Cardiology Flashcards

1
Q

When is treatment of equine ventricular arrhytmias indicated?

A
  1. Multiform VPCs.
  2. Torsades de pointes/ Wide ventricular tachycardia
  3. R on T
  4. Sustained VT with HR >120bpm
  5. Signs of cardiovascular collapse
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2
Q

Anti-arrhythmics for supra ventricular arrhythmias

A

Sotalol
Digoxin
Procainamide -IV or oral
Propranolol - IV or oral
Propafenone - IV or oral
Flecainide acetate – IV (or oral)
Amiodarone - IV
Phenytoin – oral
Metoprolol - IV
Quinidine sulphate IV/PO

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3
Q

Anti-arrhythmics for treatment of ventricular arrhythmias

A

Lidocaine - IV
Magnesium sulfate - IV or NG tube Quinidine - IV or NG tube (Quinidine gluconate discontinued)
Procainamide -IV or oral
Propranolol - IV or oral
Propafenone - IV or oral
Flecainide acetate – IV (or oral)
Amiodarone - IV
Sotalol – oral (or IV)
Phenytoin – oral
Metoprolol - I

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4
Q

Antiarrhythmic classes → Classified by function

A

Class I: Na channel blockers

Class II: β-blocker

Class III: K channel blockers

Class IV: Ca channel blockers

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5
Q

Class Ia Antiarrhythmic

A

Procainamide

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6
Q

Procainamide

A

Procainamide is a fast sodium channel blocker that affects the QRS complex.

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7
Q

Class Ib Antiarrhythmic

A

Lidocaine
Mexiletine

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8
Q

Lidocaine

A

Decreases the permeability of the neuron membrane to sodium, which causes inhibition of depolarization, resulting in blocked conduction. No effect on QRS complex.

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9
Q

Class II Antiarrhythmic

A

Atenolol

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10
Q

Class III Antiarrhythmics

A

Sotalol
Amiodarone

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11
Q

Sotalol

A

Sotalol blocks potassium channels and increases the effective refractory period of myocardial cells by prolonging repolarization AND
potent nonselective class II activity (adrenergic antagonist)

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12
Q

Amiodarone

A

Prolongs action potential and increases effective refractory period of cardiac tissue by blocking potassium channels and slowing repolarization

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13
Q

Drugs Used to Manage Ventricular Tachyarrhythmias

A

Class Ia: procainamide, quinidine
Class Ib: lidocaine, mexiletine
Class Ic: flecainide, propafenone
Class II: β-blockers: atenolol, propranolol
Class III: d,l-sotalol, amiodarone

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14
Q

Drugs Used to Slow Atrioventricular Nodal Conduction

A

Class II: β-blockers: atenolol, propranolol
Class IV: calcium channel blockers
Other: digoxin

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15
Q

Purpose of gap junctions within intercalated discs?

A

Rapid communication junctionns allowing rapid diiffusion of ions allowing easy and fast travel of the action potentials between cardiac muscle cells. This allows the cardiac muscle cells to function as a syncytium.

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16
Q

Control of heart by ANS

A

Sympathetic = STIMULATION. This results in increased cardiac contractility (2-3 x increased CO). This increased HR is due to increased AV node conduction, due to vagal inhibition.
PS = DEPRESSION. vagal tone. AV and (more) SA node effect resulting in reduceed ventricular pump ~ 50%.

17
Q

ANS control of heart rhythm

A

PS (vagal) = reduced HR - Ach - SA/AV nodes.
SNS = increased HR & contractility - NE - atria & ventricles.

18
Q

Bipolar leads

A

Two electrodes on different sides of the heart providinign a base-apex current (frontal plane).

19
Q

Augmented unipolar leads

A

Frontal plane. 2 negative and 1 positive. aVR/ aVL/ aVF leads