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Pharmac SPP > Antiarrhthmics > Flashcards

Antiarrhthmics Flashcards

1
Q

What are anti arrhythmic drugs

A

These are drugs clinically used to treat abnormalities with heart rate and rhythm

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2
Q

Heart rate

A

Number of heart beats in a minute
Normal heart rate is 60-100 bpm

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3
Q

What is heart rhythm

A

This is the pattern in which the heart beats
Normal heart rhythm is regular with atrium contracting before ventricles

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4
Q

List the the 3 things heart rate and rhythm are determined by

A

Excitation
Conduction
Contraction

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5
Q

What is excitability

A

Ability of heart cells to generate an impulse or action potential
They need to be able to convert their negative energy to positive energy internally

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6
Q

Conductivity

A

Ability of an excitable cell to be able to distribute its action potential / impulse to surrounding tissues

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7
Q

Contractility

A

Ability of an excitable cell to shorten in response to excitation

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8
Q

The heart is made up of two types of muscle tissue

A

Conducting muscle
Contractile muscle

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9
Q

List the conducting muscles

A

SA node
AV node
Bundle of His
Purkinje fibers

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10
Q

List the contractile muscles

A

Atrium
Ventricles

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11
Q

List the pattern of excitation in the conducting and contractile muscles

A

SA node gets excited first then spreads it to the atrium ( right and left) which goes ahead to contract, to the AV node which spreads it to the bundle of his , purkinje fibers then the ventricles which receive it last and go ahead to contract in response

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12
Q

What determines heart beat

A

Ventricular contraction

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13
Q

Contraction is determined by?

A

Excitation
The amount of times the SA node gets excited and conducts the impulse leading to contraction

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14
Q

What determines heart rhythm

A

The relationship between contraction in the atrium and contraction in the ventricle

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15
Q

Mechanism of excitation in conducting muscles occurs in how many phases

A

3 phases

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16
Q

List and explain the 3 phases of excitation in conducting muscles

A

Phase 0 : Ca influx which makes the cell go from negative to positively charged
Phase 3: K+ efflux cell goes back to being negative charged
Phase 4 : Ca2+\Na+ influx here the cell is still negatively charged but starts slowly becoming positively charged

The cycle keeps repeating itself

17
Q

T or F there is a resting membrane potential in excitation of conducting muscles

A

F

18
Q

Why is SA node said to be self excitatory

A

No resting membrane potential they are continuously going from depolarization to depolarization
Because of the phase 4

19
Q

How many phases are there in atrial and ventricular excitation

A

4 phases

20
Q

List the 4 phases in atrial and ventricular excitation

A

Phase 0: influx of Na+
Phase 1: efflux of potassium
Phase 2: prolonged influx of Ca2+ ion
Phase 3: efflux of K+
Phase 4: resting membrane potential Na+/k+ atpase

21
Q

During what phase of atrial and ventricular excitation does contraction occur

A

Phase 2

22
Q

Excitation in contractile tissues is the same as excitation in conducting tissues
T or F

A

F

23
Q

Most antiarrythmic drugs work at what level

A

Excitatory level

24
Q

Action potential of atrial and ventricular excitation is from what phase to what phase and resting membrane potential is what phase

A

Action potential: phase 0-3
Resting membrane potential: phase 4

25
Q

List aetiologic factors of arrhythmias

A

Heart disease
Genetic disorders
Drug induced
Fever
Anemia
Electrolyte imbalance
Thyroid disorders

26
Q

Pathophysiology of arrhythmias

A

Abnormal impulse generation :
1) automatic rhythm: enhanced or suppressed generation from sa node
Ectopic generation
2). Triggered rhythm : anemia, thyroid problems, drugs
Abnormal impulse conduction :
Conduction block : heart block, bundle branch block
Re-entry rhythm

27
Q

Classification of arrhythmias

A

Based on heart rate
Based on level of origin

28
Q

Based on heart rate:

A

Bradyarrythmias
Tachyarrythmias

29
Q

Based on level of origin

A

Supraventricular arrythmia : any other site asides ventricles sinus, atrial , nodal/ junctional

Ventricular arrhythmias

30
Q

Clinical features

A

Asymptomatic
Palpitations
Syncope
Dizziness
Chest pain
Generalized weakness
Dyspnea
Easy fatiguability
Excessive diaphoresis

31
Q

Diagnosis of arrhythmias

A

Pulse
Electrocardiogram

Others
FBC
Electrolyte, urea and creatinine
Thyroid function test
Urinalysis
Echocardiogram
Cardiac enzymes and troponin
Blood culture

32
Q

List the four main types of arrhythmias

A

Extra beats
Supraventricular tachychardias
Ventricular arrhythmias
Bradyarrhythmias

33
Q

Causes of arrhythmias

A

Arteriosclerosis
Coronary artery spasm
Heart block
Myocardial ischemia

34
Q

The slope of phase 0 is
Peak of phase 0 is

A

Conduction velocity
Vmax

Pharmac SPP (2 decks)

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