Question | Answer |
The two families of Calcium Channel Blockers | Dihydropyridnies (suffix -ipine)
Non-dihydropyridines |
What do Calcium Channel blockers do | reduce peripheral resistance
decrease blood pressure
elicit antianginal/antiarrhythmic effects |
MOA of CCB | inhibition of calcium influx into arterial smooth muscle cells |
CCB PK/PD | L-type are the most dominant in cardiac/smooth muscle
Dihydro - are more selective as vasodilators and have less cardiac depression.
verapamil has greatest cardiac depressive effects |
CCB clinical indications | HTN, Angina supraventricular tachyarrhythmias, hypertrophic cardiomyopathy, migraine, raynaud's phenomenon |
CCB toxicity | arrest, bradycardia, av block, heart failure |
end product of RAAS | renin-angiotension-aldosterone-system
arteriolar vascoconstriction, increase in blood pressure |
ARB general | block angiotension II type I receptors
very selective
-rtan as suffix for meds
most effective |
ARB pk/pd | short half-life, moderate bioavailability, no effect on bradykinin metabolism |
ARB tox | do not use during pregnancy
may cough and angioedema |
ACE-I general | block angiotension converting enzyme, stops the conversion from I to II.
suffix for meds: -pril. |
ACE-I PK/PD | eliminated by the kidneys, therefore, dose must be reduced in patients with renal insufficiency.
fairly well administered orally and mod long half-life |
ACE-I tox | severe hypotension, acute renal failure, hyperkalemia, dry consistent cough, dry cough, angioedema, do not use during pregnancy |
gram positive cocci | cluster: staphylococci |
gram positive bacilli | bacillus |
gram negative cocci | neisseria meningitidis |
gram negative bacilli | citrobacter |
anaerobes above the belt | prevotella |
below the belt anaerobes | fusobacterium |
atypical bacteria | mycoplasma
legionella
chlamydia |
ID vignettes errors | contamination, sample size, results to match to symptoms, lines present, test before antibiotics |
ID vignettes bacteria | S. viridans (endocarditis, post-dental)
N. meningitidis (meningitis)
Acinetobacter (ICU, ventilators)
Anaerobes (diabetics, PNA) |
Empiric therapy (ID vignettes) | medication that targets a broad range of bacteria |
Normal flora Strep is found | skin, oropharynx, GU, heart |
Normal Flora Staph is found | Nasopharynx, heart |
Normal flora E.coli | urinary, GU |