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CVS > 10 Arrhythmia and Drugs > Flashcards

10 Arrhythmia and Drugs Flashcards

1
Q

What is the normal resting heart rate?

A

60 to 100bpm

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2
Q

What are the different causes of tachycardic arrhythmias?

A

Ectopic pacemaker
Afterdepolriations
Atrial fibrillation

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3
Q

When are do delayed afterdepolrization arise?

A

When intracellular calcium is high?

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4
Q

When do early afterrepolarization arise?

A

During repolarization

More likely in a prolonged action potential

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5
Q

In what conditions does atrial fibrillation arise?

A

Conditions that put extra stretch and pressure on the atria

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6
Q

What is the most common arrhytmia mechanism?

A

Re-entry

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7
Q

What is re-entry?

A

The wave of depolarization travels back to re-excite the area of muscle that has already contracted

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8
Q

What does re-entry often happen as a conseqeunce of?

A

Myocardial infarction

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9
Q

What 3 things are required for reentry?

A

the Presence of a unidirectional block

Critical timing

the Length of the effective refractory period of normal tissue

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10
Q

What diseases underlying mechanism involves the accessory conduction pathway?

A

Wolff-Parkinson-White syndrome

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11
Q

What different drugs are used to target rhythm and rate?

A

Voltage sensitive sodium channel blockers

Beta-adrenoreceptor antagonists

Potassium channel blockers

Drugs that block calcium channels

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12
Q

How do sodium channel blockers work?

A

Use dependent, only blocks voltage gated sodium channels that are open, therefore preferentially blocks damaged depolarised tissue

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13
Q

Name a sodium channel blocker?

A

Lidocaine

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14
Q

What do beta blockers do?

A

Block increase in pacemaker activity

Slow conduction

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15
Q

When are beta blockers used?

A

When catecholamine levels are, following a myocadial infarction

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16
Q

List some beta blockers

A

Atenolol

Propranolol

17
Q

Why are potassium channel blockers used?

A

Prolong the action potential by blocking potassium channels

18
Q

What is the problem with Potassium channel blockers?

A

Not used as in relality cause EADs

19
Q

What one potassium channel blocker is used?

A

Amiodarone

20
Q

Blocking calcium channels has what effect?

A

Decreases the slope of the action potential in the SA node

Decreases AV nodal conduction

Decrease force of contraction

21
Q

What does adenosine do?

A

Used to terminate supravetricular tachycardias

Enhances potassium conductance

22
Q

How do cardiac glycosides work?

A

Inhibit sodium/potassium pump ATPase, leading to an intracellular rise in sodium ions, leading to a decrease in acitivty of sodium calcium exchanger, causing an increase in, intracellular calcium concentration

23
Q

What are the actions of cardiac glycosides?

A

Increases the force of contraction

Slows heart rate

reduces the hearts oxygen consumption

24
Q

What nerve to cardiac glycosides have an effect on?

A

Cause an increase in vagal activity

25
Q

Vagal nerve is under what control?

A

Parasympathetic

26
Q

When are cardiac glycosides used?

A

Heart failure with arrhythmia

27
Q

What drugs increase myocardial activity?

A

Beta adreno-receptor agonists

28
Q

What drugs reduce the workload of the heart?

A

ACE inhibitors

Beta-adrenoreceptor antagonists

Diuretics

29
Q

What drugs are sued to treat angina?

A

Beta adreno receptors
calcium channel antagonists
Organic nitrates

30
Q

How do organic nitrates work?

A

Increase the formation of nitric oxide, increasing the formation of cGMP, decreases the amount of calcium, causes smooth muscle relaxation, get vasodilation

31
Q

Where is the primary action of organic nitrates?

A

ON the venous system?

32
Q

What is the benefit of causing venodilation in angina?

A

Reduces venous pressure and so reduces return of the blood to the heart, reduces preload, reduces how hard the heart has to work

CVS (22 decks)

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