CVS

·         Hypoglycemic symptom is not masked by beta blockers is Sweating.

·         Lidocaine usually shortens the duration of the action potential and, thus, allows more time for recovery during diastole. It also blocks both activated and inactivated Na channels. This has the effect of minimizing the action of lidocaine on normal myocardial tissues as contrasted with depolarized ischemic tissues. Thus, lidocaine is particularly suitable for arrhythmias arising during ischemic episodes such as myocardial infarction (MI).

·         Only niacin improves levels of VLDL TG, HDL (max improvement), and LDL and inhibits cholesterol synthesis. It also limits the progression of atherosclerosis by lowering Lp(a) circulating fibrinogen and increasing circulating tissue plasminogen activator (tPA).

·         Only gemfibrozil acts to lower triglycerides, probably because of increased lipolysis by lipoprotein lipase and decreased lipolysis inside adipocytes, causing a net movement of triglycerides into the cell.

·          

Gemfibrozil can interact with the peroxisome proliferator activated receptor-a. Apparently, this leads to an increase in lipolysis of lipoprotein triglyceride by the action on lipoprotein lipase. Although minimal changes occur in plasma LDL levels, there is a decrease in plasma VLDL levels. Plasma HDL cholesterol may increase because of the decreased exchange of triglycerides for cholesteryl esters.

·          Digoxin levels rise with concomitant administration of diltiazem by an unknown mechanism that reduces renal clearance.

·         Calcium channel blockers:

–Nifedipine is similar to Nitrates in effect

–Verapamil is similar to β blockers in effect

·         HIT 1: Occurs because of heparin induced platelet aggregation-mild and self-limiting.

HIT 2: Occurs because of antibodies formed against heparin-platelet factor 4 complexes which leads to life threatening paradoxical thrombosis, mandates immediate discontinuation of heparin