arrythmia: therapy

Question 1

why does atrial fibrillation occur?

Answer 1

disorganised electrical signals

Question 2

vaughan-williams classification class 1A

Answer 2

fast sodium channel blockade

Question 3

vaughan-williams classification class 1B

Answer 3

intermediate sodium channel blockade

Question 4

vaughan-williams classification class 1C

Answer 4

slow sodium channel blockade

Question 5

vaughan-williams classification class II

Answer 5

B-adrenergic receptor antagonism

Question 6

vaughan-williams classification class III

Answer 6

prolong refractoriness

Question 7

vaughan-williams classification class IV

Answer 7

calcium channel blockade

Question 8

what are Antidysrhythmics

Answer 8

cardiac dysrhythmia medications, are a group of pharmaceuticals that are used to suppress abnormal rhythms of the heart

Question 9

what is the most common Antidysrhythmics

Answer 9

Digoxin

Question 10

what does Digoxin do?

Answer 10

Inhibits the sodium-potassium ATPase pump

Positive inotrope—improves the strength of cardiac contraction

Allows more calcium to be available for contraction

Used for heart failure and atrial dysrhythmias (AF)

Monitor potassium levels, drug levels, and for toxicity

Question 11

what are signs of digoxin toxicity?

Answer 11

nausea and vomitting
xanthopsia
bradycardia
tachycardia
arrrythmias

Question 12

what is amiodarone used for?

Answer 12

used for VT and occasionally in supraventricular

Question 13

whats the function of adenosine?

Answer 13

Slows conduction through the AV node

Used to convert paroxysmal supraventricular tachycardia to sinus rhythm

Only administered as fast IV push
May cause asystole for a few seconds

Question 14

can antiarrhythmics cause arrhythmias

Answer 14

yes

Question 15

indications for anticoagulations

Answer 15

atrial fibrilation: risk of stroke, peripheral emboli

Question 16

what are characteristics of arterial thrombosis?

Answer 16

adherence of platelets to arterial walls

white in colour

associted with MI, stroke and ischaemia

Question 17

what are characteristics of venous thrombosis?

Answer 17

Develops in areas of stagnated blood flow (e.g. deep vein thrombosis, left atrium),

Red in color-

Associated with Congestive Heart Failure, Cancer, Surgery.

Question 18

indications for anticoagulation?

Answer 18

atrial fibrilation

DVT/PE

after surgery

immobilisation

Question 19

whats the third commonest cause of death?

Answer 19

DVT/PE

Question 20

how does increasing warfarin affect the affinity for albumin

Answer 20

decrease

Question 21

how does increasing warfarin affect inhibition of degradation

Answer 21

increases

Question 22

how does increasing warfarin affect synthesis of clotting factors

Answer 22

decreases

Question 23

how does increasing drugs that promote bleeding effect platelets?

Answer 23

inhibits

Question 24

how does increasing drugs that promote bleeding effect clotting factors

Answer 24

inhibits

Question 25

how does decreasing warfarin activity effect metablosing enzymes?

Answer 25

induces them

Question 26

ow does decreasing warfarin activity effect clotting factor synthesis?

Answer 26

promotes

Question 27

ow does decreasing warfarin activity effect absorption

Answer 27

reduces it

Question 28

what are drugs that promote bleeding?

Answer 28

aspirin, herparin, antimetabolites

Question 29

what are drugs that increase warfarin activity?

Answer 29

aspirin, sulfonamides, cimetidine, disulfiram

Question 30

direct effect of warfarin depends on…

Answer 30

concentration of warfarin in the liver

rate or accumulation of warfarin

Question 31

what are adverse reactions?

Answer 31

bleeding
teratogenic
avoid in first and third trimesters

Question 32

how do you monitor warfarin therapy?

Answer 32

Regular INR
Watch if therapy altered
Patient education
Alcohol intake

Question 33

whaat is the acronym for assessing bleeding risk on warfarin?

Answer 33

CHADS2

congestive heart failure
hypertension
age >75
diabetes mellitus
stroke

Question 34

what are characteristics of the ideal anticoagulant?

Answer 34

oral
no need for monitoring
no interaction with food or drugs
given once or twice a day
as effective as warfarin
safer than warfarin