑุงุถูŠูŠู†~ ๐Ÿค

ู†ุจุฏูˆุง ุจุงู„ 4) drugs used in arrhythmia ๐Ÿ’ซ
โค4๐Ÿ‘2
ุฃูˆู„ ุดูŠุก ุงู„ุฏูƒุชูˆุฑุฉ ู‚ุงู„ุช ุงู† ุงู„ุฌุฒุฆูŠุฉ ู‡ุฏูŠ ู…ุชู‚ุฏู…ุฉ ูˆุงุฌุฏ ุจุงู„ู†ุณุจุฉ ู„ุซุงู„ุซุฉ ูู†ุงุฎุฏูˆุง ุนู„ูŠู‡ ู†ู‚ุงุท ู…ุนูŠู†ุฉ ู†ุฑูƒุฒูˆุง ุนู„ูŠู‡ุง~
Audio
AudioLab
ู‡ุฏูŠ ุจุฏุงูŠุฉ ุชุณุฌูŠู„ ุงู„ู…ุญุงุถุฑุฉ ู‚ุงู„ุช ุดู† ุงู„ู…ู‡ู… ูˆ ุดุฑุญุช ุจุงุซูˆูุณูŠูˆู„ูˆุฌูŠ ุจูŠุด ู†ูู‡ู…ูˆุง ุงู„ drugs
ุงู„ู„ูŠ ู‚ุงู„ุช ุนู„ูŠู‡ู† ูŠุฌู† ุดูˆุฑุช ู†ูˆุช

1 list vaughan william classification

2 adverse effects of class I a

3 adverse effects of Amiodarone

4 precautions should be done to pt taking Amiodarone
โค1๐Ÿ‘1
ู†ู‚ุงุท ู…ู‡ู…ุฉ mcq ๐Ÿ”ด

โ–ซ๏ธevery anti arrhythmic drugs have pro arrhytmogenic actions

โ–ซ๏ธprocainamide has moderate dissociation rate - moderate conduction block + ganglion blockade

โ–ซ๏ธdrugs inhibit action of quinidine: (digoxin - beta bl. - verapamil) โ†“AVN

โ–ซ๏ธclass I a used on broad sprectum
โ–ซ๏ธclass I b on ventricular arrhythmias
โ–ซ๏ธclass I c on SV arrhythmias
โ–ซ๏ธclass III (Amiadarone) broad spectrum (terminate PSVT)
โ–ซ๏ธclass IV (verapamil) SV arrhythmias (2nd choice if PSVT with asthma)

โ–ซ๏ธlidocaine blocks inactivated Na channels in ischemic tissue

โญโ–ซ๏ธlidocaine best used after MI or cardiac surgery

โ–ซ๏ธ(case) pt developed arrhythmia after cardiac surgery which drug of choice?
lidocaine

โ–ซ๏ธclass 1b (lidocaine) not used orally and can cause convulsions

โ–ซ๏ธclass Ic marked (AVN) conduction block

โ–ซ๏ธclass 1c (propafenone) CI in bronchospasm

โญโ–ซ๏ธAmiodarone (ู…ู‡ู…ุฉ ูƒู„ู‡ุง) K channel bl

โญโ–ซ๏ธ(case) use beta bl. in exercise - thyrotoxicosis - pheochromocytoma

โ–ซ๏ธAdenosine used in emergency - PSVT (drug of choice)
CI in asthma (case)

โ–ซ๏ธ(case) verapamil drug of choice in prophylaxis PSVT

โ–ซ๏ธ(case) beta bl. drug of choice in SV arrhythmia after MI

โ–ซ๏ธ(case) lidocaine drug of choice in ventricular arrhythmia from MI or from digitalis toxicity

โ–ซ๏ธcinchonism is adverse affects of quinidine (tinnitus - loss of hearing - blurred vision)
๐Ÿ‘2๐Ÿฅฐ1
ุงู† ุดุงุก ุงู„ู„ู‡ ูƒู…ู„ุช ุฌุฒุฆูŠุฉ ุงู„ุณูŠ ููŠ ุงุณ ูˆ ูƒู„ ุงู„ู†ู‚ุงุท ุงู„ู…ู‡ู…ุฉ ุชุณุงุนุฏูƒู… ููŠ ุงู„ุชุงุชูˆุฑูŠุงู„ ูˆ ุงู„ูุงูŠู†ู„ ูˆ ุฑุจูŠ ูŠูˆูู‚ู†ุง~ ๐Ÿ™๐Ÿป
โค10๐Ÿฅฐ1
ุงู…ุณูŠูƒูŠูˆุงุช ุฏ. ู…ุญู…ุฏ ุงู„ุนู…ุงู…ูŠ
โค6
ูƒุชุจุช ู…ุฌู…ูˆุนุฉ ุดูˆุฑุช ู†ูˆุช ุงู„ู„ูŠ ุงุญุชู…ุงู„ ูŠุฌู† ููŠ ุงู„ูุงุฑู…ุง ู†ุฒู„ู‡ู† ุชูˆุงุŸ
Anonymous Poll
57%
ุงู‡ุง
43%
ู†ุฒู„ูŠ ุจุนุฏ ุงู„ู…ุนู…ู„
ู‚ุฑุฑุช ุฃู† ุฃูุถู„ ู†ุฒู„ู‡ู† ุจุนุฏ ุงู„ู…ุนู…ู„ ู„ุฃู† ุฏูƒุชูˆุฑุฉ ุฎุฏูŠุฌุฉ ุงุญุชู…ุงู„ ุชู†ุฒู„ ููˆูŠุณ ุนู„ูŠ ุชูุงุตูŠู„ ุงู„ุฅู…ุชุญุงู† ูˆ ู…ู…ูƒู† ุชู‚ูˆู„ ุนู„ูŠ ุดู† ู†ุฑูƒุฒูˆุง ููŠ ุงู„ุดูˆุฑุช~ ๐Ÿค
โค20๐Ÿ‘5
ุชุฌู…ูŠุนุฉ ุดูˆุฑุช ู†ูˆุช ู„ู„ูƒูˆุฑุณุงุช ุงู„ูƒุจุงุฑ (cvs - cns - endo - blood)
ููŠ ู†ู‚ุงุท ุณู…ุนุชู‡ุง ู…ู† ุชุณุฌูŠู„ุงุช ุงู„ุฌุงู…ุนุฉ ูˆ ุงุถุงูุงุช ู…ู†ูŠ~ ๐Ÿ™๐Ÿป

ู„ูˆ ููŠ ุงุณุชูุณุงุฑ ุฃูˆ ุชุนุฑููˆุง ุณุคุงู„ ู…ู‡ู… ู…ุถูุชุด ุฏุฒูˆู„ูŠ
@kukxu0
โค28๐Ÿ‘1