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Irrerugularly Irregular rhythm = Afib Afib --> stasis of blood in the Heart ---> Thrombus formation Thrombus will embolize to the (likely) the popliteal artery leading to acute limb ischemia

194orbust  why would an embolectomy be favored over clopidogrel? +1  
194orbust  oh nvm......it's bc clopidogrel won't bust a clot, just prevents them from forming. +7  


Irrerugularly Irregular rhythm = Afib Afib --> stasis of blood in the Heart ---> Thrombus formation Thrombus will embolize to the (likely) the popliteal artery leading to acute limb ischemia

194orbust  why would an embolectomy be favored over clopidogrel? +1  
194orbust  oh nvm......it's bc clopidogrel won't bust a clot, just prevents them from forming. +7  


This is what I thought but not sure if it’s correct. There is a UWorld q where it describes co-administration of cortisol and epinephrine. Cortisol significantly enhances the effect of epi because cortisol has a permissive effect on maintaining the adrenergic receptors.

194orbust  per UWorld, "cortisol exerts a permissive effect on many hormones to help improve the response to a variety of stressors. For example, cortisol increases vascular and bronchial smooth muscle reactivity to catecholamines". FA also uses the effect of cortisol on catecholamine responsiveness as the lone example for a permissive drug interaction (FA2018 pg 229). The difference here is that we're talking about exogenous glucocorticoid and adrenergic agonist. I guess it was expected for us to assume that the mechanism is analogous for the analogous drugs +1  
maxillarythirdmolar  I'm sure it's related to the activating effect of Cortisol on phenylethanolamine-N-methyltransferase, converting NE to Epi. Sounds like a synergistic thing to me. (FA.83) +