نقاط مهمة mcq 📌

⭐▫️beta bl only used in HF (carvedilol - bisoprolol - metoprolol) مهمة

▫️nitroprusside not used in chronic only acute

▫️nitrates + hydralazin used together in HF

▫️ACEI prevent myocardial hypertrophy & remodeling & lower BP w/o reflex tachy

▫️captopril contain SH + rapid onset + short duration

▫️ACEI used in early MI with aspirin + fibrinolytics + beta bl


⭐▫️ACEI CI with bilateral renal artery stenosis (مهمة) Explain
b/c GFR is maintained by VC of the efferent arteriole by AgII

❔because they ↓ Ang-II → ↓ VC of the efferent arterioles → ↓ GFP and ↓ GFR →lead to aggravation of renal failure in both kidneys and hyperkalemia

▫️diuretics give for fluid control → ↓pulmonary congestion + ↓peripheral ankle edema

⭐▫️diuretics 1st choice in refractory pulmonary edema

⭐▫️drugs that lower mortality: (ACEl ARBs - beta bl - spironolactone)

▫️digoxin inhibits Na/K ATPase

▫️digoxin increase contractility

▫️digoxin can cause arrhythmia

▫️digoxin cause vagal stim. at (therapeutic dose) & sympathetic stim. at (toxic dose)

⭐▫️it inhibits SAN →↓HR (indicate optimal digitalization) + AVN block and increase ERP (مهمة)

⭐▫️digoxin drug of choice for HF + AF

▫️it has narrow safety margin and give yellow green coloured vision

⭐▫️digibind is first choice for TTT of digitalis toxicity

▫️dopamine given in AHF + cardiogenic shock

▫️Milrinone - Inamrinone are inodilators inhibit phosphodiesterase III

⭐▫️Sacubitril-Valsartan are inhibitor of neprilysin enzyme

⭐▫️Ivabradine TTT stable angina + CHF with ejection fraction less than 35%
▫️it selectively inhibit hyperpolar. of cyclic nucleotide channel (funny channels) on SAN

الحق صارلي شوية إحباط من أخبار اليوم بس حنزل الباقي بيش نستفيدوا كلنا~
نعرفش نقول كلام محفز 😂 بس نديروا اللي علينا و ان شاء الله التعب مش حيعدي عالفاضي نتوكلوا على الله بس و كلنا نطلعوا منها راضيين~ 🤍

نبدوا بال 4) drugs used in arrhythmia 💫

أول شيء الدكتورة قالت ان الجزئية هدي متقدمة واجد بالنسبة لثالثة فناخدوا عليه نقاط معينة نركزوا عليها~

هدي بداية تسجيل المحاضرة قالت شن المهم و شرحت باثوفسيولوجي بيش نفهموا ال drugs

اللي قالت عليهن يجن شورت نوت

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

نقاط مهمة mcq 🔴

▫️every anti arrhythmic drugs have pro arrhytmogenic actions

▫️procainamide has moderate dissociation rate - moderate conduction block + ganglion blockade

▫️drugs inhibit action of quinidine: (digoxin - beta bl. - verapamil) ↓AVN

▫️class I a used on broad sprectum
▫️class I b on ventricular arrhythmias
▫️class I c on SV arrhythmias
▫️class III (Amiadarone) broad spectrum (terminate PSVT)
▫️class IV (verapamil) SV arrhythmias (2nd choice if PSVT with asthma)

▫️lidocaine blocks inactivated Na channels in ischemic tissue

⭐▫️lidocaine best used after MI or cardiac surgery

▫️(case) pt developed arrhythmia after cardiac surgery which drug of choice?
lidocaine

▫️class 1b (lidocaine) not used orally and can cause convulsions

▫️class Ic marked (AVN) conduction block

▫️class 1c (propafenone) CI in bronchospasm

⭐▫️Amiodarone (مهمة كلها) K channel bl

⭐▫️(case) use beta bl. in exercise - thyrotoxicosis - pheochromocytoma

▫️Adenosine used in emergency - PSVT (drug of choice)
CI in asthma (case)

▫️(case) verapamil drug of choice in prophylaxis PSVT

▫️(case) beta bl. drug of choice in SV arrhythmia after MI

▫️(case) lidocaine drug of choice in ventricular arrhythmia from MI or from digitalis toxicity

▫️cinchonism is adverse affects of quinidine (tinnitus - loss of hearing - blurred vision)

ان شاء الله كملت جزئية السي في اس و كل النقاط المهمة تساعدكم في التاتوريال و الفاينل و ربي يوفقنا~ 🙏🏻

امسيكيوات د. محمد العمامي

قررت أن أفضل نزلهن بعد المعمل لأن دكتورة خديجة احتمال تنزل فويس علي تفاصيل الإمتحان و ممكن تقول علي شن نركزوا في الشورت~ 🤍

تجميعة شورت نوت للكورسات الكبار (cvs - cns - endo - blood)
في نقاط سمعتها من تسجيلات الجامعة و اضافات مني~ 🙏🏻

لو في استفسار أو تعرفوا سؤال مهم مضفتش دزولي
@kukxu0

تركيزات ال جامعه في منهج قبل الجزئي

الحمد لله مفش شورت نوت قبل الجزئي بس ليا ساعات كنت نجهز فيه و جيت بنزله توا 🙂😂
ان شاء الله حنزل باقي شورت نوت و الإكسبلاين اللي بعد الجزئي اليوم أو بكرة 🤍

طلب لو في حد كاتب الإكسبلاين قبل الجزئي يدزها بيش نزلها و نستفيدوا كلنا للأسف حصلتش فرصة نلمهن 🙏🏻
@kukxu0

BRONCHIAL ASTHMA (SN)

❕write MOA of SABA?
stimulate beta 2 receptors:
1. bronchodilation
2. inhibition of mast cell and cytokines
3. increase bronchial mucociliary clearance

❕list adverse effects of selective beta 2 agonists?
1. tremors - anxiety
2. tachycardia
3. tolerance
4. hypokalemia and ms. cramps

❕what are indications of ipratopium?
1. asthma induced by psychogenic or beta stim.
2. asthmatic pt. intolerant to tachycardia or anxiety of beta 2 agonists or theophylline (cardiac - thyrotoxicosis - elderly)
3. acute severe asthma (adjuvant)
4. COPD

❕mention disadvantages of ipratopium?
1. tolerance > blocks presynaptic M2 receptord > ACh release
2. delayed onset less effective than beta 2

❕write MOA of methylxanthines?
1. inhibit phosphodiesterase > increase CAMP
a. direct BD
b. anti inf. decrease cytokines and mast cell mediators - inhibit late asthmatic response
2. block adenosine receptors

❕list adverse effects of theophylline?
1. headache - insomnia - anxiety
2. tachy - arrhythmia
3. peptic ulcer
4. narrow safety margin (monitor serum lvl)

❕mention indications of theophylline?
1. bronchial asthma 2nd choice
a. short term relief of acute bronchospam
b. long term control (nocturnal asthma)
c. acute severe asthma
2. COPD
3. neonatal apnea

❕write MOA of corticosteroids in bronchial asthma?
1. PLA2 > decrease LT PGs > decrease inf.
2. VC > decongestant
3. increase number of beta 2 > indirect BD (potentiate beta 2 agonist)