Calcium Channel Blockers

Question 1

• are like valium to your heart
• they relax and slow down the heart
• have negative inotropic, chronotropic, dromotropic effects on the heart

Answer 1

Calcium Channel Blockers

Question 2

What is the effects of

(+) POSITIVE
Inotropy,
Chronotropy,
Dromotropy

Answer 2

Positive Inotropy: increase cardiac contractile force -> ventricles empty more completely -> cardiac output improved

Positive chronotrophy: increase rate of impulse formation at SA node -> accelerate heart rate

Positive dromotropy: increase speed that impulses from SA node travel to AV node (increase conduction velocity)

Question 3

What is the effects of

(-) NEGATIVE
Inotropy,
Chronotropy,
Dromotropy

Specially Of Calcium Channel Blockers (CCBs)

Answer 3

Negative inotropy: weaken/decrease the force of myocardial contraction

Negative chronotropy: decrease rate of impulse formation at the SA node -> decelerte heart rate

Negative dromotropy: decrease speed that impulses from SA node travel to AV node (decrease conduction velocity)

Question 4

When do you want to relax and slow down the heart?

Answer 4

To treat A, AA, AAA

1. Antihypertensive (blood vessel dilation)
2. AntiAnginal drugs (decreasing oxygen demand, relaxes the heart)
3. AntiAtrialArrhyhmia (A flutter, Afib, PACs, Atach, A bigeminy, SVT-originates in atria)

Question 5

What are side effects of CCBs

Answer 5

Headache and vasodilation

Question 6

Name CCBs

Answer 6

• name ends in (-dipine)… NOT “pine”
• also Verapamil, Cardizem (diltiazem)
  *Cardizem (diltiazem) is given continous IV drip

Question 7

What are parameters to assess before putting a pt on CCBs?

Answer 7

1. Assess for BP
2. Hold if SBP is <100

Question 8

What do you call the rhythm where
• There is a P wave, followed by a QRS, followed be a T wave for every complex
• Peaks of the P wave is equally distant to the QRS, and fall within 5 small boxes

Answer 8

Normal Sinus Rhythm

Question 9

It is a heart rhythm with no patterm

Answer 9

Ventricular Fibrillation

Question 10

It is a heart rhythm with sharp peaks with a pattern

Answer 10

Ventricular Tachycardia

Question 11

Flat Line

Answer 11

Asystole

Question 12

What to do in asystole

Answer 12

1. Start CCPR
2. Epi then Athropine

*non shockable rhythm

Question 13

If a question mentions QRS depolarization, it is ____________

Answer 13

Ventricular

Question 14

If a question mentions P wave, it is ____________

Answer 14

Atrial

Question 15

What are the 6 rhythms most commonly tested on NCLEX

Answer 15

1. A lack of QRS complexes is asystole—a flat line
2. P waves (atrial) in the form of saw tooth wave = atrial flutter
3. Chaotic P wave patterns = atrial fibrillation (a-fib)
   (Chaotic: word used to describe fibrillation)
4. Chaotic QRS complexes = ventricular fibrillation (v-fib)
5. Bizarre QRS complexes = ventricular tachycardia (v-tach)
   (Bizarre: word used to describe tachycardia)
6. Periodic wide bizarre QRS complexes = PVCs (Salvos of PVCs = A short runs of v-tach)

Question 16

PVCs (premature ventricular contractions) are usually low priority.
However, evelate them to moderate priority in under 3 circumstances…

Answer 16

1. Thre are 6 or more PVCs in a minute
2. More than 6 PVCs in a row
3. R on T phenomenon (a PVC falls on a T wave)

*PVCs after an MI is common and is a low priority (sign of reperfusion)

Question 17

What are 2 lethal arrhythmias that are high priority because it can kill a pt in 8 mins or less?
Both rhythms produce low or no cardiac output (CO), without which there is inadequate or no brain perfusion. This may lead to confusion and death

Answer 17

Asystole and A-fib

Question 18

It is a potentially lethal cardiac arrhythmia but it has CO

Answer 18

V-tach

Question 19

What is the treatment of PVCs and V-tach

Answer 19

Lidocaine
Or Amiodarone

*both are ventricular rhythms

Question 20

If the arrhythmia is ATRIAL (including SVTs)… what do we treat it with?

Answer 20

We treat Atrial Arrhythmias with “ABCDs”

A - Adenocard (Adenosine)… FASSST IV push (push in less than 8 seconds and 20 mL NS flush right after)… These pts will gop into asystole for about 30 seconds and out of it
B - Beta-clockers… These pts will go into aystole for about 30 seconds and out of it (((we use this with people with COPD because CCBs can cause bronchocontriction)
C - CCBs (decrease HR and decrese QRS)
D - Digitalis (Digoxin)m, Lanoxin (another digitalis analog)

Question 21

________ have negative inotropic, chronotropic, dromotropic effects on the heart. They treat A, AA, AAA
- antihypertensive
-antianginal (decrease oxygen demand)
- atriantrial arthmia

Side effects = headache and hypotension
*similar to CCBc

Answer 21

BETA BLOCKERS

Question 22

What is the Tx for Atrial arrhytmnias

Answer 22

ADCD

Adna
Beta
Calcium
Dig

Question 23

What are the Tx for Ventricular arrhythmias

Answer 23

Lidocaine
Amiodarone

Question 24

It is a low molecular weight-based heparin (LMWH) indicated for VTE prophylaxis following surgery

It is given subcutaneously, usually via a prefilled syringe

Answer 24

Enoxaparin

Question 25

What is Verapamil class, indication?

Answer 25

Class: CCB Indication: Prevent migraine headaches and treat vasospasm

Question 26

When is Tranexamic acid used

Answer 26

It promotes clotting and may hasten VTE, it is used before surgical procedures where significant blood loss is expected