14.03.06 Revision notes

Dihydropyridine calcium-channel blockers

    • Nifedipine

      • More affinity for vascular smooth muscle

      • Value in Raynaud's disease

      • Rarely precipitates heart failure: negative inotropic effects offset by reduction in afterload

    • Nicardipine

      • Similarly effective on smooth muscle

      • Used for angina prophylaxis and hypertension

    • Amlodipine and felodipine

      • Do not adversely affect myocardial contractility (with the risk of heart failure)

      • Longer duration of action than nifedipine

      • Useful in hypertension and angina

      • Valuable in angina associated with coronary vasospasm

      • Side-effects relate to vasodilatation and may improve after a few days (headache, flushing)

    • Isradipine, lacidipine and lercanidipine

      • Similar in effect to nifedipine but only indicated for hypertension

    • Nimodipine

      • Similar to nifedipine but has an enhanced, selective effect on the cerebral arteries

      • Useful for cerebral artery spasm and it is used solely for this purpose after subarachnoid haemorrhage (to prevent ischaemic deficit)

Antihypertensives in pre-eclampsia

    • Should be started in women with a systolic blood pressure over 160 mm Hg or a diastolic blood pressure over 110 mm Hg

    • Labetalol (PO/IV), nifedipine (PO), hydralazine (IV)

    • Avoid: Atenolol, ACEi, ARBs, Diuretics

Anterior mediastinal mass

    1. Thymus

    2. Teratoma (germ cell)

    3. Thyroid

    4. Terrible Lymphoma


    • Nicorandil

      • Dual action: Nitrate, plus causes K+ efflux => Hyperpolarisation

    • Don't use LABAs in children under 5 - Straight to LRA

    • Chlamydia treatment is given on the basis of exposure to infection rather than proven infection

  • Boerhaave's syndrome = The 10% of oesophageal perforations which occur due to vomiting

  • Titubation = Disturbance of body equilibrium in standing or walking, resulting in an uncertain gait and trembling, especially from diseases of the cerebellum

  • Quinolones (cipro) => Tendinopathy