1.

Asocieri de: antiaritmice

1. IA(Chinidina /Procainamida) +IB(Mexiletin)- CI: NU assoc Cls/Subcls IA+IC
. I + !B (n" #otalol) $ACA: %&' NU IA( Amiodarona( #otalol
). Pro*anolol+Mexiletina/+lecainida , diminua ef Proaritmic Amiodarona+!B , e- aditi.e
/. IA+ #otalol - date clinice incomplete
0. $iso*iramida +.era*amil
1. Clonidina+2era*amil , hipotens
3. Pro*a-enona + Chinidina/ Procainamida
. 4-. Ad. la antiaritmice CI.:
1. Amiodarona: Fibroza pulm, neuropat perif, depozite cornee, disf hep, tiroid : Bo *"lm( he*
. BB: bronhospasm, hiperglicelie : astm( $-Insde*( 5loc card
). Ca 5loc: ICC, BAV : dis- 2( t"l5 cond
/. $iso*iramida: ICC, or Vf, !et" urinara, glaucom, #$, tulb ritm( : %&6( *rostatism(I7(8la"com
0. +lecainida: # mortalitatea Post I%, bradi aritmii : t"l5 de cond
1. Procainamida: Sdr" &upoid , agranulocitoza : artrita cr. $iscra9ie s8
3. :idocaina+ Mexiletina : tremor : Par;inson
<. Pro*a-enona: ICC, Brspasm, proaritmic : astm( t"l5 cond( dis- 2#
=. Chinidina: or 'f, # $, diaree : 5o. di8 cr( %&6( hi*o>
1?. #otalol: or 'f, Brspasm, : astm( $@insde*( %&6( hi*o>
). AA neclasi-icate: 1. Atro*ina , 5radicardie sin"sala
. Adrenalina , sto* card
). I9o*renalina , 5loc card
/. $i8oxin , +iA
0. Adeno9in , &#2
1. CaCl , &2 *rin hi*er >
3. M8Cl , +iA( intoxic c" di8itala( &or .-
/. Cdtii *at. ce determ Aritmii: S, durere, hipo'ol, IC, tireoto(icoza, an(ietate, hiop), hipo%g, bradicardie,
acidoza, into(icatie cu digitala
0. In ce aritmii se da $i8oxina: FlA, FiA : *+,, -+,. /g/zi p"o" corelata cu 'arsta , IC asociata cu FiA
1. &o .- : %gS0+: +g in 1-+min, repetat la ,-1.min, alternati' Isoproterenol sau Paging2#$3, adm de ) 4 PA
3. Aene9a &o .-: bloc), antihist, fenotiazidice, antidepresi'e triciclice, )etoconazol, dieta proteica lichida
<" AA # $: Chinidina( $iso*iramida( Amiodarona( #otalol( Be*idil( Prod"col( Prenilamida( deri.
triciclici( +eniltia9ina( 4ritromicina( Antihistaminice: &er-enadina( Astemi9ol( #$ pe fond de hipo),%g
=. AA ' P772perioada refractara rlati'a3: IA( III( #otalol
1?. AA P7Baritmo8ene: IA( IC( III( #otalol
11" Cum actioneaza Cls I *e P7: IA '( IBC ( IC normal
1. Cum act Cls I *e PA: IA#, IB4, #PA, #Fz 5 , Cde*olari9area
1). Cum act Cls III: 5lochea9a can de > ( DD..' d"rata +9 )( # PA( # P7
1/. Cum act Cls I2 *e +9 ? : 4 de*olari9area s*ontana( 4 -rec.enta cond"cere A2( 4 PA
10. C"m actionea9a +9./ *e PA si *er re-rac: CPA( C P7
11. Cls III , *e ce +9 si c"m actionea9a , ' +9 )( creste PA si P7
13. Prin ce mecanism scade PA cls II: *rin de*rimarea +9 /( cresterea P7 si scaderea A2
1<. In ce afect se da Bloc E Adr: Fi*er*la9ie de *rostata( Fi*erli*idemie
1=. +a9ele re*olari9arii la AA:
?. In ce AA se da M8#B/: +iA( +i2( &o.2-( intoxicatie c" di8itala( *ostIMA
1. Indicatii %gS06 G laxati.e osmotice in consti*atie( atra8 a*a G 4 densit 5ol -ecal
. Care s"nt aritmiiile gra'e:+i2( &ahicardie 2 c" com*lexe lar8i
). Cls II , mecanisme si e-ecte: ef 7 deeprima Fz 6 a depolarizarii, #P!, CPA( CA2H( mec: bloc !8-adrenerg
/. $etermina tahicardie refle(a: nitratii( clonidina( hidrala9ina( .asodilatatoarele directeII( I4C
0. #"nt c"nosc"te ca hipoglicemiante: !-5locantele.
1. %edicam ce act pe al-a centrali: Clonidina( al-a-metil do*a( A"an-acina( Monoxidina( 7ilmetidina
3 Clase de medicam in IC: I4C( !-B ( di"retice
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<. Anti F&A- asocieri:
I!: 9 BIC: 9 Pre' I:
1" diur tiazidice 1" Ca bloc cu ef prelung 1" I:C
+" spirono )-ce retin ) nu I generatie +" Ca bloc
5" BB cu eliminare renala +" beta bloc 5" diuretice
6" Ca blocante 5" nitrati 6" alfa 1 bloc
," I:C 6" I:C inclusi' pre' sec 9 Pre'II:
;< : 9 Sarcina: 1" I:C
1" I:C 1" alfa metil dopa +" alfa 1 bloc
+" Ca bloc +" labetalol labetlaol i'" urgenta,
5" beta 1 bloc 5" prazosin =itroprusiat =a ce
6" la 'arst diur 6" %gS06 creste p" intra cran"
," aldost ce retin ) ," BB7 atenolol, metoprolol 9 >VS:
;islipid : *" Ca bloc 7 nifedipina, 'erapamil 1" I:C
1" I:C 9 IC: +" B!A+
+" Ca bloc 1" I:C - 4mortalitatea cu 1/* 5" beta 1 bloc
BIP +" B1B ?selecti'e- metoprolol, car'edilol21/63 6" Clonidina
1" I:C 9 AVC ," alfa metil dopa
+" Ca bloc *" beta@alfa bloc
5" alfa 1 bloc
=. " Ce NU se da in F&A + #arcina: 1" I4C ?tub crest 7 Irenala fat,
+" B7&A1
5" $i"retice- C 'ol plasm, 4circul placentara, 4 nutritia fat
)?. ;iuretice din >A: 1" &ia9idice: ICC( F&A -1 'arstnic, +" sistolica izolata 'arstnic, 5" AA
+" Ansa: ICC( I7enala
5. Aldostero: ICC( Post IMA
)1. Indicatii : Aritmice + F&A:
1. BB selecti.e
. Ca 5loc: 2era*amil( $iltia9em(dupa 4 ) posttrat diur-fa'or ectopii V Proaritmigene3
5+"Asocieri : Anti F&A
1. $i"retic + BB Princi*i": #iner8ism- e- *o9iti.e
. $i"retic+ I4C Anta8onism , e- ad.
). Ca 5loc din tulb de ritm + BB *rotector -ata de t"l5 de ritm
/. Ca 5loc + I4C , eficienta in 4 A
0. BB + al-a B - rar
55" . Cdtii *ato F&A + BB : AP, postI%A, ICC, sarcina, tahiaritmii, cele cu acti intrinseca-sunt tahicardizante
? CI
56" NU se da" F&A + BB : OBLIGATORII: astm, BP0C, BAV+/5, POSIBILE: b 'asc perif, intoler la gluc,
pers fizice acti'e ? atleti
5," I4C indicatii: CI:
1. IC toate stadiile :sarcina( steno9a de aorta se.era(
. F&A- c" risc # $@ : steno9a 5ilat a art renele( I7enala se.era
). IMA( *ost IM c" dis- 2# :Fi*er>( cardiomio*atie
/. Ne-ro*atie dia5etica
0. Protectie C2( *ostIM remodelare
5*" :f nitratilor in IC: scade 'ol V, scade PA, scade timp de eBectie, 'asodilatare coronariana epicardica,
5C" Ci in sarcina: I:C, B-bolc, diuretice
5D" 4-. Ad.
Brdilat !Adr: toleranta, agitatie, tremor, ner'oza, cefalee, transpir, slabiciuni, roseata pielii, greata, 'oma,
aritmii, >A, hipo)
+
#ta5ili9atori mastocitari: cefalee, gat uscat, brspasm tranzitoriu, tuse, roseata tegum
Imm s"*er : deri' ioguanina ?suprima madu'a hematopoetica, %itutiri(ati'eE- supresie medulara,
alopecie, nefroto(ic, afect" :pit intest, Infli(- I!esp super 4 Ig A secretoareE
IPP: 0meprazol- >ipergastrinemie secundara, >iperplazia mucoasei gastrice
&eo-ilina: C-V: S, SV, :SV, FiA, FlA, ahicA, ahic multifocala, aritmie cu instabil hemodinamica
<. 4- corticosteroi9i: Confirmat - inhi5 locala: 4 ne' de corticoster sistem, 4 simpt sau e(acerb AB, 4 ne' de
brdilat 8+ Adr de urgenta, 4 crize nocturne/echi'alent AB nocturn ? tuse,
imbunatateste indicii calitate 'ietii, ameteli functie pulm
Posibil: 4 cz deces, 4 'it declin fct pulm, # per de remisie sustinuta a crizelor
=. 4- Brdilat: Brdilatatie, stabilizare mastocitara, inhib elib &, 4 permeabil/ 'asc, 4 e(udat @ edem cai
aeriene,
# clearence mucociliar, # secret mucus
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