Cardiac Conduction, Calcium Channel Blockers, Anti-Dysrhythmic Drugs Flashcards
What has to happen for the heart to be able to pump
Electrical simulation
What does the electrical acticity of the heart cause
Contraction and blood flow
What are the 4 properties of cardiac tissue
Auto/conduc/exicitab/contractility
What is automaticity
Ability to initiate an impulse
Where does the pulse start from
SA node
What do cardiac cells do to act as a syncytium
Work as one
Can there be spontaneous depolarization of the cardiac cells
Yes
What is conductivity
Ability for an impulse to move along, SPREAD from cell to cell
What is excitability
Ability to be elctriclaly stimulated
What is contractility
Ability to respond mechanically to an impulse, STRETCH
What is the polarized state
Rest, K inside: Ca and Na outside
What is cell depolarization
Contraction
What is cell repolarization
going be to polarization
What is the hearts main pacemaker
sa NODE
What is the normal bpm from the SA node
60-100
What is the AV responsible for
The delayed impulse which prevents the ventricle from contracting too quickly, allows for better STRETCH
What is the stretch law
Starlings law
What does the bundle of HIS do
Repid impulse down to the ventricles
What are the purkinje fibers
They depolarize the cells
What are the two types of actoin potential channels
Faster and slower
What are ECGs used for
Dysrhythmia, MI, effects of MEDS
What should you remeber about lead placment
white on right, snow over grass
What is a dysrhythmia (arrhythmia)
Abnormality in the rhythm of the heartbeat
What do dycrhythmias arise from
Impulse formation disturbances
What are the two fundamental causes of dycrhythmias
Distrunances of automaticity or conduction
What are some examples of disturbances of conduction
AV block or reentry (circular motion)
What is A-fib
no definded P-wave, irregular ventricle rythm of the QRS complex
What is PAC
premature atrial contarction
What is V-fib
No pulse, blood is not pumping out because the ventricle is not pulsating correctly
What is V-tach
Saw tooth, big issue
What are the properties of dysrhythmias
Sustatained, symptomatic, above or in the ventricle, acute or long term
What are the symtpoms of a-fib
Increased HR, SOB, feeling of fluttering
What is the type of treatment you will use for long term care
Beta-blockers to decrease HR, anti-coag, because with a-fib the blood will not move well through the artria
What do beta-blockers end with
olol
How do beta blockers work
Decrease automaticity of the SA node and the time of AV node
What are the adverse affects of beta blockers
AV block, bronchospasm in ASTHMA pts
What do potasisum channel blockers end in
ONE
What is the potassium channel blocker
Amiodarone
How do potassium channel blockers work
IN emergencys, V-fib/tach
What are you going to do when you give your pt amiodarone
MONITOR, AV block
What are the drug interactions of potassium channel blockers
Increases levels of diltiazem, digoxin, warfrin, other beta-blockers
What should you keep in mind about potassium channel blockers
no grapefruit (increase), or cholestyramines (reduces), careful with dirutectics (potassium levels off)
What do calcium channels do
regulate entry of calcium into the cells
What will happen if calcium channels are blocked
Vasodilation, contraction will not happen
What happens if calcium channels are open
Increases the force of contraction and increases the SA node
What are the three subclasses of calcium channel blockers
Phenylakylamines, benzothiazepines, diyhydropyridines
What is the drug for phenylakylamines
Verapamil
What is the drug for benzothiazepines
Diltiazem
What is the drug for dihydropyridines
Nifedipine
Which drugs work of the arteriles and the heart
Verapamil and diltiazem
What drug jsut works on the arteriles
BNifedipine
What is the nomonic to rembere the drugs of calcium channel blockers
Very Nice Drugs
Verapamil, Nifedipine, Diltiazem
What does verapamil and diltiazem do
Reduce SA and AV nodes, slow ventriclular rate, stop SVT
What are verapmil and diltiazem used for
BP and dsrythmias
What are the adverse effects of verapamil and diltiazem
Bradycardia, hypotension, heart block, constipation
Can dihydropyridines be used for dysrhythmias
No
What are the adverse effects of nifedipine and amlodipine
peripheral edema in older women
What do verapamil and diltiazem act on
Smooth muscle and the heart
What are you going to teach your pts about calcium channel blockers
Monitor for slow HR, swelling, constipation
What is adenosin used for
Termination of SVT, slowers conduction of AV node, QUICKLY
How fast do you push adenosin
FAST push and FAST flush
What are the adverse effects of adenosine
Dyspnea, SOB, facial flushing, chest discomfort
What are the nursing implications for use of adenosine
O2, hooker up to everything