Pharmacology + ECG Flashcards
What is ASA classified as?
NSAID (non-steroidal anti-inflammatory drug)
Why is ASA contraindicated in patients with a history of asthma? (if they have no hx of NSAID use)
It can result in aspirin-induced-asthma
1) Believed that NSAIDS in asthmatics inhibit COX-1
2) As a result, it activates lipoxygenase pathway
3) Lipoxygenase pathway eventually increases the release of cysteinyl leukotrienes (Cys-LTs)
4) Cys-LTs induce bronchospasm and nasal obstruction
How does ASA prevent platelet aggregation?
1) ASA inhibits COX-2, an enzyme that produces prostaglandins (ex: thromboxane).
2) Prostaglandins causes platelets in blood to form blood clots. Therefore, by inhibiting prostaglandin production, ASA slows down the clotting cascade.
This is why ASA is given with chest pain/ischemia
What is nitroglycerin?
A nitrate vasodilator used to treat angina and heart failure
What does nitroglycerin do?
1) Promotes relaxation of vascular smooth muscle, causing arteriolar and venous dilation
2) As a result, this increases blood flow to the myocardium, and reduces preload and afterload
Why are phosphodiesterase inhibitors contraindicated when considering nitroglycerin?
It can result in a massive drop in blood pressure.
PDE5 inhibitors already causes a small drop in blood pressure. Combined with nitroglycerin (which also drops blood pressure), it can drop to a very low amount, potentially precipitating a heart attack.
What is Glucagon?
- Hormone produced by alpha cells in the pancreas, in an area known as the Islets of Langerhans
- Activated when blood sugar drops in low level
Specifically, how does glucagon raise blood glucose levels?
Glycogenolysis: Glucagon stimulates the liver to break down glycogen stores, which is then released to the blood as glucose
Gluconeogenesis: Conversion of amino acids into glucose
Why is Glucagon contraindicated with patients who have pheochromocytoma?
Glucagon can potentially stimulate the tumour to release catecholamines (epi and norepinephrine), which can suddenly increase blood pressure
What is Ventolin?
- Short acting selective Beta 2 adrenergic agonist
- Promotes bronchodilation by relaxing bronchial smooth muscle, increasing air flow to the lungs
- Used to treat bronchospasms, which is most commonly found in asthmatics and people with COPD
What is Dexamethasone?
- Steroid (corticosteroid)
- Used to treat inflammatory conditions such as asthma
- Decreases immune system response to reduce swelling
What drug classification do Ibuprofen and Ketorolac fall under?
NSAIDS
What is renal colic?
Pain that occurs when urinary stones block part of your urinary tract.
What should you consider when encountering a renal colic patient?
Co-administration of ibuprofen and acetaminophen
Is trace blood considered active bleeding in suspected renal colic patients?
No. Hematuria/GI bleed are considered active bleeding since it can be occult in nature.
