Cardiac Arrhythmias

Question 1

What labs should be ordered when a cardiac arrhythmia is suspected?

Answer 1

CBC, CMP, TSH, and medication levels such as Digoxin

Question 2

What causes systole?

Answer 2

Ventricular contraction

Question 3

Fatigue is especially present in which arrhythmia?

Answer 3

Atrial fibrillation

Question 4

Who is an electrophysiology referral done by?

Answer 4

Cardiology

Question 5

What are the class I drugs for tachyarrhythmias?

Answer 5

Sodium channel blockade drugs

Question 6

Name the 3 sodium channel blockade drugs from class Ia

Answer 6

Quinidine, Procainamide, Disopyramide

Question 7

Name the 3 sodium channel blockade drugs from class Ib

Answer 7

Lidocaine, Mexiletine, Tocainide

Question 8

Name the 3 sodium channel blockade drugs from class Ic

Answer 8

Flecainide, Propafenone, Moricizine

Question 9

What are the class II drugs for tachyarrhythmias?

Answer 9

Beta-blockers

Question 10

What are 3 selective beta-blockers?

Answer 10

Atenolol, Bisoprolol, Metoprolol

Question 11

What are 2 non-selective beta-blockers?

Answer 11

Nadolol, Propranolol

Question 12

What are the class III drugs for tachyarrhythmias?

Answer 12

Potassium channel blockers

Question 13

Name 5 potassium channel blockers from class III

Answer 13

Sotalol, Dofetilide, Ibutilide, Amiodarone, Bretylium

Question 14

What are the class IV drugs for tachyarrhythmias?

Answer 14

Calcium channel blockers

Question 15

Name 4 dihydropyridine calcium channel blockers

Answer 15

Amlodipine, Felodipine, Nicardipine, Nifedipine

Question 16

Name 2 non-dihydropyridine calcium channel blockers

Answer 16

Dilitazem, Verapamil

Question 17

Non-dihydropyridines affect which nodes?

Answer 17

SA and AV node

Question 18

What is the 1st intervention for a narrow-complex PSVT?

Answer 18

Carotid massage (caution with carotid plaque if present) or vagal maneuvers

Question 19

What medication is used for narrow-complex PSVT that should be used with caution in asthmatic patients?

Answer 19

Adenosine

Question 20

Which 2 drugs affect the AV node and can reduce the rate in narrow-complex PSVT?

Answer 20

Diltiazem or Verapamil

Question 21

What 3 drugs are used to slow AV conduction in narrow-complex PSVT?

Answer 21

Digoxin, CCBs, BBs

Question 22

Which class of antiarrhythmics can be used to suppress atrial automaticity?

Answer 22

Class Ia sodium channel blockers (Quinidine, Procainamide, Disopyramide), Class Ic sodium channel blockers (Flecainide, Propafenone, Moricizine), or Class III potassium channel blockers (Sotalol, Dofetilide, Ibutilide, Amiodarone, Bretylium)

Question 23

What are the 3 main components in treating atrial fibrillation or atrial flutter?

Answer 23

1. Anticoagulation for stroke prevention
2. Rate control
3. Rhythm control

Question 24

Which drugs could be used for rate control?

Answer 24

BBs, Diltiazem, Verapamil, Digoxin, or combination therapy

Question 25

Stroke risk is measured using what score?

Answer 25

CHA2DS2-VASc score

Question 26

What CHA2DS2-VASc score or prior history requires anticoagulation?

Answer 26

Score of 2 or prior stroke

Question 27

What alternative medicine can affect the effectiveness of drugs used in atrial fibrillation or atrial flutter?

Answer 27

CBD oil

Question 28

Which drug can be used for a temporary increase in atrial rate but not for AV dysfunction?

Answer 28

Atropine

Question 29

Atropine should be used with caution in MI or ACS due to:

Answer 29

Risk of worsening ischemia