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Cardiovascular, Renal and Peripheral Pharmacology > Tachyarrhythmias > Flashcards

Tachyarrhythmias Flashcards

1
Q

what does SVT stand for

A

supraventricular tachycardia

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2
Q

what does SVT involve

A

SAN, AVN, atria

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3
Q

5 types of SVT

A
  1. PSVT (paroxysmal supraventricular tachycardia)
  2. AVNRT (atrioventricular nodal re-entrant tachycardia)
  3. AVRT (atrioventricular reciprocating tachycardia)
  4. AF (atrial fibrillation)
  5. Atrial flutter
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4
Q

4 drugs that can treat PSVT

A

adrenaline, verapamil (4), diltiazem (4), amiodarone (3)

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5
Q

can get ventricular tachycardias which involve

A

Bundle of His, Purkinje Fibres and ventricles

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6
Q

what is more dangerous SVTs or VTs?

A

VTs

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7
Q

4 drugs mainly used to treat VT

A

amiodarone (3), flecainide (1c), disopyramide (1a) and lidocaine (1b)

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8
Q

what does VF stand for

A

ventricular fibrillation

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9
Q

5 different factors that can cause tachyarrhythmias

A

pre-existing CV diseases, electrolyte imbalance, drugs, emotions and lifestyle choices AND genetic disorders

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10
Q

6 types of drugs that can cause tachyarrhytmias

A
  1. asthma inhalers
  2. anti arrhythmias
  3. anti-hypertensive (this is a reflex reaction)
  4. antifungals
  5. antibiotics
  6. antihistamines
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11
Q

3 main mechanisms for tachyarrhythmias

A
  1. re-entry (AVNRT, micro re-entry and macro re-entry)
  2. EADs
  3. DADs
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12
Q

tachyarrhythmias are caused by…

A

sympathetic overactivity and an abnormal pacemaker

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13
Q

what does the re-entry mechanism cause?

A

paroxysmal supraventricular tachycardia

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14
Q

how to treat PSVT

A 
Class 4: verapamil
Class 2: beta blockers
Class 3: sotalol
Class 1c: flecainide 
Adenosine
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15
Q

what is micro-re-entry?

A

similar to AVNRT but occurs in the ventricular myocardium and purkinje fibres

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16
Q

what causes micro-re-entry

A

focal ischaemia or infarction

17
Q

if a pulse is present, then use:

A

amiodarone (3), flecainide (1c) or lidocaine (1b)

18
Q

which class of anti-arrhythmic drugs are not effective for ventricular tachycardia

A

class 4

19
Q

what is macro re-entry ?

A

re-entry via congenital accessory pathway between the atria and ventricles

20
Q

example of a macro re-entry disease

A

Wolff-Parkinson-White syndrome - caused by an abnormal pathway completely missing the SA node

21
Q

how to treat macro re-entry

A

CATHETER ABLATION or flecainide (1c) or amiodarone (3)

22
Q

what drugs are not effective in AVRT

A

AVN blockers

23
Q

what is another way of saying macro re-entry

A

AVRT

24
Q

what does EAD stand for?

A

early after depolarisation

25
Q

what does DAD stand for

A

delayed after repolarisation

26
Q

what causes EADs

A

the prolonging of the cardiac AP

27
Q

what class of anti-arrhythmics can cause EADs

A

Class 3, 1a OR medicine that is know to inhibit repolarising K channels in phase 3 of the cardiac AP

28
Q

during prolonged AP, are the Na channels activated?

A

no

29
Q

what channel triggers the EAD

A

the L-type Ca channels in the heart can still recover and trigger EAD

30
Q

what happens to the heart rate during an EAD

A

slows down

31
Q

EADs can trigger

A

TdP, a type of ventricular tachycardia

32
Q

what are DADs due to

A

calcium build up in the cardiac myocyte that doesn’t have enough time to recover to basal level in between APs

33
Q

what promotes a Ca build up in the cell?

A

fast HR

34
Q

drugs that increase Ca release

A

caffeine

35
Q

another cause of DAD

A

digoxin overdose

36
Q

what causes atrial fibrillation

A

micro re-entry or EADs

37
Q

drug used to control the rate of atrial fibrillation

A

digoxin

38
Q

what can be used to treat EADs and DADs

A 
class 2 - beta blockers
class 1c - flecainide
class 3 - amiodarone
class 4 - diltiazem

Cardiovascular, Renal and Peripheral Pharmacology (13 decks)

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