4.29 pharm antiarrh cardiologist

Question 0

What do you do if there’s hemodynamics compromise

Answer 0

Sedate and shock

Question 1

3 cardinal signs of hemodynamics compromise

Answer 1

Angina
Hypotension
Heart failure (pulmonary edema, rales)

Question 2

Rate control drugs for a fib and a flutter

Answer 2

Beta blockers (metoprolol, esmolol)
Calcium channel blockers (diltiazem, verapamil)
Amiodarone
Digoxin

Question 3

Why is diltiazem better than verapamil for rate control in a fib and flutter

Answer 3

Doesn’t lower BP as much

Less likely to worse HF

Question 4

Don’t use beta blocker if

Answer 4

COPD

Asthma

Question 5

Target heart rate for rate control drugs

Answer 5

<110

Question 6

Ablation strategy for a fib and flutter rate control

Answer 6

Ablate AV node

Implant permanent pacemaker

Question 7

What drugs are used for rhythm control

Answer 7

Dofetilide
Dronedarone
Flecainide
Propafenone
Sotalol

Ibutilide (acute)
Amiodarone (second line)

Question 8

Only rhythm control drug you can use if have HF or other significant structural heart disease

Answer 8

Dofetilide

Question 9

What rhythm control drugs can prolong QT interval

Answer 9

Dofetilide
Propafenone
Sotalol

Ibutilide (acute)

Question 10

First line rhythm control if have HF

Answer 10

Amiodarone

Dofetilide

Question 11

Ablation to treat a fib

Answer 11

Ablate pulmonary veins

Question 12

Good candidate for rate control drugs

Answer 12

Young symptomatic patients with good rate control

Question 13

Characteristics of accessory pathway tissue

Answer 13

Fast response (unlike AV node)
Na channels (unlike AV node, which uses Ca)

Question 14

A fib plus accessory pathway. What drug should you not give

Answer 14

AV blockade drugs like adenosine

Question 15

A fib and accessory pathway. What drugs can you give

Answer 15

Procainamide

Ibutilide

Question 16

Best option for patients with a fib and accessory pathway

Answer 16

Sedate and shock

Question 17

What to do if have AV nodal reentry

Answer 17

Block AV node

Question 18

What to do if have AV reentry with accessory pathway

Answer 18

Block AV node

Question 19

Best drug for paroxysmal SVTs

Answer 19

Adenosine (if no asthma)

Question 20

If person has paroxysmal SVTs and asthma, what can you give

Answer 20

Diltiazem

Verapamil

Question 21

Have paroxysmal SVTs. What 2 options for chronic treatment

Answer 21

Ablation
Drugs except class IB

Question 22

If can’t tell what pt has on EKG, what drug can you give them

Answer 22

Adenosine

Question 23

Adenosine side effects

Answer 23

Chest pain
Atrial and ventricular arrhythmias
Bronchospasm

Question 24

Chronic therapy for sustained V Tach

Answer 24

ICD if can't be corrected Ablation if heart structurally normal Amiodarone if too sick for ICD

Question 25

What drug can you try for polymorphic ventricular tachycardia when shocking

Answer 25

Magnesium

Question 26

Best chronic treatment for v fib

Answer 26

ICD

Question 27

Drugs to try if shock doesn't work

Answer 27

Epinephrine Amiodarone Mg if polymorphic vt

Question 28

What drugs can be used to reduce ICD shocks

Answer 28

Sotalol | Amiodarone

Question 29

Progression of drugs for atrial flutter

Answer 29

Block AV node (beta blocker, diltiazem, dig) THEN Flecainide or Propafenone Can't just give Flecainide or Propafenone first or else get 2:1 to 1:1 (incr HR)

Question 30

Emergency drugs for cardiac arrest (VT, VF)

Answer 30

Amiodarone

Question 31

Emergency drug for acute termination of supra ventricular tachycardias

Answer 31

Adenosine