Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm 1 > drug therapy for dysrhythmias > Flashcards

drug therapy for dysrhythmias Flashcards

(78 cards)

Start Studying
1
Q

describe how the heart is an electrical pump

A

-electricity resides in specialized tissues that generate and conduct electrical impulses (contractlu tissue)
-activities result in effective cardiac contraction and blood distribution throughout the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the path of electricity in the heart

_______ -> _________ -> __________ …

A

SA node -> AV node -> bundle of His -> right and left bundle branches -> purkinje fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

the heart oumps in regular intervals with four events, what are they?

A

1) stimulation from electrical impulse
2) transmission to adjacent tissue
3) contraction of atria, then ventricles
4) relaxation of atria, then ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

cardiac conduction relies on…

two things

A

automaticity and conductivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe…

automaticity

A

ability of the heart to generate an electrical impulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe…

conductivity

A

ability of cardiac tissue to transmit electrical impulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the cells of muscle contraction in the heart

A

myocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

contraction of myocytes is initiated by electril impulses, known as…

A

action potentials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

action potential releases internal stores of ____ into the muscle cells and triggers contraction

A

Ca+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the contracting unit of muscle cells that contains actin and myosin?

A

sarcomere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe troponin

A

Ca+ sensitive complex in muscle cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what part of the conduction system can start an impulse?

A

-any part may start an impulse
-but SA node has the fastest rate of automaticity (pacemaker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

initiation of an impulse is dependent on…

A

Na and K ion movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

electrical stimulus must reach specific ____ to cause contraction

A

threshold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what happens after contraction?

A

-period of decreased excitability
-cells cannot respond to new stimulus (absolute refractory period)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

describe the process of conductivity

A

-impulses originate in SA node
-transmitted though intermodal pathways to AV node
-impulse is delayed for a period of time
-impulse then travels predictable route

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

look at this pic for a minute

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

describe dysrhythmias

(arrthuthmias)

A

-abnormalities in cardiac rate or rhythm
-can originate in any part in conduction system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what does dyrhythmia result from?

A

irregular electrical impulse formation, conduction, or both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what allows cells other than SA node to initiate electrical impulse that reach the highest level in contraction

SA nose failure or slow depolarization

A

automaticity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is it called when an impulse originates somewhere other than SA node

A

ectopic focus (more commonly called ectoptic beat)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ectopic beat is activated by…

A

-hypoxia (low O2)
-ischemia (low blood flow to tissue)
-hypokalemia (low K+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does ectopic beat indicate?

A

indicates myocardial irritability

potentially serious cardiac function impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what part of an EKG will atrial function show up on?

A

P wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
# describe... atrial tachycardia
HR in atria is faster than normal
26
# describe... atrial flutter
-atria beat regularly but faster than normal and more often than ventricles do -narrow QRS
27
# describe... atrial fibrillation
-atrai beat irregularly -SA node firing so fast, AV node cant keep up with the signals -no P wave on EKG
28
what are some different atrial dysrhythmias
-tachycardia -flutter -fibrillation -PACs (premature atrial contraction)
29
what are some different ventricular dysrhythmias
-tachycardia -flutter -fibrillation -PVCs (premature ventricular contraction)
30
# describe... ventricular tachycardia
-rapid contraction of ventricles -idiopathic -leads to cardiac arrest | this is a shockable rhythm
31
# describe... ventricular fibrillation
-quick, rapid ventricle contraction -widens out to vtach then to asystole
32
what part of EKG readings indicate ventricular function
QRS complex
33
# describe... sinus bradycardia
-normal rhythm but slow -HR <59bpm
34
# describe... sinus tachycardia
-normal rhythm, but fast -HR >100bpm
35
# describe... heart block
-medical emergency -signal between atria and ventricular pathway is interrupted either totally or partially
36
describe the prior goal of pahrmacotherapy for dysrhythmias
-ppl went straight to meds -supressing dysrhythmias with meds resulted in higher mortality rate among pts receiving antidysrhythmic drug therapy than those who were not
37
what is the newest goal of therapy for dysrhythmias
-prevent, relieve symptoms, and prolong survival -increase in nonpharmacologic stretgies for dysrhythmia management
38
what are some nonpharmacologic stretegies for dysrhythmia management? | and describe them just a little
-**cardioversion** (shock heart) -**defibrillation **(used in emergency medicine, used for vtach and vfib) -**radiofrequency catheter ablation** (uses catheter to send radiofrequency to stop dysrhythmias) -**pacemakers** (implanted, used for brady arrythmias and sinus bradycardia) -**implantable cardioverter defibrillators (ICD)** (used for tachy arrythmias)
39
the mechanisms of action of anidysrythmic drugs are grouped into 3 possibilities, what are they?
-reduce automaticity -slow conduction of impulses through the heart -prolong refractory period
40
antidysrhymic drugs are classified according to...
mechanism of action and conduction system effect
41
what are some indications of use of antidysrhythmic drugs?
-conversion of atrial fibrillation or flutter to NSR (normal sinus rhythm) -maintaining NSR postconversion -suppresion of fast or irregular ventricular rate that alters cardiac output -presence of dangerous dysrhythmias that are potentially fatal
42
anyone with afib is going to be taking...
anticoagulants
43
# describe... sodium channel blockers
-**now rarely used** -can cause/worsen dysrhythmias -binds to and blocks the opening of sodium channels -MOA depends on which class (IA, IB, IC) the med is in
44
what are sodium channel blockers used in the treatment of
atrial dysrythmia, supreventricular tachycardia (bursts of high rapid HR)
45
what are some side effects of sodium channel blockers
**-arrhythmias -bradycardia -hypotension** -respiratory depression -dizziness -syncope -drowsiness -fatigue -confusion -anticholinergic
46
what are some examples of sodium channel blockers
-quinidine -lidocane (used for ventricular dysrhythmias)
47
what are some nursing concerns associated with sodium channel blockers
interferes with anticoagulants and respiratory issues
48
describe the action of beta adrenergic blockers
reduce activation of beta receptors = decrease conduction through SA/AV nodes = decrease automaticity = slower HR **decreases cardiac excitability, cardiac workload, and oxygen consumption**
49
what are beta adrenergic blockers used in the treatment of?
-management of dysrhythmia from excessive SNS stimulation, afib, and a-flutter (thought to slow ventricular rate) -post MI/CHF (though to prevent vfib)
50
what are some side effects of beta-adrenergic blockers?
-**bradycardia** -AV block -hypotension -**dizziness, syncope** -bronchospasm -dyspnea -drowsiness -fatigue -erectile dysfunction
51
what are some nursing concerns/pt teaching associated with beta adrenergic blockers?
-**rebound hypertension/tachycardia/dysrhythmias with abrupt withdrawal: must taper off over two weeks** -caution with PMH of asthma/respiratory disease -use with verapamil (ca+ blocker) can increase risk of heart block, as well as bradycardia and hypotension
52
what are some examples of beta adrenergic blockers
-propanolol -acebutolol -esmolol
53
describe potassium
-main intracellular ion -involved with cardiac rhythm (contractility of the myocardium)
54
what is the normal value of K+
3.5 to 5.0 mEq/L
55
describe hypokalemia | whats the lab value
less than 3.5mEq/L
56
what are the signs and symptoms of hypokalemia
-ventricular dysrhythmias -muscle weakness/decreased DTRs -weak peripheral pulses
57
describe treatment of hypokalemia
-increase dietary K+ rich foods -oral meds (preferred) -peripheral IV meds
58
describe oral administration of K+
-no more than 20 mEq/hr -give with meals/assess swallowing -pills can be split -availabe in liquid or pill form
59
describe peripheral IV administration of K+
-20-40 mEq/hr -do not exceed 20 mEq/hr (can do 40 mEq/2hrs) -burnsssss -if burning occurs, stop and assess site
60
describe hyperkalemia | whats the lab value
greater than 5.0 mEq/L
61
what are the signs and symptoms of hyperkalemia
-dysrhythmias -vfib -heart block -cardiac arrest -muscle twitching -numbness in hands, feet, and mouth
62
describe the tx of hyperkalemia
-restrict dietary K+ rich foods -sodium polystyrene (binds to K+ and causes diarrhea) -IV administration of insulin/dextrose shift K+ back into cells
63
how do potassium channel blockers work?
-inhibit adrenergic stimulation -block K+ channels = prolong duration of action potential = slow repolarization = prolong refreactory period
64
what are K+ channel blockers used to treat?
-IV for life threatening tachydysrhythmias (not first line r/t fisk for pulmonary toxicity) -PO for recurrent tachycardia, V&A fibrillation and A flutter
65
what are some side effects of K+ channel blockers
-bradycardia -hypotension (weakness and dizziness) -worsen or new dysrhythmias -**pulmonary toxicity (IV)** -**hepatotoxicity** -blurred vision/photosensitivity CAUTION with AV block, shock, hypotension, respiratory depression, renal/hepatic impairment
66
what are some examples of potassium channel blockers?
-amiodarone (IV) -dofetilide -ibutilide -sotalol
67
what are some nursing concerns associated with K+ channel blockers?
-monitor HR, BP, and ALT/AST levels -ausculate and evaluate lung sounds
68
describe how calcium channel blockers work
block calcium ion channels = reduce automaticity in SA node and slow conduction through AV node = slow HR = prolong refractory period
69
what are calcium channel blockers used to treat?
-supraventricular dyrhythmias (@ SA and AV nodes) -tachycardia -can be emergency med for Afib, SVT requiring IV administration
70
what are some side effects of calcium channel blockers
-**bradycardia** -**hypotension (HA, dizziness, lightheadedness)** -flushed skin -MI -**hepatotoxicity** -peripheral edema caution with heartblock, sick sinus syndrome, heart failure, hypotension, hepatic/renal insufficiency, pragnancy
71
what are some examples of calcium channel blockers
-diltiazem -verapamil
72
what are some nursing concerns asociated with calcium channel blockers
-avoid grapefruit and grapefruit juice -monitor when beta blockers and digoxin -monitor for peripheral edema
73
name two unclassified antiarrhythmic drugs
adenosine and digoxin
74
describe adenosine
-emergency med, used for SVT when a vagal meneuver doesnt work -naturally occurring component of all body cells
75
how does adenosine work
depresses conduction @ AV node = resotre NSR in SVT pts
76
how is adenosine administered
-rapid bolus administration r/t rapid metabolism out of the system -given slowly, wont reach cardiac tissue
77
what are some vagal maneuvers | (actions to stop SVT)
-hold breath and bear down for 20 secs -stick face in ice water
78
describe components of pharmacologic therapy of dysrhythmias
-requires accurate ID of dysrhythmia -understand mechanisms of dysrhythmia -monitoring is imperitive: observing hemodynamic and ECG effects of dysrhythmia -knowledge of pharmacologic actions of specific meds -therapeutic effects outwaugh potential adverse effects

Pharm 1 (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions