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Flashcards in Review session Deck (98)
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1

Main difference between slow/fast AP

Fast - upstroke by Na
Slow - upstroke by Ca (no phase 1,2)

2

Slow AP conduction at ____?

SA/AV nodes

3

IN nodal pacemaker cells, how does beta1, M2, and alpha 1 affect AP

beta 1 - increase phase 4 slope = increase HR/inotropy/lusitropy
M2/Alpha 2 - decrease phase 4 slope = decrease HR

4

Phase 4 in slow AP driven by which current

funny current

5

Phase 4 in fast AP is driven by

Ik1, Ina, Ica
Na/K and Na/C
(Na out/K in) (Na in/Ca out)

6

Phase 0 in fast AP driven by:

INa in

7

Phase 1 in fast AP driven by:

IKto (transient outward K current)

8

Phase 2 in fast AP driven by

Plateau = Ca in = K out

9

Phase 3 in fast AP driven by:

Ikr/Ikr pushing K out

10

Group 1 = ___ blocker
Example

Na channel
Procainamide/lidocaine

11

Group 2 = ___ blocker
Example

beta
esmolol

12

Group 3 = ___ blocker
Example

Potassium channel
amiodarone

13

Group 4 = ___ blocker
Example

Calcium channel
Verapamil
Diltiazem

14

Group 5 = ___ blocker
Example

miscellaneous
Adenosine, K/Mg

15

Ib difference from Ia/Ic drugs

Lidocaine - targets ONLY depolarized ventricles (target inactivated)
Ia/Ic = on atria-ventricles (target open)

16

Class III effects

blocks repolarization (K) --> rhythm control
increase QT - refractory

17

Class I effects

delays upstroke (conduction) and decrease AP - rhythm control

18

Class II effects

Decrease heart rate/AV conduction (block beta) - increase phase 4 time (decrease slope)

19

Class IV effects

Decrease AV conduction/HR
Block Ca = slow phase 0 in node

20

_____ have greater ratio of vascular dilation to cardiac effects

Dihydropryidines/nifedipine

21

_____ mostly affects cardiac nodal tissue (phase _) and cardiac muscle (phase _)

class 4 - verapamil/diltiazem
0, 2

22

Adenosine is an _____ nucleoside, acts as ___ on _____ receptor at ____

endogenous
Agoinst
A1/P1 purinergic receptors
AV node

23

Adenosine causes ____

hyperpolarization (increase IK1) - reduce phase 0
Increase refractory period

24

Digoxin, vagal maneuver, Ach, Adenosine on slow AP

phase 4 - hyperpolarized + decrease slope

25

Ach acts on __ receptor and adenosine acts on __ receptor - coupled to ___

M2
A1
Gi/o

26

Bradyarrhytmias due to 2 facotrs:

failure to initiate (sinus node dysf)
Failure to conduct - AV block

27

Treatment of Sinus Node dysfunction (brady)

Pacemaker
remove causative agent (Beta/ca blocker)

28

Treatment of AV block (brady)

Acute: Dopamine, epi, atropine, electrical stimulation/transvenous pacing
Chronic: permanent cardiac pacing

29

Rate control drugs

class II (beta) IV (CCB) - AV blocks
Digoxin - parasympathomimetic
Adenosin - membrane hyperpol

30

Rhythm control drugs

Class I, III
increase refractory period (block K) (Ia,III)
Decrease conduction velocity (block Na channels - I, III-amiodarone)