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therapeutics 3 - exam 2 > arrhythmias pt 6 > Flashcards

arrhythmias pt 6 Flashcards

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1
Q

what is the treatment of choice for sinus bradycardia?

A

only if symptomatic –> atropine

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2
Q

what is the treatment of choice for AF –> ventricular rate control?

A

BB, diltiazem, or verapamil for pts w/o HFrEF
BB with or w/o concomitant digoxin for HFrEF pts

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3
Q

what is the treatment of choice for AF (conversion to sinus rhythm) in HFrEF pts?

A

oral amiodarone, ibutilide (not if LVEF under 30%), or dofetilide

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4
Q

what is the treatment of choice for AF (conversion to sinus rhythm) for pts with normal EF?

A

oral amiodarone, dofetilide, oral flecainide (single loading dose), oral propafenone, or ibutilide

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5
Q

what is the treatment of choice for pts without structural HD for AF (maintenance of sinus rhythm)?

A

dofetilide, dronaderone, flecainide, propafenone, sotalol, or catheter ablation

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6
Q

what is the treatment of choice in CAD pts for AF (maintenance of sinus rhythm)?

A

dofetilide, dronaderone, sotalol, or catheter ablation

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7
Q

what is the treatment of choice in HFrEF pts for AF (maintenance of sinus rhythm)?

A

amiodarone, dofetilide, catheter ablation

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8
Q

what is the treatment of choice for AF (stroke/systemic embolism prevention) and CHADS-VASc score of 2+?

A

dabigatran
rivaroxaban
apixaban
edoxaban

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9
Q

when is warfarin the treatment of choice for AF (stroke/systemic embolism prevention)?

A

if pt has mechanical heart valve or valvular AF (mitral valve stenosis)
if pt is on hemodialysis or has end-stage CKD (not on hemodialysis) (could also be apixaban)

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10
Q

what is the treatment of choice for SVT (acute termination)?

A

adenosine
if ineffective –> BB, diltiazem, or verapamil

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11
Q

what is the treatment of choice for SVT (prevention of recurrence)?

A

catheter ablation
OR
normal EF –> BB, diltiazem, or verapamil
HFrEF –> amiodarone, digoxins, dofetilide, or sotalol

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12
Q

what is the treatment of choice for asymptomatic PVCs?

A

no treatment

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13
Q

what is the treatment of choice in symptomatic PVCs in pts without HFrEF?

A

BB
diltiazem
verapamil

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14
Q

what is the treatment of choice for symptomatic PVCs in HFrEF pts?

A

BB

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15
Q

what is the treatment of VT (acute termination) in pts with structural HD?

A

DCC or procainamide

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16
Q

what is the treatment of choice in VT (acute termination) with no structural HD, but verapamil-sensitive?

A

verapamil

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17
Q

what is the treatment of choice for VT (acute termination) in pts with no structural HD, but with out flow tract VT?

A

BB

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18
Q

what is the treatment of choice in VF?

A

defibrillation
Epi
IV amiodarone

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19
Q

what is the treatment of choice in VT or VF (prevention of recurrence)?

A

ICD
amiodarone or sotalol

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20
Q

in what cases should DCC be used?

A

if hemodynamically unstable in VT (acute termination), SVT (acute termination), and AF (conversion to sinus rhythm)

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21
Q

what are the indications and AE associated with adenosine?

A

SVT
AE –> CP, flushing, SOB, sinus pauses

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22
Q

what are the indications and AE of aminophylline?

A

SB in pts after heart transplant or spinal cord injury
AE –> AF, CP, dizziness, seizures, syncope, tachycardia, tremor, V

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23
Q

what are the indications of amiodarone?

24
Q

what is the AE of amiodarone by dosage form?

A

IV –> hypotension, bradycardia
PO –> blue grey skin discoloration, photosensitivity, corneal microdeposits, pulmonary fibrosis, hepatoxicity, bradycardia, thyroid dysfunction

25
Q

what are the indications and AE of atropine?

A

SB
AE –> tachycardia, urinary retention, blurred vision, dry mouth, mydriasis

26
Q

what are the indications and AE of digoxin?

A

AF, SVT
AE –> NV, anorexia, ventricular arrhythmias

27
Q

what are the indications and AE of diltiazem?

A

AF, SVT
AE –> hypotension, bradycardia, HF exacerbation, AV block

28
Q

what are the indications and AE of dofetilide?

A

AF
AE –> TdP

29
Q

what are the indications and AE of dronedarone?

A

AF
AE –> bradycardia, ND, asthenia, rash

30
Q

what are the indications and AE of esmolol?

A

AF, SVT
AE –> hypotension, bradycardia, AV block, HF exacerbation

31
Q

what are the indications and AE of flecainide?

A

AF
AE –> dizziness, blurred vision, HF exacerbation

32
Q

what are the indications and AE of ibutilide?

A

AF
AE –> TdP

33
Q

what are the indications and AE of lidocaine?

A

VF
AE –> confusion, seizures

34
Q

what are the indications and AE of metoprolol?

A

AF, PVCs
AE –> hypotension, bradycardia, AV block, HF exacerbation (tart only)

35
Q

what are the indications and AE of procainamide?

A

VT
AE –> hypotension, TdP

36
Q

what are the indications and AE of propafenone?

A

AF
AE –> dizziness, blurred vision

37
Q

what are the indications and AE of propranolol?

A

AF, PVCs
AE –> hypotension, bradycardia, AV block, HF exacerbations

38
Q

what are the indications and AE of sotalol?

A

AF, VT
AE –> B-blockade, TdP

39
Q

what are the indications and AE of theophylline?

A

SB in pts after heart transplant or spinal cord injury
AE –> AF, CP, dizziness, seizures, syncope, tachycardia, tremor, V

40
Q

what are the indications and AE of verapamil?

A

AF, SVT
AE –> hypotension, HF exacerbation, bradycardia, AV block, constipation (oral)

41
Q

what is the dosing of adenosine?

A

6mg IV over 2 minutes, 12mg IV over 2 minutes, 12mg IV over 2 minutes if necessary

42
Q

what is the dosing of amiodarone in VF?

A

300 mg IV/IO diluted in 20-30mL D5W

43
Q

what is the dosing of lidocaine in VF?

A

1-1.5 mg/kg IV/IO

44
Q

what is the dosing of dofetilide?

A

based on CrCl
over 60 –> 500 mcg BID
40-60 –> 250 mcg BID
20-40 –> 125 mcg BID
under 20 –> CI

45
Q

what is the dosing of sotalol?

A

80-120 mg BID

46
Q

what IV drugs are most likely to cause hypotension?

A

VD
procainamide
amiodarone

47
Q

what drugs are most likely to cause HFrEF exacerbation?

A

Flecainide
V
BB in unstable pts

48
Q

what drugs are most likely to cause bradycardia?

A

VD
BB
digoxin
amiodarone
dronedarone

49
Q

what drugs are most likely to cause proarrhythmias aka TdP?

A

ibutilide
dofetilide
sotalol
procainamide

50
Q

what drugs are most likely to cause GI issues?

A

aminophylline
amiodarone (during oral loading phase)
digoxin (in toxicity)
dronedarone
theophylline

51
Q

what drug is most likely to cause constipation?

52
Q

what drug is more likely to cause CNS toxicity?

A

digoxin (confusion)
amiodarone (tremor)

53
Q

what drugs are most likely to cause dizziness/blurred vision?

A

flecainide
propafenone

54
Q

what are the unique AE of amiodarone that no other drugs have?

A

hepatotoxicity
pulmonary fibrosis
hypo/hyper thyroidism
corneal micro deposits
photosensitivity and/or blue-grey skin discoloration

55
Q

what drug is most likely to cause flushing/CP?

therapeutics 3 - exam 2 (13 decks)

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