9/7/12 pt. II Flashcards
Procainamide, disopyramide, and quinidine are what type of drug?
Class IA antiarrhythmic
Class I anti-arrhythmics affect ____ channels in the following states:
IA: _______
IB: _______
IC: _______
fast sodium channels;
open
inactive
resting
What is the main adverse cardiac side effect of quinidine? Mech?
tachycardia; anti-muscarinic and anti-alpha-adrenergic actions (reflex tach)
What drug can be used to prevent the tachycardia often associated with quinidine, e.g. in a patient w/ A-fib?
digoxin
What is cinchonism?
Side effects of quinidine or quinine. ocular, auditory, CNS, and GI dysfunction.
Is TMP-SMX (bactrim) a CYP450 inducer or inhibitor?
Inhibitor
What are the side effects of reserpine use as an antihypertensive?
nasal congestion, increased gastric acid–>peptic ulcer, depression
What is the RLS in NE synthesis, as well as the one targeted in tx of pheochromocytoma?
Tyr –> DOPA via Tyr hydroxylase
Cyclosporin and tacrolimus are both what kind of immunosuppressants?
calcineurin inhibitors
What effect of digoxin toxicity can cause V-tach and V-fib? Mech?
delayed afterdepolarizations d/t increased intracellular calcium (escapes sarcoplasmic reticulum to initiate an early depolarization)
What effect of digoxin allows it to slow the HR? Mech?
Slowed AV nodal conduction via stimulation of the vagus nerve.
Define delayed afterdepolarization.
early depolarization of the cardiomyocyte in phase 4 of th AP
Define early afterdepolarization.
early depolarization of the cardiomycyte in phase 2 or 3 of the AP.
Name 3 causes of early afterdepolarization.
- hypokalemia
- bradycardia
- type IA antiarrhythmics (e.g. quinidine)
What can early afterdepolarizations cause?
tach, torsade, and other arrhythmias
How does digoxin increae intracellular calcium?
Blockade of Na+/K+ ATPase, thereby inhibiting the Na+/Ca++ exchanger.
PVC, thorotrast, or arsenic exposure is associated with development of what rare vascular neoplasm?
liver angiosarcoma
What is the cause of death in infants w/ severe, uncorrected coarctation of the aorta?
CHF
What is “nutcracker syndrome”?
Compression of the left renal v. between the aorta and SMA. Causes left varicocele/LLQ pain, hematuria, and left flank pain
What is SMA syndrome?
compression of the 3rd pt of the duodenum between the SMA and aorta.
Renal cell carcinoma originates in cells of which structure?
proximal tubule
Renal cell carcinomas, the most common type of renal neoplasm, are also known as _______.
Clear cell carcinoma
Restrictive lung disease characterized by bilateral hilar lymphadenopathy, noncaseating granulomas, increased ACE and Ca++.
Sarcoidosis
What is the tx for sarcoidosis?
steroids
What is the primary defect in thalassemias?
mRNA processing
What is, by far, the most common cause of lumenal narrowing leading to claudication in larger, named arteries, such as the common femoral a.?
athersclerosis
Concentric, onion-like thickening of arteriolar walls affecting the kidneys, retina, and intestines is usually caused by _______?
malignant htn
Medication-induced fat redistribution is caused by which 2 types of drugs?
corticosteroids and HAART
