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Cardiovascular > Arrhythmia - therapy > Flashcards

Arrhythmia - therapy Flashcards

1
Q

What is an arrhythmia?

A

Any deviation from the normal rhythm of the heart

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2
Q

What are the different types of arrhythmias?

A

Sinus arrhythmia

Supraventricular arrhythmia

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3
Q

What causes supraventricular arrhythmia?

A

Atrial fibrillation

SVT

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4
Q

What causes ventricular arrhythmia?

A

Ventricular tachycardia

Ventricular fibrillation

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5
Q

What are class IA, IB and IC drugs?

A

Fast, intermediate and slow sodium channel blockers

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6
Q

Give examples of class IA drugs

A

Quinidine
Procainamide
Dispyramide

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7
Q

Give examples of class IB drugs

A

Lidocaine
Mexiletine
Tocainide

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8
Q

Give examples of class IC drugs

A

Flecainide

Propafenone

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9
Q

Give examples of class II drugs

A

Atenolol

Bisoprolol

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10
Q

Give examples of class III drugs

A

Amiodarone
Bretylium
Sotalol

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11
Q

Give examples of class IV drugs

A

Diltiazem

Verapamil

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12
Q

What are class II drugs?

A

Beta blockers

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13
Q

What are class III drugs?

A

Prolong refractoriness by reducing or blocking sympathetic nervous system stimulation

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14
Q

What are class IV drugs?

A

Calcium channel blockers

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15
Q

What is the first line of medication for Atrial fibrillation?

A

Class II drugs such as atenolol or bisoprolol

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16
Q

Name the antidysrythmics that don’t fit into one class

A

Digoxin

Adenosine

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17
Q

How does Digoxin work?

A

Inhibits the sodium-potassium ATPase pump so has a positive inotropic effect, improving strength of cardiac contraction

18
Q

What has to be monitored when using Digoxin?

A

Potassium levels

Drug interactions

19
Q

What are the signs of Digoxin toxicity?

A 
Nausea 
Vomiting 
Xanthopsia 
Bradycardia 
Tachycardia 
Arrhythmia - VT and VF
20
Q

What is the treatment for Digoxin toxicity?

A

Stop Digoxin

Give Digibind if levels of Digoxin are very high

21
Q

When is Digoxin toxicity most serious?

A

When Potassium levels are low

22
Q

How does adenosine work?

A

Slows conduction through the AV node so turns paroxysmal supraventricular tachycardia to sinus rhythm

23
Q

How should adenosine be administered?

A

Fast IV push

24
Q

What can adenosine cause for a few seconds?

A

Asystole

25
Q

What can all antiarrhythmics cause?

A

Arrhythmias

26
Q

Name some anticoagulants

A 
Warfarin 
Dabigatran 
Rivaroxaban 
Apixaban 
Edoxaban
27
Q

What are anticoagulants used for?

A 
Valvular heart disease 
Atrial fibrillation 
Thromboembolism 
Deep vein thrombosis risk  
After surgery
28
Q

When is atrial fibrillation most common?

A

After the age of 60

29
Q

How does Warfarin work?

A

Inhibits production of active clotting factors

30
Q

What drugs promote warfarin activity?

A 
Aspirin 
Sulfonamides 
Cimetidine 
Disulfiram 
Oral antibiotics 
Heparin antimetabolites
31
Q

What drugs decrease warfarin activity?

A

Barbiturates
Phenytoin
Vitamin K
Cholestyramine

32
Q

What are the adverse effects of warfarin?

A

Bleeding

Teratogenic

33
Q

When should the use of warfarin be avoided in pregnancy?

A

First and third trimesters

34
Q

What should be done when monitoring warfarin therapy?

A

Regular INR
Patient education
Alcohol intake
Watch if altered therapy

35
Q

How is the risk of bleeding assessed with warfarin?

A 
CHADS2 score 
Congestive heart failure 
Hypertension 
Age >75 years 
Diabetes Mellitus 
Stroke or TIA
36
Q

What are class I drugs?

A

Membrane-stabalizing agents

37
Q

What are class II drugs used for?

A

General myocardial depressants for both supra ventricular and ventricular dysrhythmias

38
Q

What are class III drugs used for?

A

Used for difficult dysrhythmias such as:
Life threatening ventricular tachycardia or fibrillation
Atrial fibrillation or flutter
Sustained ventricular tachycardia

39
Q

What are class IV drugs used for?

A

Paroxysmal supra ventricular tachycardia

Rate control for atrial fibrillation and flutter

40
Q

What is Amiodarone used for?

A

Ventricular tachycardia

Supra ventricular tachycardia

41
Q

What are the side effects of amiodarone?

A 
Thyroid problems 
Pulmonary fibrosis 
Slate
Corneal deposits 
LFT abnormalities

Cardiovascular (34 decks)

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