𝟛𝕣𝕕 𝕪𝕖𝕒𝕣 𝕟𝕠𝕥𝕖𝕤 ~🗒

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

امسيكيوات د. محمد العمامي

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

نقاط مهمة mcq 🔴 ▫️every anti arrhythmic drugs have pro arrhytmogenic actions ▫️procainamide has moderate dissociation rate - moderate conduction block ▫️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

اللي قالت يجي 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

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

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 💫

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) ▫️diuretics giver 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 version ⭐▫️digibind is first choice for TTY 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

السلايدات اللي قالت عليها الدكتورة مهمات جدا📍

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 ❕side affects of ACEI? ⭐⭐⭐ ▫️حنزل السلايد ❕CI of ACEI? ▫️hypotension - pregnancy - bilateral artery stenosis ⭐ ⭐⭐⭐❕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? ▫️نزله سلايد ❕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? ⭐⭐⭐

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

نبدوا بال 3) drugs used in heart failure💫 الشيت كلامه واجد بس تلقو معظمه مكرر و أهم جزئية هي digoxin