anti HTA+:

IR:diur tiazidice,ansa-furos,spirono-K,BB cu elim renala, Ca bloc, IEC

BIC: Ca bloc cu eff prelungite,nu prima generatie;BB;nitrati;IEC inclusiv prev sec
AVC:- prev I:IEC;Ca bloc;diuretice;alfa 1 bloc
-prev II:IEC;alfa 1 bloc;labetolol iv. urgenta;nitroprus Nu-creste p i. cran
DZ:IEC;Ca bloc;beta 1B;la varst diur tiazidice;la varst diur aldost
sarcina:alfa metil dopa ;labetalol;prazosin;MgSO4;BB=ateno-metoprolol,acebutolol;Ca
bloc=nifedipina,verapamil
dislipid:IEC,Ca bloc
IC: IEC-scade mortalitateacu1/6;B1B selective- metroprolol, carvedilol scade
mortalitatea cu ¼
HVS:IEC;BAT2;beta 1B;clonidina;alfa metil dopa, alfa bloc

2. Ce nu se da in HTA+ sarcina: IEC-tulb crest=IR fat;diuretice-scad vol plasm, scad circ

placenta,scad nutrit fat; BRAT2

#Diuretic in HTA:tiazid:ICC,HTA-1 varstnic,2sistolica izolata varstnic,3 nu inteleg

ansa:ICC,insuf renala
aldost:ICC, post IMA

4 Asociere de:
Diuretice ???
-antiHTA –diuretic+BB
-diuretic+IEC
-Ca bloc din tulb de ritm+BB protector fata de tulb de ritm
_Ca bloc+IEC- eficienta scaderea TA
-BB+alfa B-rar
-AA: -IA(clonidina,procainamida)+IB(mexiletina)can Na activ vs can Na inact ………
-I+BB9nu sotalol)
alte: -propranolol+mexiletina/flecainida- diminua efectul proaritmic
-IA+sotalol- date clinice incomplete
-clonidina+verapamil- hipotensiune
-disopiramida+verapamil
-propafenona+chinidina/procainamida

5.Indicatii:aritmie+HTA:BB selective;Ca bloc Verapamil Diltiazem( dupa scad K post

trat diur-favor ectopii V proaritmigene)

6.Eff adv:
AA:-amiodarom:fibr Pulm,neuropat perif, depoz cornee,disf hep+tir
-BB:bhspasm,hiperglicemie
-Ca bloc:Icc,BAV
-disopiramida:ICC,torsada vf,ret urin, glauc, creste QT,tulb ritm
-flecainida:creste mortalit post IM, bradiaritm
_procainamida:sdr. lupoid,agranulocitoza
-lidocaina+mexitilina: tremor
 -propafenona:ICC,brspasm,proaritm
-chinidina:torsada vf, creste QT,diaree,hipoK
-sotalol:torsada vf, brspasm,DZ ins dep
Brdilat beta 2 adr: toleranta,tremor,nervoz,cefalee,transpir,slabiciune,roseata
pielii,greata.voma,aritmii HTAhipoK
CoSt:sistemic:metab-Intol gluc,obez,dislip,proteoliz
-Os:scade abs Ca,necr avasc cap femur,osteopor
CV:retent Hd,HTA,ATS
-supresia sis imn-vuln la inf
M.striata:miopatie,scade mas musc
-piele:atrofie
-hipogonadism
-ulcer peptic
-cataracta
-neuro:euforie,depresie,tulb somn,ideatie psihotica
-tulb crestere copii:scade secr de horm de crestere,inhib ef fact de crestere
insulin-like
-local:disfonie,fav dezv fungi candid orofar,iritatia gat,tuse
Stabil Mast:cefalee,gat uscat,iritatie,brspasm tranzitoriu,tuse,roseata tegumentara
Sulfasarazina:cefa,greata,disgastr,anemie megalobl,scade abs ac.fol,r.
alerg,artralgii,agmul,Tt-penie
Imunosupr:deriv tioguanina- suprima mad he poet
mtxat-supres med,alopecie,nefrotox,epit intest
nustiucum-InfRespSup scade IgA secrt
IPP: omeprazol-hipergastr sec,hiperplazie muc gastr
TeofilinaC-V:tahi sinusala,TSV,ESV,Fia,Ftt,tahi atr,tahic multifocala,aritmie cu iritabilit
hemodin

6.AA neclasificate: atropina-bradic sinusala

adrenalina-stop card
izoprenalina-bloc card
digoxin-fiA
adenozin-TSV
CaCl2-TV prin hiperK
MgCl2-FiV,intoxi digit,torsada vf

7.Efecte coSt:Confirmat:Inh Local;scade Nevde Cssyst,scade simpt sau exacerb

AB,scade nev de brdilbeta2adr de urgenta,scade crize nocturne/echivalent AB noct-
tuse,imbunat indici calit vietii,ameli fct Pu
Posibil:scade cz deces,scade vit declin fct Pu,creste per de remisie sust a
crizelor

8.efecte BrhDil:Brdil,stab mast,inhib elib LT,scade permeab microvasc,scade

exudat+edem CA,creste clearance mucocil,creste secr mucus
9 cresterea Sv BB in IC:scade risc de aritmii-eff antiaritm prin cresterea activ simp
in ICC

10 clase de med in IC:IEC,BB,Ca bloc,nitriti,diuretice

11 med ce act pe alfa 2 centrali:clonidina

12 cond patol HTA+BB:angina P,post IMA,ICC,sarcina,tahiaritmii,cele cu act

intrinseca sunt tahicardizante=CI

13 nu se da HTA+BB:obligatorii:astmă,BPOC,BAV;posibile:boala vasc perif,intol la

glu,pers fiz active-atleti

14 cond pat ce det aritmii:TS:durere,hipovol,IC,tirotox,anxietate

15 in ce aritmii se da digoxina:Fi A:62,5-250 microg/zi p.o corel cu varsta

16 torsada vf:MgCl2-2g in 1-2 min,repetat la 5-10 min,alternativ isoproterenol sau

Pacing(creste QT)

17 geneza torsada:bloc K+,antihist,fenotiazide,antidepres 3 ciclice,ketoconazol,dieta

proteica lichida

18 Aacreste QT:quinidina,disopiramida,amoidarona,sotalol,bepidil
probucol,prenilamida der.
triciclica,fenitiazina,eritromicina,antihistaminice:terfenadina,astemizol;creste QT
pe fond de hipo K+Mg+

19 AA creste PR

20 AAproaritmogene:IC,A,III-sotalol

21 cum act clasa I pe PR efract????

22 cum act clasa I pe PA:Ia creste,Ib scade

23 cum act III:creste durata faza 3 creste PA creste PRE

24 clasa IV pe faza 0:scade depol spontana,scade frecv cond AV;scade PA

25 in ce af se da bloc alfa adr? hiperplazie prostata,hiperlipidemie

26 clase laxative……………

27 indicatii MgSO4-laxative osm in constipatie,atrag apa=scade dens bol fecal