Arrythmias Flashcards
When should fleicanide or propefenone use be avoided?
Iscahemic heart disease or structural abnormalities within the heart
What drug is used first line in arrythmias after MI associated with hypotension?
Atropine
What drug is used second line for arrythmias following MI if first line isn’t successful?
Adrenaline/ Ephedrine
What drug is recommended in paroxymal supraventricular arrythmia in a patient with asthma?
Verapamil
What type of supraventricular arrythmias are cardiac glycosides contraindicated in?
supraventricular arrythmias associated with accessory conducting pathways e.g., wolff-parkinson white syndrome
First line for paroxysmal supraventricular arrythmias?
Adenosine
Which arrythmias drug is contra-indicated in severe obstructive airway disease and why?
Propafenone as weak BB effect
Which anti-arrythmic drug should be avoided in prostatic hyperplasia and angle-closure gluacoma?
Disopyramide
Which BB is most widley used in ventricular arrythmias?
Sotalol
Name two drugs that can be used in rhythm control for a patient presenting with symptoms of AF for <48 hours?
Fleicanide or amiodarone
When should anticoagulation be started and stopped when a person is going for cardioversion to treat AF?
started 3 weeks prior and continued until 4 weeks after
What is first line treatment for a patient presenting with AF with symptoms present for >48 hours?
Rate control- BB or rate-limiting CCB (given LVEF> 40%)
When is digoxin indicated as monotherapy in AF?
If non-paroxsymal AF, pt is predominantly sedentary or if other rate-limiting drugs not suitable
What is 2nd line treatment in AF?
Combination of 2 of the following: Diltiazem, BB, digoxin
When should special management be sought in AF?
If treatment fails to resolve symptoms or cardioversion fails specialist advice should be sought within 4 weeks
What CHADSVASC score is required to consider anticoagulation in a male with AF?
1
What are the symptoms of AF?
Chest pain, syncope, palpitations, breathlessness, can be asymptomatic
What values are considered a high bleeding risk with the ORBIT tool?
4-7
When should Apixaban be reduced to 2.5mg BD in non-valvular AF?
If pt has at least 2 of following:
- over 80
- Creatinine is more than 133
-<60kg
OR if CrCl 15-29ml/min
When should Edoxaban be reduced to 30mg OD in non-valvular AF?
- 60kg or less
- CrCl 15-50ml/min
- on concurrent Pgp inhibitors
When should rivaroxaban be reduced to 15mg OD in non-valvular AF?
If CrCl 15-29ml/min
Which DOACs need to be taken with food?
Rivaroxaban 15mg and 20mg tablet
Name the reversal agent for heparin and LMWH?
Protamine sulphate
