Differential Diagnosis Drug Induced Bradycardia

Hypertension Exercise Program

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Hypertension: P1-selective > nonselectives, which also block bronchodilation and peripheral vasodilation and could exacerbate bron-chospasm in obstructive pulmonary disease and lower extremity claudication in peripheral vascular disease.

Angina: Reduce anginal attacks and decrease post-myocardial infarction mortality. Tachydysrhythmias: Used in theophylline overdose, butadenosine preferred over P-blockers. Tremor: Propanolol over prescribed agitation, stage fright, and panic attacks ("shakes"). Migraine headaches.

Hyperthyroidism: P-blockers moderate the sympathetic, hyperdynamic effects of thyroid storm.

Side Effects

Bronchospasm: Nonselectives prevent bron-chodilation and promote bronchospasm in chronic obstructive pulmonary disease (COPD) patients.

High anaphylaxis risk: Nonselectives block cat-echol's ability to reduce mast cell degranulation in patients with atopic allergies. Hypoglycemia: All ß-blockers mask sympathetic response to hypoglycemia and interfere with gluconeogenesis/glycogenolysis. Withdrawal: Rebound increased heart rate and elevated blood pressure on abrupt withdrawal can precipitate MI and CVA.

P-Blockers: Hypotension, depressed mental status, slightly elevated K, ECG — prolonged PR interval and widened QRS. CCBs: Hypotension, preserved mental status, ECG — PR prolonged interval and widened QRS complex.

Digoxin: Nausea and vomiting, hyperkalemia, hypertension, and mental status preserved; ECG — prolonged PR, ST changes, atrial then ventricular dysrhythmias.

Na-channel blockers: Seizures, hypotension, depressed mental status, ECG — widened QRS complex.

Cholinergics: SLUDE, DUMBBELS, ECG — sinus tachycardia or paradoxical bradycardia. a-agonists: a1 = phenylpropanolamine (PPA): Severe hypertension, intracranial hemorrhage (ICH), sinus bradycardia; a2 = clonidine, imid-azolines: cause an opioid toxidrome, with pinpoint miosis and sinus bradycardia.

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Coping with Asthma

Coping with Asthma

If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.

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