bianca Shared "Pharm E2" - 42 Picmonics

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Pharm E2

Class I Antiarrhythmics (Na+ Channel Blockers) Overview
Indications
Arrhythmias
Local Anesthesia
Mechanism of Action
Block or Slow Conduction
Block Na+ Channels
Raise Threshold
State Dependent
Contraindication
Hyperkalemia
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1 min
Class IB Antiarrhythmics (Na+ Channel Blockers)
Indications
Arrhythmias
After Myocardial Infarction
Mechanism of Action
Affect Ischemic Tissue
Decrease AP duration
Drugs
Mexiletine
GI Upset
Lidocaine
CNS Depression
Tocainide
Phenytoin
Hirsutism
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2 mins
Class IC Antiarrhythmics (Na+ Channel Blockers)
Indications
Used as Last Resort
V-Tach
Mechanism of Action
No Effect on AP Duration
Drugs
Propafenone
Flecainide
Contraindications
Post-Myocardial Infarction
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55 secs
Class III Antiarrhythmics (K+ Channel Blockers)
Indications
Arrhythmias
Mechanism of Action
Increase AP Duration, ERP, and QT Interval
Drug Names
Amiodarone
Check Function Tests
Dirty Drug
Ibutilide
Dofetilide
Sotalol
Beta-Blocker
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2 mins
Class IA Antiarrhythmics (Na+ Channel Blockers)
Indications
Arrhythmias
Mechanism of Action
Increase AP, ERP, and QT interval.
Drugs
Disopyramide
Procainamide
Drug-induced Lupus
Quinidine
Cinchonism
Shared Side Effects
Thrombocytopenia
Torsades de Pointes
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1 min
Class IV Antiarrhythmics (Ca2+ Channel Blockers)
Indications
SVT
Subarachnoid Hemorrhage
Mechanism of Action
Decrease Conduction Velocity
Increase PR Interval and ERP
Drugs
Verapamil
Diltiazem
Nimodipine
Side Effects
Cardiovascular
Constipation
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2 mins
Warfarin
Mechanism of Action
Interferes with Vitamin K-dependent Clotting Factors
Extrinsic Pathway
Bridge with Heparin
Indications
Chronic Anticoagulation
Side Effects
Bleeding
Necrosis
Cytochrome P450
Contraindications
Pregnancy
Antidote
FFP + Vitamin K
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2 mins
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
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58 secs
INR Lab Value
0.8-1.2 Normal Range
Warfarin
2.0-3.0
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1 min
Coagulation Cascade
Secondary Hemostasis
Intrinsic Pathway
Partial Thromboplastin Time (PTT)
Heparin
Extrinsic Pathway
Prothrombin Time (PT)
Warfarin
Common Pathway
Thrombin
Convert Fibrinogen to Fibrin
Stabilizes the Platelet Plug
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2 mins
Deep Vein Thrombosis (DVT) Management
Diagnosis
Compression Ultrasound (CUS) with Doppler
D-Dimer
Contrast Venography
Treatment
IVC Filter
Heparin for Acute Management
Warfarin for Long-term Management
Thrombectomy/Thrombolysis
Stockings
Walking
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4 mins
Protein C or S Deficiency
Pathophysiology
Autosomal Dominant
Inability to Inactivate Factor Va and VIIIa
Symptoms
Hypercoagulable State
Recurrent DVTs or DVTs at Young Age
Treatment
Begin Heparin
Slowly Bridge to Warfarin
Hemorrhagic Skin Necrosis
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2 mins
Vitamin K
Sources
Dark Green Leafy Vegetables
Synthesized by Intestinal Flora
Mechanism
Activated by Epoxide Reductase
Gamma Carboxylation of Glutamate
Activation of Clotting Factors II, VII, IX, X, Protein C and S
Considerations
Deficiency with Broad Spectrum Antibiotics
Neonatal Hemorrhage with Increased PT and aPTT
Warfarin is a Vitamin K Antagonist
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4 mins
Adenosine (Adenocard)
Mechanism
Slows AV Conduction
Indications
Supraventricular Tachycardia (Paroxysmal)
Side Effects
Bradycardia
Flushing
Dyspnea
Considerations
Rapid IV Push
Caffeine and Theophylline Decrease Effectiveness
Dipyridamole May Intensify Effects
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2 mins
Magnesium Sulfate
Mechanism
Muscle Relaxant
Indications
Preterm Labor Contractions
Preeclampsia
Side Effects
Warm Feeling
Hypotension
Decreased Deep Tendon Reflexes (DTRS)
Decreased Respiratory Rate
Decreased Urine Output
Paralytic Ileus
Antidote
Calcium Gluconate
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2 mins
Wolff-Parkinson-White Syndrome
WPW Pattern vs. WPW Syndrome
Pathophysiology
Ventricular Pre-excitation Syndrome
Accessory Conduction Pathway
Signs & Symptoms
Supraventricular Tachycardia
Atrial Fibrillation
Diagnosis
Shortened PR Interval
Delta Wave
Widened QRS
Treatment
No Treatment if Asymptomatic
Treat Arrhythmia
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3 mins
Clopidogrel (Plavix)
Mechanism
ADP Receptor Antagonist
Prevent Platelet Aggregation
Indications
Acute Coronary Syndrome (ACS)
Prevention of Thrombotic Events
Side Effects
Bleeding
Thrombotic Thrombocytopenic Purpura (TTP)
Pancytopenia
Abdominal Pain
Considerations
Withhold Before Surgery
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2 mins
Ticlopidine (Ticlid)
Mechanism
ADP Receptor Antagonist
Irreversibly Inhibits Platelet Aggregation
Indications
Thrombotic Event Prevention
Side Effects
Neutropenia
Thrombotic Thrombocytopenic Purpura (TTP)
GI Distress
Rash
Considerations
Withhold Before Surgery
Monitor Blood Count
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2 mins
Abciximab and Tirofiban (GP IIb/IIIa Inhibitors)
Mechanism
IIb/IIIa Receptor Inhibitors
Inhibits Platelet Aggregation
Indications
Thrombotic Event Prevention
Acute Coronary Syndrome (ACS)
Percutaneous Coronary Intervention (PCI)
Side Effects
Bleeding
Considerations
Expensive
Combination Drug Therapy
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2 mins
Alteplase
Mechanism
Tissue Plasminogen Activator
Indications
Thrombosis
Side Effects
Bleeding
Contraindications
Intracranial Hemorrhage
Internal Hemorrhaging
Considerations
Minimize Bleeding
Monitor for Shock
Antidote
Aminocaproic Acid
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2 mins

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