Clotting
- Extrinsic pathway - Tissue factor / Factors IX + X
- PT
- PT ratio / INR
- For monitoring warfarin
- Intrinsic pathway - Surface contact / Factor XII
- APTT
- For monitoring heparin
Clonidine
- Centrally acting α2 adrenergic agonist
- Useful ITU drug
- Mildly sedating
- Anti-hypertensive
- Other indications:
- ADHD
- Anxiety/panic disorder
- Pain
- Withdrawal symptoms (narcotics, alcohol, nicotine, dexmedetomidine)
- Stree
- Sleep disorders
- PTSD
- Restless legs syndrome
- Rosacea flushing/redness
- Diabetic neuropathy
- Migraine
- Hot flushes
Rosacea subtypes
- Erythematotelangiectatic rosacea
- Permanent redness (erythema) with a tendency to flush and blush easily
- It is also common to have small widened blood vessels visible near the surface of the skin (telangiectasias) and possibly intense burning, stinging, and/or itching sensations
- People with this ETR type often have sensitive skin
- Skin can also become very dry and flaky
- In addition to the face, symptoms can also appear on the ears, neck, chest, upper back, and scalp
- Papulopustular rosacea
- Some permanent redness with red bumps (papules) with some pus filled (pustules) (can last 1–4 days or longer; extremely varied syptoms)
- This subtype can be easily confused with acne
- Phymatous rosacea
- This subtype is most commonly associated with rhinophyma, an enlargement of the nose
- Symptoms include thickening skin, irregular surface nodularities, and enlargement
- Phymatous rosacea can also affect the chin (gnathophyma), forehead (metophyma), cheeks, eyelids (blepharophyma), and ears (otophyma)
- Small blood vessels visible near the surface of the skin (telangiectasias) may be present
- Ocular rosacea
- Red (due to telangiectasias), dry, irritated or gritty, eyes and eyelids.
- Watery eyes
- Eyelids often develop cysts
- Some other symptoms include foreign body sensations, itching, burning, stinging, and sensitivity to light
- Eyes can become more susceptible to infection
- About half of the people with subtypes 1-3 also have eye symptoms
- Blurry vision and loss of vision can occur
Notes- Milrinone in heart failure
- Phosphodiesterase 3 inhibitor
- Increases cardiac contractility
- Vasodilates => Reduced afterload
- VATS
- AVRs often disrupt the primary conduction pathways => Complete heart block
- Always put pacing wires in
- Rolandic infarcts
- Can give treatment dose dalteparin for 45 days in renal impairment
- Beta-blockers are not contra-indicated in patients with lower extremity arterial disease (LEAD)
- PDA = posterior descending artery
- If the PDA (a.k.a. posterior interventricular artery) is supplied by the right coronary artery (RCA), then the coronary circulation can be classified as "right-dominant".
- If the PDA is supplied by the circumflex artery (CX), a branch of the left artery, then the coronary circulation can be classified as "left-dominant".
- If the PDA is supplied by both the right coronary artery (RCA) and the
circumflex artery, then the coronary circulation can be classified as
"co-dominant".
- Only a few patients with heparin-induced antibodies develop heparin-induced thrombocytopenia (HIT)
- Heparin-PF4-IgG antibodies can identify patients at risk of developing life-threatening HIT
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