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Antidysrhythmics Flashcards

(64 cards)

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1
Q

Dysrhythmia

A

abnormal rate or rhythm of heart

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2
Q

The electrical conduction of the heart

A

SA node –> AV node —> Bundle of HIS —> Purkinje Fibers

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3
Q

SA Node

A

Gate keeper of heart

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4
Q

AV node

A

gateway for impulse to reach the ventricles; delays impulse travel

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5
Q

Automaticity

A

heart’s ability to generate an electrical impulse

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6
Q

Conductivity

A

ability of heart to transmit electrical impulses

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7
Q

How are action potentials generated?

A

by movement of ions into and out of the cell

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8
Q

Slow action potentials

A

SA and AV nodes

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9
Q

Fast Action Potentials

A

Myocardium and His-Purkinje system

Conducts electricity quickly through the heart

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10
Q

depolorization

A

contraction

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11
Q

P wave

A

depolarization of the atria

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12
Q

QRS complex

A

depolarization of the ventricles

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13
Q

T wave

A

repolarization of the ventricles

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14
Q

PR interval

A

time between onset of P and onset of QRS complex

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15
Q

QT interval

A

time between onset of QRS complex and end of T wave

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16
Q

ST segment

A

between end of QRS complex and start of t wave

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17
Q

ectopic

A

impulses starting in cells other than SA node

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18
Q

Causes of dysrhythmia

A

Disturbances of automaticity

Disturbances of conduction

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19
Q

Supraventricular Tachy

A

Intervention: vasalva maneuvers/Cardioversion

Drug Therapy: Adenosine/Class II or IV Drugs

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20
Q

Atrial Fibrillation

A

Interventions: Cardioversion

Drug Therapy: Class II or IV drugs/ Anticoagulation

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21
Q

Atrial Flutter

A

Intervention: Cardioversion

Drug Therapy: Class II or IV drugs/ Anticoagulation

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22
Q

Sustained Ventricular Tachycardia

A

Intervention: Cardioversion

Drug Therapy: Procainamide, Lidocaine, Amiodarone

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23
Q

Ventricular Filbrillation

A

Life threatening
Intervention: Cardioversion/CPR
Drug Therapy: Amiodarone/Lidocaine

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24
Q

Torsades de Pointes

A

Life threatening
Intervention: Cardioversion/ Stop QTc prolonging drugs
Drug Therapy: Magnesium

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25
Class I
Sodium Channel Blockers
26
Class II
Beta-Blockers
27
Class III
Potassium Channel Blockers
28
Class IV
Calcium Channel Blockers
29
Sodium Channel Blockers
Double Quarter Pounder Lettuce Mayo Fries Please
30
Sodium Channel Blockers | Class 1A
Disopyramide Quinidine Procainamide
31
Sodium Channel Blockers | Class 1B
Lidocaine | Mexiletine
32
Sodium Channel Blockers | Class 1C
Flecainide | Propafenone
33
Adverse Effects Quinidine
Diarrhea 1/3 patients (33%) | Cinchonism
34
Cinchonism
hearing loss, tinnitus, dizziness, flushing, and blurry vision
35
Adverse Effects for Procainamide
SLE (Lupus) reaction : rash Blood dycrasias : blood abnormalities Arterial embolism : clot traveling in artery
36
Adverse Effects for Lidocaine
CNS effects | Toxic Doses: seizure, respiratory arrest
37
Monitoring Considerations for Lidocaine
Narrow therapeutic index | Monitor: drug levels
38
Monitoring Considerations for Flecainide
Increase mortality in post MI patients with asymptomatic Vtach
39
4 Approved drugs for Class II: Beta-blockers
Propranolol Acebutolol Esmolol Sotolol
40
Adverse Effects of Propranolol
Av Block Sinus Arrest Hypotension Bradycardia
41
Monitoring of Propranolol
Give IV SLOWLY to avoid hypotension | Monitor: HR, BP, ECG
42
Monitoring of Esmolol
Very fast acting Short half-life Monitor: HR, BP, ECG
43
Monitoring of Sotalol
also causes blockage of K channels; can be considered Class II Monitor: HR, BP, ECG
44
Adverse Effects of Amiodarone
Toxicity: lungs, liver, eyes, thyroid | Photosensitivity
45
Monitoring of Amiodarone
Hypotension | give through 0.22 micron filter
46
Adverse Effects of Dronedarone
Photosensitivity | Hepatotoxicity
47
Monitoring of Dronedaron
Contraindicated in pregnancy
48
Monitoring of Dofetilide
initiated therapy in the hospital
49
Monitoring of Sotalol
Class II and III agent - do NOT use like a typical beta-blocker
50
Adenosine Mechanism of Action
Decreased automaticity of SA node Decreased Conduction through the AV node Prolonged PR interval
51
Adenosine Indications
Termination of SVT ONLY | NOT for treatment of afib or aflutter
52
Adenosine Pharmokinetics
EXTREMELY short half-life (2-10 seconds) | Must be given IV push
53
Adenosine Adverse Effects
momentary asystole Chest discomfort Flushing (at least 20mL)
54
Adenosine Drug Interactions
Methylxanthines (ex. theophylline) block adenosine receptors, do not give drug if patient is on this
55
Digoxin Physiologic effects
decreased conduction through AV node increases vagal tone high drug level usually needed
56
Digoxin Indications
atrial fibrillation | atrial flutter
57
What do Sodium Channel Blockers do?
Decrease conduction velocity in the atria, ventricles and His-Purkinje system
58
What do Beta-Blockers do?
Decrease automaticity in SA node Decrease conduction velocity through AV node Decrease myocardial contractility
59
Class III: Potassium Channel Blocker Drugs
``` Amiodaron Ibutilide Dofetilide Dronedarone Sotalol ```
60
What do Potassium Channel Blockers do?
delay repolarization of fast action potentials | Prolong the QT interval
61
What is a common Adverse Drug Effect (ADE) with IV administration
Hypotension
62
What is something to consider relating to Class III drugs?
All of the medications here can cause QT elongations leading to Torsades de Pointes
63
What do Calcium Channel Blockers Do?
Decrease SA node automaticity Decrease AV node conduction velocity Decrease myocardial contraction
64
Calcium Channel Blocker Drugs
Diltiazem | Verapamil

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