Drugs for Heart Block or Dysrhythmia

Question 1

Contrindicationss of Beta Blockers

Answer 1

Bradycardia, broncoconstriction, Hypotension or hypoglycemia

Question 2

New drug that targets Nai funny channels (If channels

Answer 2

Ivabradine that specifically targets Na+ channels that control entry of Na+ into the SA node

Question 3

Mechanisms of SNS increased SA activity

Answer 3

Will act on B1 receptors to increase cAMP and increased opening of Ca2+ channels

Question 4

Mechanisms of PNS increased SA activity

Answer 4

Will act on M2 muscarinic receptors which will cause a decrease in cAMP and this will promote the opening of K+ channels and increased time to hyperpolarise

Question 5

What are the two considerations related to treating Arrhytmias

Answer 5

Rate or Rhythm

Question 6

What drugs regulate Rate

Answer 6

Beta blockers, Ca2+ blockers and Digoxin

Question 7

What drugs regulate Rhythm

Answer 7

Solatol, Flecainide and Amiodarone

Question 8

What drugs to manage Bradycardia

Answer 8

○ Isoprenoline
○ Duboutamine
○ Atropine
○ If not sustained increase then can use a temporary pacing wire or then switch to a pace maker

Question 9

What drugs to manage SVT

Answer 9

Adenosine, Verapamil, Beta Blockers (metoprolol and Atenolol)

Question 10

What drugs to manage AF/ Flutter

Answer 10

○ Amiodarone to restore sinus rhythm

○ Then safest route is to control rate, Beta Blockers, Ca2+ and then digoxin

Question 11

What drugs to manage VT

Answer 11

• Restore rhythm with Amiodarone (stable) or DC reversion if Unstable

Question 12

What 2 factors must be managed based on Coaggulopathy

Answer 12

Stroke vs Bleeding

Question 13

Drugs to promote stroke

Answer 13

Aspirin

Question 14

Drugs to promote Bleeding

Answer 14

Warfarin and the new class of anticoagulants

Question 15

What are the new branch of anti-coaggulants

Answer 15

Dabigatran, Rivaroxiban and Apixiban