Clinical Disorders

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Clinical Disorders by Mind Map: Clinical Disorders

1. Angina - complications of atherosclerosis

1.1. LOS

1.1.1. 1. Contrast the differences between stable and unstable forms of ischemic heart disease and angina

1.1.2. 2. Understand the role of laboratory values and electrocardiography in the diagnosis of acute coronary syndrome

1.1.3. 3. Describe the natural history of acute coronary syndrome as well as the associated complications

1.1.4. 4. Describe the treatments, both pharmacologic and non-pharmacologic, employed in patients with acute coronary syndromes and stable angina

1.2. MEDS

1.2.1. Vasodilators

1.2.1.1. calcium-channels blockers

1.2.1.1.1. amlodipine

1.2.1.1.2. felodipine

1.2.1.1.3. isradipine

1.2.1.1.4. nicardipine

1.2.1.1.5. nifedipine

1.2.1.1.6. nimodipine

1.2.1.1.7. nitrendipine

1.2.1.2. nitrodilators

1.2.1.2.1. isosorbide dinitrate

1.2.1.2.2. isosorbide mononitrate

1.2.1.2.3. nitroglycerin

1.2.1.2.4. erythrityl tetranitrate

1.2.1.2.5. pentaerythritol tetranitrate

1.2.1.2.6. sodium nitroprusside

1.2.2. Cardioinhibitory drugs

1.2.2.1. beta blockers

1.2.2.1.1. Non-selective beta 1 and 2

1.2.2.1.2. Selective beta 1

1.2.2.2. calcium-channels blockers

1.2.3. Ranolazine

1.2.4. Anti-thrombotic drugs

1.2.4.1. anticoagulants

1.2.4.1.1. Heparin

1.2.4.1.2. Warfin

1.2.4.2. anti-platelet drugs

1.2.4.2.1. Aspirin

1.2.4.2.2. Clopidogrel

1.2.4.2.3. Prasugrel

1.2.4.2.4. Ticagrelor

2. Arrhythmias

2.1. LOS

2.1.1. 1. Describe the Classification of antiarrhythmic drugs based on mechanism of action

2.1.2. 2. Describe the differing effects of Class I agents on Action Potential duration, and on QRS and Qt intervals

2.1.3. 3. Describe the effect of Amiodarone on the action potential of myocytes and SA/AV nodal cells

2.1.4. 4. Describe the spectrum of toxicity that could be seen with amiodarone treatment

2.1.5. 5. Describe the difference of Use dependence and Reverse Use dependence and how drug toxicity could be effected by slow or fast heart rates

2.1.6. 6. Describe the use of adenosine to treat SVT

2.2. MEDS

2.2.1. Class I - Sodium-channel blockers

2.2.1.1. Class 1A

2.2.1.1.1. atrial fibrillation, flutter; supraventricular & ventricular tachyarrhythmias

2.2.1.1.2. quinidine

2.2.1.1.3. procainamide

2.2.1.1.4. disopryamide

2.2.1.2. Class 1B

2.2.1.2.1. ventricular tachyarrhythmias (VT)

2.2.1.2.2. lidocaine

2.2.1.2.3. tocainide

2.2.1.2.4. mexiletine

2.2.1.3. Class 1C

2.2.1.3.1. supraventricular tachyarrhythmias (SVT) and ventricular tachyarrhythmias (VT)

2.2.1.3.2. flecainide

2.2.1.3.3. propafenone

2.2.1.3.4. moricizine

2.2.2. Class II

2.2.2.1. Beta blockers

2.2.2.2. Non-selective - Beta 1 and 2

2.2.2.3. Beta 1 Selective

2.2.3. Class III

2.2.3.1. Potassium-channel blockers

2.2.3.2. amiodarone

2.2.3.3. dronedarone

2.2.3.4. bretylium

2.2.3.5. sotalol

2.2.3.6. ibutilide

2.2.3.7. dofetilide

2.2.4. Class IV

2.2.4.1. Calcium-channel blockers

2.2.4.2. amlodipine

2.2.4.3. felodipine

2.2.4.4. isradipine

2.2.4.5. nicardipine

2.2.4.6. nifedipine

2.2.4.7. nimodipine

2.2.4.8. nitrendipine

3. Lipid Disorders

3.1. LOS

3.1.1. 1. Identify the type of lipids and their function.

3.1.2. 2. Identify the components of the lipoprotein structure and the subtypes of lipoproteins.

3.1.3. 3. Identify the role of non-statin therapy for reduction of LDL and triglycerides.

3.1.4. 4. Identify the role of statin therapy for secondary prevention following a coronary heart disease event.

3.1.5. 5. Recognize most common side effects of anti-hyperlipidemic therapies.

3.2. MEDS

3.2.1. HMG-CoA reductase inhibitor

3.2.1.1. Atorvastatin

3.2.1.2. Lovastatin

3.2.1.3. Pravastatin

3.2.1.4. Rosuvastatin

3.2.1.5. Simvastatin

3.2.2. bile acid resins

3.2.2.1. Cholestyramine​

3.2.2.2. Colestipol​

3.2.2.3. Colesevelam​

3.2.3. Ezetimibe

3.2.3.1. Ezetimibe

3.2.4. fibrates

3.2.4.1. Fenofibrate​

3.2.4.2. Gemfibrozil​

3.2.5. niacin

3.2.5.1. niacin

3.2.6. PCSK9 inhibitors

3.2.6.1. Alirocumab​

3.2.6.2. Evolocumab​

4. Chronic Heart Failure

4.1. LOS

4.1.1. 1. Describe the major drug groups used for the treatment of heart failure

4.1.2. 2. Describe the mechanism(s) of action of a prototypic commonly used drug

4.1.3. 3. Describe its pharmacokinetics and associated dosing considerations

4.1.4. 4. Describe the mechanism for important drug interactions

4.1.5. 5. Describe the drug-disease interactions, adverse drug effects, toxicity, and contraindications of the groups of CHF drugs.

4.1.6. 6. Describe which class of drugs improves survival in heart failure patients

4.1.7. 7. Describe the treatments, both pharmacologic and non-pharmacologic, employed in patients with acute coronary syndromes and stable angina

4.2. MEDS

4.2.1. Diretics

4.2.1.1. thiazide

4.2.1.1.1. chlorothiazide

4.2.1.1.2. chlorthalidone

4.2.1.1.3. hydrochlorothiazide

4.2.1.1.4. hydroflumethiazide

4.2.1.1.5. indapamide

4.2.1.1.6. methyclothiazide

4.2.1.1.7. metolazone

4.2.1.1.8. polythiazide

4.2.1.2. loop diretics

4.2.1.2.1. bumetanide

4.2.1.2.2. ethacrynic acid

4.2.1.2.3. furosemide

4.2.1.2.4. torsemide

4.2.2. Vasodilators

4.2.2.1. Potassium-sparing

4.2.2.1.1. amiloride

4.2.2.1.2. eplerenone

4.2.2.1.3. spironolactone

4.2.2.1.4. triamterene

4.2.2.2. angiotensin converting enzyme (ACE) inhibitors

4.2.2.2.1. benazepril

4.2.2.2.2. captopril

4.2.2.2.3. enalapril

4.2.2.2.4. fosinopril

4.2.2.2.5. lisinopril

4.2.2.2.6. moexipril

4.2.2.2.7. quinapril

4.2.2.2.8. ramipril

4.2.2.3. angiotensin receptor blockers (ARBs)

4.2.2.3.1. candesartan

4.2.2.3.2. eprosartan

4.2.2.3.3. irbesartan

4.2.2.3.4. losartan

4.2.2.3.5. olmesartan

4.2.2.3.6. telmisartan

4.2.2.3.7. azilsartan

4.2.2.3.8. valsartan

4.2.2.4. nitrodilators

4.2.2.4.1. isosorbide dinitrate

4.2.2.4.2. isosorbide mononitrate

4.2.2.4.3. nitroglycerin

4.2.2.4.4. erythrityl tetranitrate

4.2.2.4.5. pentaerythritol tetranitrate

4.2.2.4.6. sodium nitroprusside

4.2.2.5. natriuretic peptides

4.2.2.5.1. Natriuretic peptides (NPs) are peptide hormones that are synthesized by the heart, brain and other organs

4.2.3. Cardiostimulatory or inotropic

4.2.3.1. phosphodiesterase inhibitors

4.2.3.1.1. PDE3 inhibitors

4.2.3.1.2. PDE5 inhibitors

4.2.3.2. digitalis

4.2.3.3. beta-agonists

4.2.3.4. phosphodiesterase inhibitors

4.2.4. Cardioinhibitory

4.2.4.1. beta-blockers

4.2.4.2. calcium-channel blockers (for diastolic dysfunction)

4.2.4.2.1. Non-selective β1/β2

4.2.4.2.2. carteolol

4.2.4.2.3. carvedilol

4.2.4.2.4. labetalol

4.2.4.2.5. nadolol

4.2.4.2.6. penbutolol

4.2.4.2.7. pindolol

4.2.4.2.8. propranolol

4.2.4.2.9. sotalol

4.2.4.2.10. timolol

4.2.4.2.11. β1-selective

4.2.4.2.12. acebutolol

4.2.4.2.13. atenolol

4.2.4.2.14. betaxolol

4.2.4.2.15. bisoprolol

4.2.4.2.16. esmolol

4.2.4.2.17. metoprolol

4.2.4.3. centrally acting sympatholytics

4.2.4.3.1. amlodipine

4.2.4.3.2. elodipine

4.2.4.3.3. isradipine

4.2.4.3.4. nicardipine

4.2.4.3.5. nifedipine

4.2.4.3.6. nimodipine

4.2.4.3.7. nitrendipine

4.2.4.3.8. alpha 2 adrenoceptors

4.3. LOS

4.3.1. 1. Describe how drugs that dilate blood vessels, reduce blood volume, or reduce cardiac output lead to a decrease in arterial pressure.

4.3.2. 2. Describe how diuretics decrease blood volume.

4.3.3. 3. Describe the differences between thiazide, loop, and potassium-sparing diuretics in terms of their site of action in the kidney and their overall efficacy in lowering blood pressure.

4.3.4. 4. Describe the mechanism of action (MOA) of classes of drugs that lower arterial pressure?

4.3.5. 5. Describe common side effects of specific drug classes. Understand which ones can cause orthostatic hypotension and reflex tachycardia.

5. Systemic Hypertension

5.1. MEDS

5.1.1. Diretics

5.1.1.1. thiazide

5.1.1.2. loop diretics

5.1.1.2.1. chlorothiazide

5.1.1.2.2. chlorthalidone

5.1.1.2.3. hydrochlorothiazide

5.1.1.2.4. hydroflumethiazide

5.1.1.2.5. indapamide

5.1.1.2.6. methyclothiazide

5.1.1.2.7. metolazone

5.1.1.2.8. polythiazide

5.1.1.3. Potassium-sparing

5.1.1.3.1. bumetanide

5.1.1.3.2. ethacrynic acid

5.1.1.3.3. furosemide

5.1.1.3.4. torsemide

5.1.1.4. alpha-adrenoceptor antagonists (alpha-blockers)

5.1.1.4.1. amiloride

5.1.1.4.2. eplerenone

5.1.1.4.3. spironolactone

5.1.1.4.4. triamterene

5.1.2. Vasodilators

5.1.2.1. angiotensin converting enzyme (ACE) inhibitors

5.1.2.1.1. prazosin

5.1.2.1.2. doxazosin

5.1.2.1.3. terazosin

5.1.2.1.4. trimazosin

5.1.2.2. angiotensin receptor blockers (ARBs)

5.1.2.2.1. benazepril

5.1.2.2.2. captopril

5.1.2.2.3. enalapril

5.1.2.2.4. fosinopril

5.1.2.2.5. lisinopril

5.1.2.2.6. moexipril

5.1.2.2.7. quinapril

5.1.2.2.8. ramipril

5.1.2.3. Calcium-channel blockers

5.1.2.3.1. candesartan

5.1.2.3.2. eprosartan

5.1.2.3.3. irbesartan

5.1.2.3.4. losartan

5.1.2.3.5. olmesartan

5.1.2.3.6. telmisartan

5.1.2.3.7. azilsartan

5.1.2.3.8. valsartan

5.1.2.4. nitrodilators

5.1.2.4.1. amlodipine

5.1.2.4.2. felodipine

5.1.2.4.3. isradipine

5.1.2.4.4. nicardipine

5.1.2.4.5. nifedipine

5.1.2.4.6. nimodipine

5.1.2.4.7. nitrendipine

5.1.2.5. natriuretic peptides

5.1.2.5.1. isosorbide dinitrate

5.1.2.5.2. isosorbide mononitrate

5.1.2.5.3. nitroglycerin

5.1.2.5.4. erythrityl tetranitrate

5.1.2.5.5. pentaerythritol tetranitrate

5.1.2.5.6. sodium nitroprusside

5.1.2.6. phosphodiesterase inhibitors

5.1.2.6.1. Natriuretic peptides (NPs) are peptide hormones that are synthesized by the heart, brain and other organs

5.1.2.7. ganglion blockers

5.1.2.7.1. PDE3 inhibitors

5.1.2.7.2. PDE5 inhibitors

5.1.2.8. postassium-channel blockers

5.1.2.8.1. trimethaphan camsylate

5.1.2.9. renin inhibitors

5.1.2.9.1. minoxidil

5.1.2.10. beta-blockers

5.1.2.10.1. aliskiren

5.1.3. Cardioinhibitory drugs

5.1.3.1. calcium-channel blockers

5.1.3.1.1. Non-selective β1/β2

5.1.3.1.2. carteolol

5.1.3.1.3. carvedilol

5.1.3.1.4. labetalol

5.1.3.1.5. nadolol

5.1.3.1.6. penbutolol

5.1.3.1.7. pindolol

5.1.3.1.8. propranolol

5.1.3.1.9. sotalol

5.1.3.1.10. timolol

5.1.3.1.11. β1-selective

5.1.3.1.12. acebutolol

5.1.3.1.13. atenolol

5.1.3.1.14. betaxolol

5.1.3.1.15. bisoprolol

5.1.3.1.16. esmolol

5.1.3.1.17. metoprolol

5.1.3.2. centrally acting sympatholytics

5.1.3.2.1. amlodipine

5.1.3.2.2. felodipine

5.1.3.2.3. isradipine

5.1.3.2.4. nicardipine

5.1.3.2.5. nifedipine

5.1.3.2.6. nimodipine

5.1.3.2.7. nitrendipine

6. Pulmonary Hypertension

6.1. LOS

6.1.1. 1. Define pulmonary hypertension.

6.1.2. 2. Identify the various factors that may contribute to the development of pulmonary hypertension.

6.1.3. 5. Describe complications of pulmonary hypertension

6.1.4. 6. Describe pharmacological treatments for pulmonary hypertension

6.2. MEDS

6.2.1. thiazide

6.2.1.1. Alpha 2

6.2.1.2. guanabenz

6.2.1.3. guanfacine

6.2.1.4. α-methyldopa

6.2.1.5. clonidine

6.2.2. Diretics

6.2.2.1. loop diretics

6.2.2.1.1. chlorothiazide

6.2.2.1.2. chlorthalidone

6.2.2.1.3. hydrochlorothiazide

6.2.2.1.4. hydroflumethiazide

6.2.2.1.5. indapamide

6.2.2.1.6. methyclothiazide

6.2.2.1.7. metolazone

6.2.2.1.8. polythiazide

6.2.2.2. calcium-channel blockers

6.2.2.2.1. bumetanide

6.2.2.2.2. ethacrynic acid

6.2.2.2.3. furosemide

6.2.2.2.4. torsemide

6.2.3. Vasodilators

6.2.3.1. Prostaglandins

6.2.3.1.1. amlodipine

6.2.3.1.2. felodipine

6.2.3.1.3. isradipine

6.2.3.1.4. nicardipine

6.2.3.1.5. nifedipine

6.2.3.1.6. nimodipine

6.2.3.1.7. nitrendipine

6.2.3.2. endothelin receptor antagonist

6.2.3.2.1. prostaglandins

6.2.3.3. ntric oxide

6.2.3.3.1. bosentan

6.2.3.3.2. ambrisentan

6.2.3.4. cAMP-Dependent Phosphodiesterase Inhibitors (PDE3)

7. Myocardial Infarction

7.1. LOS

7.1.1. 1. Contrast the differences between stable and unstable forms of ischemic heart disease and angina

7.1.2. 2. Understand the role of laboratory values and electrocardiography in the diagnosis of acute coronary syndrome

7.1.3. 3. Describe the natural history of acute coronary syndrome as well as the associated complications

7.1.4. 4. Describe the treatments, both pharmacologic and non-pharmacologic, employed in patients with acute coronary syndromes and stable angina

7.2. MEDS

7.2.1. nitrodilators

7.2.1.1. PDE3 inhibitors

7.2.1.1.1. milrinone

7.2.1.1.2. inamrinone (amrinone)

7.2.1.1.3. cilostazol

7.2.1.2. PDE5 inhibitors

7.2.1.2.1. sildenafil

7.2.1.2.2. tadalafil

7.2.2. vasodilators

7.2.2.1. angiotensin converting enzyme (ACE) inhibitors

7.2.2.1.1. isosorbide dinitrate

7.2.2.1.2. isosorbide mononitrate

7.2.2.1.3. nitroglycerin

7.2.2.1.4. erythrityl tetranitrate

7.2.2.1.5. pentaerythritol tetranitrate

7.2.2.1.6. sodium nitroprusside

7.2.2.2. angiotensin receptor blockers (ARBs)

7.2.2.2.1. benazepril

7.2.2.2.2. captopril

7.2.2.2.3. enalapril

7.2.2.2.4. fosinopril

7.2.2.2.5. lisinopril

7.2.2.2.6. moexipril

7.2.2.2.7. quinapril

7.2.2.2.8. ramipril

7.2.2.3. beta-blockers

7.2.2.3.1. candesartan

7.2.2.3.2. eprosartan

7.2.2.3.3. irbesartan

7.2.2.3.4. losartan

7.2.2.3.5. olmesartan

7.2.2.3.6. telmisartan

7.2.2.3.7. azilsartan

7.2.2.3.8. valsartan

7.2.3. cardiac depressant drugs

7.2.3.1. Class I - Sodium-channel blockers

7.2.3.1.1. Non-selective β1/β2

7.2.3.1.2. carteolol

7.2.3.1.3. carvedilol

7.2.3.1.4. labetalol

7.2.3.1.5. nadolol

7.2.3.1.6. penbutolol

7.2.3.1.7. pindolol

7.2.3.1.8. propranolol

7.2.3.1.9. sotalol

7.2.3.1.10. timolol

7.2.3.1.11. β1-selective

7.2.3.1.12. acebutolol

7.2.3.1.13. atenolol

7.2.3.1.14. betaxolol

7.2.3.1.15. bisoprolol

7.2.3.1.16. esmolol

7.2.3.1.17. metoprolol

7.2.4. Anti-arrhythmics

7.2.4.1. Class 1A

7.2.4.1.1. atrial fibrillation, flutter; supraventricular & ventricular tachyarrhythmias

7.2.4.1.2. quinidine

7.2.4.1.3. procainamide

7.2.4.1.4. disopryamide

7.2.4.2. Class 1B

7.2.4.2.1. ventricular tachyarrhythmias (VT)

7.2.4.2.2. lidocaine

7.2.4.2.3. tocainide

7.2.4.2.4. mexiletine

7.2.4.3. Class 1C

7.2.4.3.1. supraventricular tachyarrhythmias (SVT) and ventricular tachyarrhythmias (VT)

7.2.4.4. Class II

7.2.4.4.1. flecainide

7.2.4.4.2. propafenone

7.2.4.4.3. moricizine

7.2.4.4.4. Beta blockers

7.2.4.4.5. Non-selective - Beta 1 and 2

7.2.4.5. Class III

7.2.4.5.1. Beta 1 Selective

7.2.4.5.2. Potassium-channel blockers

7.2.4.6. Class IV

7.2.4.6.1. amiodarone

7.2.4.6.2. dronedarone

7.2.4.6.3. bretylium

7.2.4.6.4. sotalol

7.2.4.6.5. ibutilide

7.2.4.6.6. dofetilide

7.2.4.6.7. Calcium-channel blockers

7.2.4.7. thrombolytics

7.2.4.7.1. amlodipine

7.2.4.7.2. felodipine

7.2.4.7.3. isradipine

7.2.4.7.4. nicardipine

7.2.4.7.5. nifedipine

7.2.4.7.6. nimodipine

7.2.4.7.7. nitrendipine

7.2.5. Anti-thrombolytics

7.2.5.1. tissue plasminogen activator (tPA)

7.2.5.2. Streptokinase

7.2.5.3. Urokinase

8. Cardiomyopathy

8.1. LOS

8.1.1. 1. Describe the types of cardiomyopathy classifying them based on anatomic appearance and abnormal physiology of the left ventricle

8.1.2. 2. Describe etiologies of dilated cardiomyopathy

8.1.3. 3. Describe the difference in pathophysiology of heart failure from Dilated Cardiomyopathy vs Restrictive Cardiomyopathy

8.2. MEDS

8.2.1. Dilated Cardiomyopathy

8.2.1.1. diuretics

8.2.1.2. Renin-angiotensin

8.2.1.3. beta-blockers

8.2.1.4. anticoagulants

9. Myocarditis

9.1. LOS

9.1.1. 1. Classify infective endocarditis (IE) by duration of symptoms, nature of the valve and side of the heart involved

9.1.2. 2. Describe predisposing conditions and pathogenesis of IE

9.1.3. 3. Group bacteria causing IE according to the source of bacteremia and type of IE

9.1.4. 4. Relate IE complications to various clinical manifestations

9.1.5. 5. Compare and contrast acute vs. subacute IE, including microbial etiology

9.1.6. 6. Distinguish bacterial causes of IE based on the blood cultures growth, explain culture negative endocarditis (CNE) and describe pathogens

9.1.7. 7. List Dukes criteria and degree of importance in diagnosis of IE

9.1.8. 8. Describe principles of treatment in IE and list the antibiotics used in most common bacterial infections

9.1.9. 9. Describe symptoms and signs, diagnostic approach and treatment of myocarditis. List most common pathogens. Describe Chagas’ disease and Lyme carditis.

9.1.10. 10. Describe the four subtypes of pericarditis, symptoms and signs, diagnostic approach and treatment. List most common pathogens. Describe viral and TB pericarditis.

9.2. MEDS

9.2.1. nitroimidazole

9.2.2. nitrofuran

9.2.3. NSAIDS

10. Lyme Myocarditis

10.1. MEDS

10.1.1. ceftriaxone IV, followed by doxycycline

11. Acute Pericarditis

11.1. MEDS

11.1.1. NSAIDs

12. Tuberculous pericarditis

12.1. MEDS

12.1.1. pyrazinamide

12.1.2. isoniazid

12.1.3. rifampcin

12.1.4. ethamobutanol