Cardiovascular Toxidromes

Question 1

Cardiac Action Potential Stages
(5)

Answer 1

0 - Rapid Depolarisation (systole)
1 - Notch
2 - Plateau
3 - Rapid Repolarisation
4 - Baseline (diastole)

Question 2

Cardiovascular Drugs
Class 1
Type

Answer 2

Sodium Blockers

Question 3

Cardiovascular Drugs
Class 2
Type

Answer 3

Beta Blockers

Question 4

Cardiovascular Drugs
Class 3
Type

Answer 4

Potassium Blockers

Question 5

Cardiovascular Drugs
Class 4
Type

Answer 5

Calcium Blockers

Question 6

Cardiovascular Drugs
Class 5 (OTHER)
Type

Answer 6

Cardiac Glycosides

Question 7

Cardiovascular Drugs
Class 1 Effects

Answer 7

drop rate of repolarisation (drug dependent)

Question 8

Cardiovascular Drugs
Class 2 Effects

Answer 8

• decrease SA node rate
• decrease AV conductivity
• increase refractory period

Question 9

Cardiovascular Drugs
Class 3 Effects

Answer 9

• increase refractory period
• increase action potential duration

Question 10

Cardiovascular Drugs
Class 4 Effects

Answer 10

• decrease action potential duration
• decrease AV conduction & contractility

Question 11

Cardiovascular Drugs
Class 5 Effects

Answer 11

• increase in chronotropic
• decrease in inotropic

Question 12

Cardiovascular Drugs
Class 1 Pharmocodynamics

Answer 12

• sodium channel blockers slow NA+ influx during stage 0

Question 13

Sodium Blockade Toxicity
Neuro Symptoms
(5)

Answer 13

• ALOC
• agitation
• tremors/twitching
• seizures
• coma

Question 14

Sodium Blockade Toxicity
Respiratory Symptoms

Answer 14

• tachypnoea
• bradypnoea (terminal sign)

Question 15

Sodium Blockade Toxicity
Cardio Symptoms

Answer 15

• hypotension
• bradycardia or tachycardia (tachy = bad)
• AV or bundle branch blocks
• QRS widening
• R axis deviation
• VT or VF

Question 16

Diagnosis

Answer 16

Sodium Blockade Toxicity

Question 17

Cardiovascular Drugs
Class 2 pharmacodynamics

Answer 17

beta receptors blunt chronotropic, intotropic and metablic effect of catecholamines

Question 18

Beta Blockers
Common Effects
(4)

Answer 18

• reduce arrythmias, particularly tachyarrythmias
• reduce blood pressure
• manage psychological stress
• reduce workload for angina or following MI infarction

Question 19

Common drug class for -lol

Answer 19

class 2 beta blockers

Question 20

Beta Blocker Toxicity
Neuro Symptoms

Answer 20

• ALOC
• seizures
• coma (seen with propranolol)

Question 21

Beta Blocker Toxicty
Respiratory Symptoms

Answer 21

• bronchospasm
• pulmonary oedema

Question 22

Beta Blocker Toxicity
Cardio Symptoms

Answer 22

• hypotension
• bradycardia
• AV blocks, complete dissociation
• QRS widening
• R axis deviation

Question 23

Beta Blocker Toxicity
Peripheral Symptoms

Answer 23

• hypoglycaemia
• hyperkalaemia

Question 24

Diagnosis

Answer 24

Beta Blocker Toxicity

Question 25

Cardiovascular Drugs Class 3 pharmacodynamics (3)

Answer 25

- K+ prolong overall action potential by reducing K+ efflux out of cells -prolongs effective refractory & QT - blunts myocytes ability to respond to ectopic stimuli

Question 26

Potassium Toxicity Neuro Symptoms

Answer 26

- ALOC - tremors - seizures - coma

Question 27

Potassium Toxicity Respiratory Symptoms

Answer 27

- depression at high doses

Question 28

Potassium Toxicity Cardio Symptoms

Answer 28

- hypotension - bradycardia - AV blocks - QT prolongation - risk of TdP - VF

Question 29

Potassium Toxicity Peripheral Symptoms

Answer 29

- nausea - sweating - hypoglycaemia - hypokalaemia

Question 30

Diagnosis

Answer 30

Potassium Toxicity

Question 31

Cardiovascular Drugs Class 4 pharmacodynamics

Answer 31

calcium channel blockers restrict calcium ingress slowing cardiac conduction and contractiility

Question 32

Cardiovascular Drugs Calcium Blockers Effects

Answer 32

- reduce tachyarrythmias - antihypertensive - reduce cardiac workload for angina or following MI infarction

Question 33

Cardiovascular Drugs Calcium Channel Blockers 3 Types

Answer 33

- phenylalkylamines - benzothiazepines - dihydropyridines

Question 34

Cardiovascular Drugs Calcium Blockers Phenylalkylamines cardiac vs peripheral

Answer 34

- decrease in AV conduction - decrease inotropic effect - moderate peripheral vasodilation

Question 35

Cardiovascular Drugs Calcium Blockers Benzothiazepines cardiac vs peripheral

Answer 35

- milder cardiac effects - moderate peripheral vasodilation

Question 36

Cardiovascular Drugs Calcium Blockers Dihydropyridines cardiac vs peripheral

Answer 36

- peripheral vasodilation only

Question 37

Cardiovascular Drugs Calcium Toxicity Neuro Symptoms

Answer 37

- headache - ALOC - seizures/coma, rare and show late stage

Question 38

Cardiovascular Drugs Calcium Toxicity Respiratory Symptoms

Answer 38

- depression progressing to failure

Question 39

Cardiovascular Drugs Calcium Toxicity Cardio Symptoms

Answer 39

- peripheral vasodilation - refractory hypotension - bradycardia - AV block - complete block

Question 40

Cardiovascular Drugs Calcium Toxicity Peripheral Symptoms

Answer 40

- hyperglycaemia - ketoacidosis - renal failure

Question 41

Diagnosis

Answer 41

Calcium Toxicity

Question 42

Cardiovascular Drugs Class 5 - Digoxin Pharmocodynamics

Answer 42

inhibits function of the NA/K pump increasing intracellular sodium and restricting calcium loss

Question 43

Cardiovascular Drugs Class 5 - Digoxin Effects

Answer 43

- contractility increases improving CO - decreased automaticity decreasing HR - increased refractory period decreases arrythmia risk

Question 44

Cardiovascular Drugs Class 5 - Digoxin Neuro Symptoms

Answer 44

- headache - visual disturbances - agitation - ALOC - fatigue

Question 45

Cardiovascular Drugs Class 5 - Digoxin Respiratory Symptoms (1)

Answer 45

- dependent on CNS status

Question 46

Cardiovascular Drugs Class 5 - Digoxin Cardio Symptoms (4)

Answer 46

- dysrhythmias & heart blocks (vary by pt) - high risk of PVCs - high risk of VT - high risk of VF