Cardio1 Flashcards
Some Risky Meds Can Prolong QT.
Sotalol Risperidone (antipsychotics) Macrolides Chloroquine Protease inhibitors (-navir) Quinidine (Class Ia; class III)- not used anymore Thiazides
*Also, ondansetron
Where and during which weeks does fetal erythropoiesis occur?
Yolk sac: 3-8 weeks
Liver: 6 weeks to birth
Spleen: 10-28 weeks
Bone marrow: 18 weeks to adult
*Beta Thalassemia: liver and spleen are re-recruited to make blood, which leads to hepatosplenomegaly
What are the 5 causes of R to L shunts?
the 5 T’s:
Truncus arteriosus Transposition of great vessels Tricuspid atresia Tetralogy of Fallot TAPVR (Total anomalous pulmonary venous return)
What is the mnemonic FROM JANE?
Signs of bacterial endocarditis: Fever Roth spots Osler nodes (painful) Murmur Janeway lesions (painless) Anemia Nail-bed hemorrhage Emboli (septic bc have bacteria)
How do the antiarrhythmics work: Class 1A, 1B, 1C?
Class 1A: increase AP duration, increase ERP, used for both AT and VT, work on “open state”
Class 2A: decrease AP duration, preferentially affect ischemic tissue, use post-MI, works on “open and deactivated” states.
Class 3A: prolongs refractory period in AV node, minimal change in AP duration, use for SVT (afib), never give post-MI.
*all decrease slope of phase 0
How do the antiarrhythmics work: Class 2 (beta-blockers)
Decrease SA and AV nodes by decreasing cAMP and Ca++ currents. Suppress abnormal pacemakers by decreasing slope of phase 4.
*Remember that phase 0 of pacemaker cells is run by Ca++ in pacemaker cells, and Na+ in non-pacemaker cells.
How do the antiarrhythmics work: Class III (K+ channel blockers)?
They increase AP and ERP and QT interval. Use for A-fib, A-flutter, and ventricular tachy (amiodarone, sotalol).
How do the antiarrhythmics work: Class IV (Ca++ channel blockers)?
Decrease conduction velocity, increase ERP and PR interval. Used for rate control in A-fib.
What are the Class 1 antiarrhythmic drugs?
1A: Procainamide, Disopyramide, Quinidine
1B: Lidocaine, Mexiletine
1C: Propafenone, Flecainide
What are the Class 2 antiarrhythmic drugs?
Beta-1 Selective: Metoprolol, Esmolol, Atenolol
Non-Selective: Propranolol, Timolol, Carvedilol (don’t use in asthmatics)
What are the Class 3 antiarrhythmic drugs?
Amiodarone, Ibutilide, Dofetilide, Sotalol
What are the Class 4 antiarrhythmic drugs?
Verapamil, Diltiazem
