17: Drugs & Arrythmia Flashcards
What are the 3 types of rhythm disturbances?
- Bradycardias (too slow)
- Tachycardias (too fast)
- Disorganised
What are 4 causes of bradycardias?
- Physiological
- Sinus node
- AV node
- Neural mediated
What are 3 causes of tachycardias?
- Atrial
- Junctional, SVT
- Ventricular
What are 3 types of cardiac devices and their clinical use?
- Pacemaker for slow heartbeats
- Defibrillator for fast heartbeats
- CRT for impaired ventricular performance (cardiomyopathy and LBBB)
What are the four main drug classes?
Class I - sodium channel agents (mostly blocking)
Class II - beta blockers
Class III - potassium channel blockers
Class IV - slow calcium channel blocker
At low doses sotalol has class __ activity but at high doses it has class ___
Class II, Class III
What is the relationship between vagal tone and arrhythmia?
- Can be a trigger
- Ask patients what they are doing when the arrhythmia comes on e.g. in bed at night
What are some important side effects of beta blockers?
- Fatigue
- Bradycardia
Amiodarine has an important interaction with which drug?
Warfarin
What is the mechanism of pro-arrhythmia?
- Prolongation of repolarisation
- Development of EADs which cause torsades, alteration in re entry pathways
What is the clinical use of adenosine?
Abortion of acute tachycardia in relatively low doses
What are the branches of AF treatment?
Rate and rhythm control
What are the treatment options for AF?
- Drug
- Device
- Intervention
- Drug: beta blockers, Ca antagonists, amiodraine, anticoagulants
- Device: pacemaker
- Intervention: ablation therapy
What are some of the side effects of amiodarone?
- Myalgias
- Gait disturbance
- Insomnia
- Prolongation of coagulation time
- Digoxin toxicity
What are some examples of amiodarone toxicity?
- Pulmonary fibrosis
- Hypo or hyperthyroidism
- Liver failure
- Bone marrow suppression
- Renal failure
- Photosensitivity
- Corneal deposits
