Quinolones A/E

GCAT (nitrogen bases)

G it upsets
C onfusion (↓GABA) C artilage damage
A llergy A naphylaxis
T endon of achilles rupture

Sulphonamides A/E

SHREK ?❤ بإضافة A = shreak

S teven-Johnson reaction
H emolysis
R enal impairment (crystaluria)
E nzyme inhibitor
K ernicterus

A llergy-rash A granulocytosis
طبعا GIT upsets موجودة فيهن كلهن

MeTroniDAzole A/E

M etallic taste
T eratogenic
D isulfiram like reaction
A taxia

Tetracyclines A/E (mnemonics)

STARS

S uper infections
T eeth and bone discoloration - deformity
A bdominal upsets
R enal impairment
S kin photo sensitivity

⁉️⁉️ Warfarin ? Heparin

نقاط مهمة mcq ?

▫️every anti arrhythmic drugs have pro arrhytmogenic actions

▫️procainamide has moderate dissociation rate - moderate conduction block + ganglion blockade

▫️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

▫️cinchonism is adverse affects of quinidine (tinnitus - loss of hearing - blurred vision)

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) Explain
b/c GFR is maintained by VC of the efferent arteriole by AgII

❔because they ↓ Ang-II → ↓ VC of the efferent arterioles → ↓ GFP and ↓ GFR →lead to aggravation of renal failure in both kidneys and hyperkalemia

▫️diuretics give 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 vision

⭐▫️digibind is first choice for TTT 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