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Clinical Pharmacology > Cardiac Arrhythmias > Flashcards

Cardiac Arrhythmias Flashcards

1
Q

what causes bradycardia

A

sinus bradycardia or conduction block

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2
Q

what is an arrhythmia

A

a disturbance in the cardiac cycle due to abnormal pacemaker activity or conduction/contraction of the heart muscle leading to an insufficient cardiac output

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3
Q

describe the electrical action potential seen in ventricular myocytes

A

influx of Na causes depolarisation
small amount fo repolarisation due to K efflux
plateau stage where there is no change in electrical charge due to equal influx of Ca and efflux of K
depolarisation due to K efflux
Na/K ATPase sets up membrane potential in refractory period

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4
Q

describe the action potential seen in SAN cells

A

funny current/pacemaker potential occurs where there is slow depolarisation due to Na influx through HCN channels
Ca influx then causes rapid depolarisation
repolarisation due to K efflux

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5
Q

what can cause tachycardia

A 
ectopic activity 
fibrillations 
after depolarisations 
re-entry loops 
wolff-parkinson-white syndrome
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6
Q

what are ectopic beats

A

where points away from the SAN fire electrical impulses - these can be ventricular or supra ventricular

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7
Q

what can cause ectopic beats

A

damage to the heart e.g. in ischaemia
mitral valve disease - stenosis causes dilation of atrial and regurgitation causes irritation of atria
high blood pressure

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8
Q

what are after depolarisations

A

where there are abnormal depolarisation of the myocytes

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9
Q

what are early after-depolarisations

A

where there is abnormal depolarisation in phase 2/3 of the normal action potential

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10
Q

what are late after-depolarisations

A

where there is abnormal depolarisation in phase 4 of the normal action potential

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11
Q

what can after-depolarisations result in

A 
long QT (Torsades de point)
scarring of the tissue
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12
Q

what are re-entry loops

A

where an impulse is blocked and so travels backwards and re-excites the tissue it give came from giving a new action potential in quick succession

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13
Q

what is wolff-parkinson-white syndrome

A

where there is abnormal electrical conduction in the heart and the impulse travels down the bundle of Kent giving a fast heart rate

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14
Q

what are fibrillations

A

uncoordinated and irregular heart beats in either the atria or ventricles, often resulting in tachycardia

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15
Q

what are the causes of fibrillations

A

ectopic beats
high blood pressure
mitral valve disease

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16
Q

what is atrial flutter

A

irregular heart beats from the atria which are less chaotic than those seen in AF

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17
Q

why must anticoagulants be given with AF

A

as there is increased risk of clot formation and so stroke

18
Q

give 3 examples of sodium channel blockers

A

IA - quinidine
IB - lidocaine
IC - flecainide

19
Q

what do sodium blockers do

A

cause depolarisation to occur more slowly helping to control the rhythm of the heart

20
Q

what do beta blockers do

A

block sympathetic activation of SAN cells by decreasing the slope of the funny current - therefore they control the rate of impulse generation

21
Q

give some examples of beta blockers

A

propanolol and bisoprolol

22
Q

what do potassium blockers do

A

control the rhythm of the heart by increasing the refractory period

23
Q

give 2 examples of potassium blockers

A

amiodarone and sotalol

24
Q

what do calcium blockers do

A

slow down the heart rate - therefore are rate controlling

25
Q

what are the rate controlling drugs

A

calcium and beta blockers

26
Q

what are the rhythm controlling drugs

A

Na and K blockers

27
Q

give an example of a Ca blocker

A

verapamil

28
Q

what is used to treat AF

A
  1. rate controlling drugs with digoxin

2. Rhythm controlling drugs.

29
Q

what are beta blockers used for

A

rate control in AF

tachycardia

30
Q

what are calcium blockers used for

A

rate control in AF

tachycardia

31
Q

what is amiodarone used for

A

any arrthymia

32
Q

what are the side effects of amiodarone

A

pulmonary fibrosis, hepatic damage, thyroid disease and increased LDL

33
Q

what is sotalol used for

A

tachycardia

rhythm control in AF

34
Q

what are the side effects of sotalol

A

increased QT (Torsades de Points)

35
Q

what is adenosine used for

A

diagnosis for coronary artery disease

supra-ventrciular tachycardia

36
Q

what does adenosine do

A

stops the heart for 20 seconds

37
Q

what is digoxin used for

A

AF

38
Q

how does digoxin work

A

inhibits Na/K/ATPase so slows down the heart rate

39
Q

what is used to treat Wolff-parkinson-white syndrome

A

flecainide

40
Q

what is lidocaine used to treat

A

tachycardia due to ischaemic heart disease

41
Q

can flecanide be used on its own

A

no - will increase the hearts response to supra-ventriulcar arrhythmias causing an increase in heart rate - so needs to be used with AVN blocker

Clinical Pharmacology (18 decks)

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