Arrythmias Flashcards
What are select drugs that can increase or prolong the QT interval?
What is the mnemonic for von williams classification?
What are your antiarrythmics?
Class 1a and Class 3(also other class 1), Quinolones and Macrolides, Tricyclics, Citalopram, Escitalopram, Setraline is preferred in cardiac patients, 5-HT3 receptor antagonists, droperidol, haloperidol, thioridazine and ziprasidone, fingolimod and methadone.
Double Quarter Pounder, Lettuce, Mayo, Fries, Please! Because Dieting, During, Stress, Is, Always, Very, Difficult?
Disopyramide, Quinidine, Procainamide, Lidocaine, Mexiletine, Flecainide, Propafenone, Beta blockers, Dronedarone, Dofetilide, Sotalol, Ibutilide, Amiodarone, Verapamil, Diltiazem.
What drugs give you rate control?
When do you anticoagulate with cardioversion?
How do Class 1 antiarrythmics work?
Beta blockers or the class 4, non DHP CCB’s. Don’t give a non DHP calcium channel blocker to patients with HFrEF
3 weeks before and 4 weeks after. 2-3 is goal INR.
Na-channel; blockers, negative inotrope.
How do class 2 work?
How do class 3 work?
How does class 4 work?
Beta blockers
K-channel, amiodarone is preferentially used in HR, Sotalol blocks K-channels and is a beta blocker
Ca-channel, non dhp. Slow the rate do not use the nonDHP in HFrEF
How does digoxin work?
How does adenosine work?
What to know about Amiodarone?
Na-K-ATPase blocker, increase force of cardiac conduction(inotrope positive), lowers heart rate(negative chronotrope)
Activates adenosine receptors, used for PSVT’s.
Pulmonary and hepatoxicity, hospitalized during loading dose. NON PVC container, watch for hypo and hyperparathyroidism, blue skin, optic neuropathy, dizziness, bradycardia, hypotension, ataxia, N/V, constipation, tremor, contains iodine.
Do you ever use sofosbuvir and amiodarone together?
What to know about class 4 non DHP’s?
What to know about digoxin?
NO! Can enhance bradycardic effect.
Diltiazem(cardizem), Verapamil, Edema, HA, dizziness, hypotension, arrhythmias, HF, constipation( with verapamil), gingival hyperplasia. Use with statins not metabolized by CYP3A4(pravastatin, rosuvastatin, pitavastatin).
Digitek, digox, lanoxin. typical dose is 0.125-0.25 and therapeutic range is 0.8-2.Lower dose or frequency when CrCl <50, decrease dose by 20-25% when going from oral to IV. Antidote is digifab. Watch for toxicity and greenish-yellow halos.
What to know about disopyramide?
What to know about Quinidine?
What to know about Procainamide?
Anticholinergic effects.
Take with Food, watch for DILE, avoid in G6PD deficiency, COOMBS test, diarrhea(35%), stomach cramping(22%), cinchonism(tinnitus, hearing loss, blurred vision, headache, delirium
Active NAPA is renally cleared, agranulocytosis, ANA, DILE
Do 1B drugs help afib?
What to know about Lidocaine?
What to know about Flecainide?
NO, only ventricular arrhythmias.
Refractory VT/Cardiac Arrest
Proarrythmic, CI’d in heart failure and MI.
What to know about Propafenone(Rythmol)?
What to know about Dronedarone(Multaq)?
What to know about Sotalol?
CI’d in heart failure, myocardial infarction. Proarrythmic and taste disturbance(metallic).
Increased risk of death, stroke, and HF in patients with decompensated HF or permanent afib. Hepatic failure, pulmonary disease(including pulmonary fibrosis), QT prolongation, avoid in use with CYP3A4 drugs and drugs that prolong the QT. Dronedarone does not contain iodine and does not affect the thyroid like amiodarone does.
Non-selective,decrease frequency in CrCl <60,
What to know about ibutilide(corvert)?
What to know about dofetilide(tikosyn)?
What to know about Adenosine(adenocard)?
hypokalemia and magnesemia
must be initiated with continuous ecg monitoring, assess CrCl for a minimum of 3 days, proarrythmic.
T1/2 is less than 10 seconds, used in PSVT’s.
What is the hearts normal cardiac conduction pathway?
What labs increase the risk of digoxin toxicity?
SA node–> AV node–> Bundle of HIS–> Right and Left bundle branches–> Purkinje Fibers
Hypokalemia, magnesemia, and hypercalcemia
