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Bradycardia Diagnostic and Management Algorithm

CONSIDER ETIOLOGY (not inclusive): 
 - STRUCTURAL: sick sinus, AV block, ischemia,
Hypothyroidism - TOX: beta-blockers ... TREATMENT - Drugs ... (beta-blockers, ... Electrolytes (hyperkalemia ... #Algorithm #Differential
Drugs causing hyperkalemia
 • Impaired release of renin: NSAIDs, Beta blockers, Cyclosporine, tacrolimus, Diabetes, Elderly
 •
Drugs causing hyperkalemia ... renin: NSAIDs, Beta ... #hyperkalemia # ... medications #causes ... #differential #
Bradycardia - Differential Diagnosis Framework

BRADI Mnemonic
 • BRASH/Hyperkalemia
 • Reduced oxygen/Glucose/Temp
 • ACS
 • Drugs
 •
Bradycardia - Differential ... Temp • ACS • Drugs ... Medications: ... • Beta blockers ... #differential #
Mechanisms of Drug-Induced Hyperkalemia 
 • Direct renin inhibitor (Aliskiren)
 • Renin release inhibition (NSAIDs, Beta-Blockers)
Mechanisms of Drug-Induced ... Hyperkalemia ... inhibition (NSAIDs, Beta-Blockers ... #differential # ... pharmacology #potassium #medications
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
Hyperkalemia - Differential ... phlebotomy High ... reactions Common Drugs ... potassium • Beta ... Medications 2.
The Diagnostic Approach to Hyperkalemia
Drugs
 - Amiloride
 - Spironolactone
 - Triamterene
 - Trimethoprim
 - Pentamidine
 -
Drugs - Amiloride ... transplant - SLE High ... - NSAlDs - Beta-Blockers ... #Hyperkalemia ... Algorithm #diagnosis #differential
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
Hyperkalemia - Differential ... phlebotomy High ... reactions Common Drugs ... potassium • Beta ... Medications 2.
Causes of Hyperkalemia - Differential Diagnosis Framework
 • Cellular Shift:
   - Exercise
- Differential ... hyperosmolality - Medications ... : beta blockers, ... #Differential # ... Causes #potassium #high
Bradycardia - Differential Diagnosis 
 • Cardiac disease: Myocardial ischemia / infarction, Myocarditis, Congenital disorders, Cardiomyopathies,
Bradycardia - Differential ... disturbance (e.g. hyperkalemia ... ) • Medications ... (e.g. digoxin, beta ... channel blockers
Intraoperative  Bradycardia - Guidelines for Crises in Anaesthesia
Bradycardia in theatre should not be treated as
could have made a drug ... Consider known drug ... Also consider: high ... toxicity (→ 3-10); beta-blocker ... myocardial infarction, hyperkalaemia