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NAPLEX > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

rate and rhythm of the heartbeat is set by the rapidly firing cells in the?

A

sinoatrial node

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2
Q

NSR originates in the?

A

SA node

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3
Q

what causes the atrium to contract

A

SA node

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4
Q

what causes the ventricles to contract

A

purkinje fibers

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5
Q

define supraventricular arrhythmia

A

originating above the AV node

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6
Q

define ventricular arrhythmia

A

originating below the AV node

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7
Q

define ventricular tachycardia

A

series of PVCs in a row resulting in a heart rate >100

also absence of peripheral pulse

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8
Q

which antiarrhythmics prolong the QT interval

A 
Class 1-especially 1a
class 3
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9
Q

common drugs that prolong QT interval (7)

A 
quinolones
macrolides
azoles
TCAs
SSRIs
5-HT3 receptor antagnoists
antipsychotics
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10
Q

when is a QTc considered prolonged

A

> 440 msec

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11
Q

How to remeber vaughan williams drug classes

A

Double Quarter Pounder, Lettuce, Mayo, Fries Please!

Because Dieting During Stress Is Always Very Difficult

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12
Q

Class 1a Vaughan williams

A

Disopyramide
Quinidine
Procainamide

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13
Q

Class 1b Vaughan Williams

A

Lidocaine

Mexiletine

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14
Q

Class 1c Vaughan Williams

A

Flecainide

Propafenone

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15
Q

Class 2 Vaughan Williams

A

Beta-blockers

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16
Q

Class 3 Vaughan Williams

A 
Dronedarone
Dofetilide
Sotalol
Ibutilide
Amiodarone
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17
Q

Class 4 Vaughan Williams

A

Verapamil

Diltiazem

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18
Q

Rate control for Afib

A

Beta blockers
Non-DHP
digoxin

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19
Q

Rhythm control for Afib

A

Class 1a, 1c, or 3 antiarrhythmics

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20
Q

Goal HR in symptomatic Afib

A

< 80

21
Q

Goal HR in asymptomatic Afib

A

<110

22
Q

Afib with HFrEF should not recieve

A

non-DHP

23
Q

Define paroxysmal Afib

A

terminates spontaneously or within 7 days of onset

24
Q

Define persistant afib

A

sustained > 7 days

25
Q

Define long-standing persistent afib

A

continuous > 12 months

26
Q

Define permanent afib

A

joint decision has been made to cease further attempts to restore or maintain NSR

27
Q

Define valvular afib

A

moderate to severe mitral stenosis or with a mechanical heart valve; long-term anticoagulation with warfarin is indicated

28
Q

Define non-valvular afib

A

without moderate to severe mitral stenosis or a mechanical heart valve

29
Q

Cardioversion and thromboembolism prophylaxis

A

started 3 weeks prior

continued for at least 4 weeks

30
Q

MOA of class 1 VW class

A

Na-channel blocker

31
Q

MOA of class 2 VW class

A

beta-blocker

32
Q

MOA of class 3 VW class

A

K-channel blocker

33
Q

MOA of class 4 VW class

A

CCB-non-DHP

34
Q

MOA of digoxin

A

Na-K-ATPase blocker

35
Q

MOA of adenosine

A

activates adenosine receptors to decrease AV node conduction

36
Q

What is the preferred antiarrhythmic used in HF

A

amiodarone

37
Q

What is the indication for adenosine

A

paroxysmal supraentricular tachyarrthmias (PSVTs)

38
Q

warning for amiodarone (6)

A 
pulmonary toxicity
hepatoxicity
proarrhythmic
hyper/hypothyroidism (hypo more common)
optic neuropathy
photosensitivity
39
Q

contraindication for amiodarone

A

iodine hypersensitivity

40
Q

Amiodarone and digoxin dosing

A

decrease digoxin by 50%

41
Q

Amiodarone and warfarin dosing

A

decrease warfarin by 30-50%

42
Q

Amiodarone and simvastatin and lovastatin dosing

A

simvastatin max 20 mg/day

lovastatin max 40 mg/day

43
Q

therapeutic range of digoxin with Afib

A

0.8-2 ng/mL

44
Q

which electrolytes levels can cause increased risk of digoxin toxicity

A

low K, Mg

High Ca

45
Q

Major SE for disopyramide

A

Anticholinergic effects

46
Q

Warning for quinidine

A 
hemolysis risk (avoid in G6PD deficiency)
Drug-induced lupus erthematosus
47
Q

Boxed warning for procainamide

A

agranulocytosis

drug-induced lupus erhtematosus

48
Q

Class 1b is used in what only

A

ventricular arrhythmias

no efficacy in afib

49
Q

Dronedarone boxed warning

A

increased risk of death, stroke, HF in pateints with decompensated HF or permanent Afib

NAPLEX (65 decks)

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