clinical 7/6/10

change in c.i.
-just when i was warming up to the other, we get a new c.i. let's see how it goes...

aox2
-i think if you have any doubt, you should just go ahead and ask the questions. i was surprised at what year he thought it was.

a-fib
-rapid, irregularly irregular atrial rhythm; atria dont contract, av system bombarded with many electrical stimuli, causing insonsistent irregularly irregular ventricular rate, usu tachycardic; atrial thrombi often form >> risk of embolic stroke; one of most common arrhythmias; affects men and whites more; affects 10% of people 80+ yo; sometimes precipitates HF (bc CO decr w/o atrial contraction); the longer AF present, the less likely is spontaneous conversion, or cardioversion by any means
-most common causes: htn, cardiomyopathy, mitral valve DOs (left AV valve), hyperthyroidism, binge drinking
-sx: irregularly irregular pulse, often otherwise asymptomatic
-dx by ekg: wavy baseline, lacks discernible P waves (atria), irregular QRSs
tx: drugs to control hr, anticoagulation drugs, cardioversion

tamsulosin (Flomax)
-tx s/s bph
-moa: a1-blocker relaxes bladder sm >> urine flow improved >> decr s/s bph
-adv fx: hypotension

ezetimibe (Zetia)
-tx hypercholesterolemia
-reduces plasma cholesterol by blocking absorption of it in the small intestine