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Jason's Cardiovascular Block > Drugs for Arrhythmias & CVS > Flashcards

Drugs for Arrhythmias & CVS Flashcards

1
Q

What happens if you completely block receptors of the heart with propranolol and atropine?

A

Nothing much. Heart beats on its own.

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2
Q

T/F the autonomic system controls the beating of the heart itself.

A

false. only the rate.

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3
Q

SA node depolarizes spontaneously with what ion? What’s the membrane potential?

A

Ca2+ at ~60mV - +20mV

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4
Q

What happens at phase 3 of SA node spontaneous depolarization?

A

K+ out

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5
Q

How does the parasympathetic slow down the SA node?

A

via ACh –>muscarinic (M2) receptors –>GPCR decrease cAMP = open K+ channels which slows down pre potential threshold.

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6
Q

how does sympathetic acceleration of SA node happen?

A

NA –>B1 adrenoreceptors –>GPCR –>increase cAMP, open Ca2+ channels which increases slope of pre potential threshold

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7
Q

What’s a risk of accelerating the SA node?

A

can trigger dysrhythmias

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8
Q

resting membrane of ventricular action potential?

A

-90mV

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9
Q

ventricular action potential depolarization involves which ion?

A

Na+ in

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10
Q

4 Symptoms of dysrhythmias:

A

SOB, faiting, fatigue, chest pain

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11
Q

3 mechanisms of dysrhythmias:

A
  1. altered formation (Nodes)
  2. altered conduction (extra beats, or conduction block)
  3. triggered activity (excess sympathetic
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12
Q

What is conduction block?

A

ventricles adopt their own slower pace than the nodes

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13
Q

4 classes of antidysrhythmics

A
  1. Na+ (mild, mod, strong) (1a, 1b, 1c)
  2. B-adrenoceptor antagonist (SA node)
  3. K+ blocker, delay phase 3
  4. Ca2+ blocker (great for SA AV nodes
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14
Q

Na+ blockers reduce slope 0 and peak of SA/AV nodes. T/F?

A

False. it’s of the ventricular action potential.

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15
Q

What’s quinidine? does two things to the action potential graph:

A

moderate Na+ channel blocker

  1. prolong repol
  2. increase effective refractory period
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16
Q

what’s ERP

A

effective refractory period

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17
Q

what’s flecainide? how does it effect ERP?

A

strong Na+ channel blocker no effect on ERP

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18
Q

what’s lignocaine?does two things to the action potential graph:

A

mild Na+ channel blocker

  1. shorten repol
  2. decrease ERP
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19
Q

What else does lignocaine do? why is it dangerous as a dysrhythmic?

A

local anesthetic. small therapeutic window

20
Q

2 ways how B-adrenoreceptor antagonists work?

A
  1. inhibit sympathetic

2. stabilising purkinje fibres

21
Q

K+ channel inhibitors do what to the graph?

A

prolong the phase 3

22
Q

Long term use of Amiodarone?

A

pulmonary fibrosis

23
Q

What is Amiodarone

A

K+ channel inhibitor antidysrhythmic

24
Q

Ca2+ blockers do what 2 things?

A

slow conduction, increase refractory

25
Q

What’s verapamil?

A

Ca2+ channel blocker for SA/AV nodes

26
Q

BP must be what to be called hypertension?

A

> 140/90 mmHg

27
Q

1 treatment for hypertension?

A

lifestyle mods

  1. no smoking
  2. diet
  3. weight
  4. stress
28
Q

2 ways body controls BP:

A

neuronal, hormonal

29
Q

Sympathetic alpha-1 adrenoreceptors do what?

A

constrict vessels

30
Q

Sympathetic beta-1 adrenoreceptors do what?

A

increase heart rate

31
Q

5 classes of antihypertensive drugs:

A

ABCDO

  1. angiotensin
  2. Beta adrenoreceptor
  3. calcium channel blockers
  4. diuretic
  5. other
32
Q

Renin converts what to what?

A

Angiotensinogen to angiotensin 1

33
Q

‘prils’

A

ACE inhibitors block ang1 to II

34
Q

Contraindicated for ‘prils’ and ‘sartans’

A
  1. Preg
  2. bilat renal stenosis
  3. angioneurotic oedema
35
Q

Blocking Ang 1 to 2 does what 4 things:

A

reduces

  1. vascular tone
  2. aldosterone production
  3. cardiac hypertrophy
  4. preent bradykinin breakdown
36
Q

Candesartan and Losartan, which is long and which is short acting

A 
Losartan = short, reversible
Candesartan = long irreversible
37
Q

‘sartans’ targets what?

A

angiotension 1 receptors

38
Q

‘olols’ target what?

A

B-adrenoreceptors

39
Q

Beta blocker does what two things to cardiac output?

A

reduce rate and contractility

40
Q

Do beta blockers affect renin release?

A

Yep. Reduces it.

41
Q

How do you get CNS effects with B-adrenoceptor antagonists?

A

cause it’s lipid soluble

42
Q

B-adrenoceptor antagonists contraindicated in:

A

Diabetes, asthma, AV block

43
Q

What’s diltiazem?

A

Ca2+ blocker, not as strong as verapamil

44
Q

What are the dihydropyridines?

A

Ca2+ blockers, Felodipine, Nifedipine both vascular, careful with tachyarrhythmias

45
Q

Thiazide Diuretics do what?

A

decrease Na and Cl in renal tubes, so more water is excreted, less fluid = less BP and blood volume

Jason's Cardiovascular Block (15 decks)

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