Dysrhythmias Flashcards Preview

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Flashcards in Dysrhythmias Deck (44):
1

ventricular arrhythmias

tachycardia, fibrillation

2

atrial arrhythmias

flutter, fibrillation

3

AV junction arrhythmias

AV nodal reentry, acute SVT

4

Class I actions

all block sodium
IA- slows phase 0 depol
IB- shortens phase 3 repol
IC- markedly slows phase 0 depol

5

class II actions

B Blocker
suppress phase 4 depol

6

class III actions

K blocker
prolongs phase 3 repol

7

class IV actions

Ca blocker
shortens AP

8

indicated for atrial and vent arrhythmias, used to maintain rhythm post cardioversion. Class IA

quinidine

9

contraindicated in heart block, SA node dysfunction, cardiogenic shock, severe uncompensated HF, SLE

class IA antiarrhythmics (quinidine)

10

ADRs include arrhythmias, N/V/D, cinchonism,

class IA antiarrhythmics (quinidine)

11

drug metab inhibited by cimetidine. Induced by phenytoin, rifampin, barbiturates. Decreases digoxin clearance

class IA antiarrhythmics (quinidine)

12

metabolized to N-acetylprocainamide, which prolongs duration of AP

procainamide

13

ADRs: hypotension, lupus erythematosus like syndrome, aystole or ventricular arrhythmias, depression, hallucinations, psychosis

procainamide

14

produces negative inotropic effect- contraindicated in HF, causes peripheral vasoconstriction

disopyramide

15

ADRs- anticholinergic, proarrhythmic

disopyramide

16

prototype and DOC for emergency treatment of cardiac arrhythmias post mI. No negative inotropic effect, no impairment of LV dysfunction

lidocaine

17

extensive 1st pass metabolism, dose adjustment in liver failure

lidocaine

18

contraindicated in SA disorders, AV block

lidocaine

19

ADRs- confusion, slurred speech, drowsiness, parasthesias, agitation, cardiac arrhythmias

lidocaine

20

used in chronic vent arrhythmias associated with previous MIs

mexiletine, tocainide

21

associated with pulmonary toxicity that can lead to fibrosis

tocainide

22

questionable safety- blocks Na channels, indicated for refractory ventricular arrhythmias (PVCs)

flecainide

23

have negative inotropic effects (not used in CHF). ADRs include dizziness, blurred vision, HA, nausea, can aggravate pre-existing arrhythmias or induce life threatening vent tachy

class IC- flecainide

24

indicated post MI vent arrhythmias, tachyarrhythmias caused by increased sympathetic activity, atrial flutter and fib, AV nodal reentrant tachycardia

class II- B Blockers

25

block potassium channels, prolonging repolarization and duration or AP. Indicated in vent and supraventricular arrhythmias

class II- B Blockers

26

effective in preventing arrhythmia recurrence and decreasing mortality in patients with sustained VTACH

sotalol

27

ADR includes torsade de pointes

sotalol

28

has class I, II, III, and IV actions (dominant class III). Antianginal and antiarrhythmic activity

amiodarone

29

indicated for refractory SVT and ventricular tachyarrhythmias

amiodarone

30

Long half life. ADRs include pulmonary fibrosis, GI intolerance, tremor, ataxia, hyper/hypo thyroidism, neuropathy, muscle weakness, blue skin discoloration

amiodarone

31

slowed phase 4 spontaneous depol and slowed conduction in tissues dependent on calcium currents (AV node)

CCBs

32

indicated for atrial arrhythmias, reentrant suprevent tachy, reducing vent rate in atrial flutter and fib, HTN, angina

CCB

33

ADRs: hypotension. Contraindicated in pts with preexisting depressed cardiac function due to its negative inotropic properties

CCB

34

endogenous nucleoside that acts at tissues in lungs, afferent nerves, and platelets

adenosine

35

has a short DOA. Decreases conduction velocity, prolongs the refractory period and decreases automaticity in the AV node

adenosine

36

contraindicated in 2nd and 3rd degree heart block

adenosine

37

DOC for abolishing supraventricular tachycardia

adenosine

38

ADRs- transient facial flushing, chest pain, dyspnea, bronchospasm

adenosine

39

shortens refractory period in atrial/vent cells while prolonging effective refractory period and decreasing conduction velocity in purkinje fibers

digoxin

40

indicated to control vent rate in Afib and Aflutter. ADRs include ectopic vent beats- VTACH and VFIN

digoxin

41

this should be considered in all afib patients who are severely symptomatic or hemodynamically unstable

immediate DCC

42

all afib patients need

anticoagulation
ventricular rate control
restoration of normal sinus rhythm

43

when would you chose long term pharm rate control (rather than cardioversion)

no deterioration in sx w afib and HR controlled
normal LV function
duration of afib > 1 year
failure to maintain NSR despite cardioversion

44

when would you chose cardioversion

symptomatic with NSR
LVH
duration of afib < 1 year
young, active patients