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Pharm > Cardiac Arrythmias > Flashcards

Cardiac Arrythmias Flashcards

End Test 2

1
Q

List the different types of arrhythmias

A

Bradycardia

Block
-1st degree
-2nd type 1 & 2nd type 2
-3rd degree

Tachycardia
- SVT
-Atrial
-Sinus
-VTach

Fibrillation
-Atrial
-Ventricular

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2
Q

Illustrate the intrinsic conduction system and subsequent EKG reading.

A

Sinoatrial node/packemaker
-Enforces contraction rate of 75 bpm
-Muscarinic and beta adrenergic input

AV Node
-slow: junction of artia and ventricles

Atrioventricular bundle/bundle of His
-In ventricular septum

Purkinje fibers
-Spread within the muscle of the ventricular walls

P wave
-Atrial depolarization

QRS
-Ventricular depolarization

T wave
-Ventricular repolarization

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3
Q

What is the M gate?

A

The activation gate on the outter part of the cell

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4
Q

What is the H gate?

A

The inactivation gate on the inner part on the cell

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5
Q

What is the Recycling period (refractory period)

A

M gate closes
H gate opens

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6
Q

What happens at Phase 0 in a cardiac AP?

A

Na reaches membrane potential

Na+ V-G channels open & Na+ rushes into cell

initial depolarization

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7
Q

What happens at Phase 1 in a cardiac AP?

A

Cell overshoot (Vrm +40)

K+ V-G channels open

K+ leaves the cell

Repolarization starts here

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8
Q

What happens at Phase 2 in a cardiac AP?

A

Ca++ enters (extends depolarization promoting contraction) – Ca++ channels are much slower

Ca++ influx results in plateau

K+ is still leaving the cell

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9
Q

What happens at Phase 3 in a cardiac AP?

A

K+ only is leaving the cell

Ca++ channels close

Cell still being repolarized

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10
Q

What happens at Phase 4 in a cardiac AP?

A

Return to baseline V(rm)

Na/K/ATPase returns normal gradients

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11
Q

Differentiate disturbances in impulse formation and impulse conduction.

A

Disturbance in impulse formation:
-SA/AV nodal abnormalities
-Ion changes
-Late/early depolarization
-SNS stimulation

Disturbance in impulse conduction: -Block
-Reentry (1 way block - becomes reexcited)

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12
Q

Describe EKG differences in heart block

A

1st: PR > 0.20 seconds

2nd type 1: Progressive prolongation of PR interval then QRS drops

2nd type 2: PR constant; randomly dropped QRS

3rd: Complete disruption of AV conduction

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13
Q

What 3 things must occur for reentry (circus movement)?

A
  1. Obstacle (scar tissue)
  2. Unidirectional block
  3. Conduction time must be long enough to reenter same areas after refractory period
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14
Q

Best Tx for type 2 and 3 heart block?

A

Pacing/pacemaker

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15
Q

What are Class I antiarrhythmias?

A

Na+ channel blockers

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16
Q

What are Class II antiarrhythmias?

A

Sympatholytics: Beta Blockers

17
Q

What are Class III antiarrhythmias?

A

K+ channel blockers

prolonged action potential duration

18
Q

What are Class IV antiarrhythmias?

A

Ca++ channel blockers

19
Q

Which medication fits into all 4 classes of antiarrhythmias?

A

Amiodarone

20
Q

Drugs: Class I antiarrhythmias

A

Class IA: Quinidine, Procainamide

-Prolong the AP
-Increase effective refractory period
-increases QT

Class IB: Lidocaine

-Shortens AP
-decreases effective refractory period

Class IC: Flecainide

-no effects on ERP
- min effects on AP

21
Q

Drugs: Class II antiarrhythmias

A

propranolol
Esmolol

suppress ventricular ectopic depolarization

22
Q

Drugs: Class III antiarrhythmias

A

Satolol

Prolong AP by blocking K channel
More K+ inside cell

23
Q

Drugs: Class IV antiarrhythmias

A

Verapamil

-prolongs AV conduction
-slows SA node
-Blocks Ca++ channels

24
Q

Describe the effects of adenosine of SVT.

A

Enhanced K+ conductance
Inhibition of cAMP induced calcium influx

25
Q

What is the first line drug for SVT?

A

Adenosine

26
Q

What are some additional antiarrhythmias?

A

Digoxin
Adenosine
Magnesium
Calcium
Potassium

27
Q

T/F: Adenosine has a long half life

A

F

28
Q

List non-pharmacological therapy for arrhythmias.

A

Vagal maneuvers
Pacemakers
Cardioversion
Ablation
Surgery

29
Q

Tx: Bradycardia

A

Symptomatic: Atropine

Chronic: Pacemaker

30
Q

Tx: Heartblock

A

Symptomatic: Atropine/Transcutaneous pacing

Chronic: Pacemaker

31
Q

Tx: SVT

A

Symptomatic: Adenosine/transcutaneous pacing

Chronic: CCB, Beta Blockers

32
Q

Tx: Sinus Tach

A

Symptomatic: Adenosine, CCB, Cardiovert

Chronic: Cardiac Ablation

33
Q

Tx: VTach (wide complex)

A

Symptomatic: Amiodarone

Chronic: Amiodaron, Satolol

34
Q

Tx: Afib

A

Symptomatic: Diltiazem, Verapamil

Chronic: Beta blockers, Amiodarone

35
Q

Tx: Vfib

A

Symptomatic: CPR, Defib

Chronic: Amiodarone, lidocaine

Pharm (30 decks)

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