Atrial Fibrillation Flashcards Preview

Pharmacology Exam 2 > Atrial Fibrillation > Flashcards

Flashcards in Atrial Fibrillation Deck (21):
1

What is the most common cardiac dysrhythmia in clinical practice?

atrial fib

2

Which a-fib applies to patients <60 without clinical or ECHO evidence of cardiopulmonary disease?

Lone a-fib

3

Which a-fib is self-terminating, lasts <24 hrs) and can be recurrent?

Paroxysmal a-fib

4

Which a-fib is no self-terminating, lasts >7 days and can be recurrent?

Persistent a-fib

5

Which a-fib occurs when cardioversion fails?

Permanent a-fib

6

What are the Class III antiarrhythmics for pharmacological cardioversion?

Dofetilide, Ibutilide and Amiodarone

7

What are the Class I antiarrhythmics for pharmacological cardioversion?

Flecainide and Propafenone

8

Which Class of antiarrhythmics for pharmacological cardioversion should be avoided in patients with structural heart disease?

Class I

9

Which drugs are used for a-fib rate control in patients without an accessory pathway?

Esmolol (or if not sure b/c quick onset and short duration)
Metoprolol
Diltiazem
Verapamil

10

Which drug is used for rate control in patients with an accessory pathway like WPW?

Amiodarone

11

Which drugs are used for rate control with heart failure and without an accessory pathway?

Digoxin and Amiodarone

12

Which anti arrhythmic should be used with caution in patients with decreased renal function because or narrow T.I. and DDI?

Digoxin

13

Postoperative A-fib - DOC

oral beta blocker
alt. diltiazem or verapamil

14

AMI - treatment

DC cardioversion
IV amiodarone to slow RVR
IV beta blockers
UFH

15

WPW - a-fib treatment considerations

IV procainamide or ibutilide to restore sinus rhythm

16

Pregnancy - a-fib treatment

digoxin, a beta blocker or non DHP CCB
DC cardioversion
1st/3rd trimester UFH
2nd trimester Warfarin

17

Treatment acute a-fib (<48 hrs)

If not hemodynamically stable --> DC cardiovert
If stable --> pharmacologic cardioversion
No anticoagulation

18

Treatment acute a-fib (>48 hrs)

If not hemodynamically stable --> IV heparin + DC cardiovert
Continue Warfarin with INR 2-3 x 4 wks
If stable --> Warfarin INR 2-3 x 3 wks, DC cardiovert, continue Warfarin x 4 wks

19

Treatment chronic a-fib

1. Attempt rate control first
2. risk assessment for antithrombotic therapy using CHADS2 score

20

Based on CHADS2 score…who gets ASA vs Warfarin?

0 ASA
1 ASA or Warfarin
2-6 Warfarin
(Warfarin is given when risk of stroke is higher than risk of bleeding)

21

Criteria for CHADS2 score

CHF (1 pt.)
HTN (1 pt.)
Age > 75 (1 pt.)
DM (1 pt.)
Stroke or TIA (2 pts.)