L20 Flashcards Preview

P&T Block 1 > L20 > Flashcards

Flashcards in L20 Deck (18):
1

What are the 3 options for wide QRS complex tachycardia?

VTach - monomorphic or polymorphic
VFib
SVT w/ aberration

2

What does VTach look like?

Tachycardia
3+ consecutive premature ventricular contractions
Concordance of QRS - all pointing down
Atrial ventricular dissociation - any P waves (might see some in 3) are separated from QRS - ventricle and atrial depolarizations separated

3

What does VFib look like?

No discernible rhythm
Doesn't even look like QRSs

4

What does Torsades de Pointes look like on EKG? What could it progress to?

EAD --> long QT --> polymorphic ventricular tachycardia
String of high amp QRS followed by low amp QRS
May progress to VFib

5

What is the shared mechanism of Class 1 anti-arrhythmics?

Na blockers

6

Changes to AP for class 1a vs 1b vs 1c

1a - longer AP = longer QT
1b = shorter AP
1c = no change to AP

7

What are class 2, 3, 4, 5 anti-arrhythimcs?

2 = BBs
3 = K blockers
4 = Ca CB
5 = Digoxin

8

Med to treat acute wide complex tachy

Amiodarone
2md = procainamide
Others: lidocaine, Mg, BBs

9

Amiodarone
- Toxicity

Tox:
- Bradycardia
- Pneumonitis
- Hypo/hyperthyrodism
- Transaminitis (liver enzymes)
- Peripheral neuropathy

10

What causes the BP drop seen with amiodarone

Drug detergent

11

Amiodarone drug ints

↑activity Digoxin, quinidine, warfarin
Worsens bradycardia due to BB, Ca CBs

12

Long term treat wide complex tachy w/o structural heart disease

Ablation

13

Long term treat wide complex tachy w/ structural heart disease

Implantable cardioverter defibrillator

14

What is Brugada's syndrome

Defective Na channel in heart - less Na current
= structural heart disease --> ventricular tachy
"Channelopathy"

15

What is long QT syndrome

Na or K channel structural abnormalities that lead to ↑risk VTach

16

Drugs that induce long QT

Antibiotics: macrolides, etc

17

Define sudden cardiac death

Death within 1 hr of cardiac symptoms
Likely due to ventricular arrhythmia
Aka dying of VFib

18

What drug do you know to beneficial post-MI?

BBs