Arrhythmias and treatments

Question 1

What does paroxysmal mean?

Answer 1

Starts and ends abruptly

opposite of sustained

Question 2

What are the 5 classes of anti-arrhythmic drugs?

Answer 2

1- Sodium blockers
2 - beta blockers
3 - potassium blockers
4 - calcium blockers
5 - miscellaneous

Question 3

What is the vagal manoeuvre?

Answer 3

Carotid sinus massage or gentle eyeball pressure

Try if supraventricular tachycardias

Question 4

How can supraventricular tachycardias be treated?

Answer 4

IV esmolol or diltiazem
(or oral)
Vagal manoeuvre?

Question 5

What is the 1st line drug for atrial fibrillation?

Answer 5

Digoxin

Question 6

After digoxin, what other drugs can be used to treat atrial fibrillation?

Answer 6

Diltiazem

+/- Beta blockers - NEVER IN UNCONTROLLED CHF (worsens poor systolic function)

Question 7

At what heart rate does ventricular tachycardia require treatment?

Answer 7

> 200bpm

Question 8

How is ventricular tachycardia treated with emergency IV treatments?

Answer 8

Lidocaine
Esmolol
Amiodraone CRI

Question 9

What oral anti-arrhythmics can be used to treat ventricular tachycardia?

Answer 9

Sotalol
Magnesium chloride
(Amiodarone - hepatotoxic long term)

Question 10

What causes atrial standstill (type of bradycardia)

Answer 10

Hyperkalaemia

Question 11

What breed of dog and what endocrine condition are prediposed to atrial standstill?

Answer 11

WHWT
Addison’s - hyperkalaemia
(Consider urinary causes of hyper K)

Question 12

How can you test to see if bradyarrhythmias are vagally mediated?

Answer 12

Atropine response test

If >50% increase in HR, vagal mediated

Question 13

What is the life-threatening treatment for bradyarrhythmias?

Answer 13

Terbutaline - less risk of arrhythmias

Atropine?

Question 14

What oral medications can be used to treat bradyarrythmias?

Answer 14

Terubtaline
Theophylline
Propanetheline