drugs - HF, shock & arrythmias Flashcards
what are non-pharmacological managements of SVT
- vagal manoeuvres
- carotid massage
- cardioversion
what are the 4 classes of anti-arrhythmic medications
- sodium channel blockers
- beta blockers
- potassium channel blocking agents
- calcium channel blocking agents
what is the mechanism of action of amiodarone
- class 3: sodium blocking
- treats arrhythmias above and below AV node
- very potent
- contains iodine, needing additional processing
what are the adverse effects of amoidarone
- hepatic disorders
- hyperthyroidism
- nausea
- respiratory disorders
- skin reactions
what is atropine
- non-selective muscarinic antagonist
- used for bradycardia
what is the mechanism of action of atropine
- M2 receptors are bound with acetylcholine
- these slow down the heart
- atropine blocks the receptors so the heart doesnt slow down
- blocked M2 in SA and AV prevents vagal nerve activity on the heart
what is inotropy
contraction of the heart
what is chronotropy
heart rate
what is dromotropy
conduction velocity
what are additional indications for atropine
- poisoning by organophosphorus insecticides/ nerve agents
- control of muscarine side effects
- premedication before anaesthesia
what are the adverse effects of atropine
- constipation
- dizziness
- dry mouth
- flushing
- headache
- nausea
- palpitations
- skin reactions
- urinary disorders
- vision disorders
what are common symptoms of acute heart failure
- dyspnoea
- peripheral oedema
- cardiogenic shock
- chest pain
what is used as acute heart failure management
- continuous positive pressure ventilation
- morphine
- GTN
- Furosemide
what are the objectives of continuous positive pressure ventilation
- open collapsing alveoli
- raise intrathoracic pressure
how does CPP open collapsing alveoli
- shift fluid in alveoli back into pulmonary capillaries
- reduces pulmonary oedema
- increases intra-alveolar pressure
how does CPP raise intrathoracic pressure
- increases pressure in the vena cava
- serves to reduce filling pressure
how is morphine used in the management of acute heart failure
- venodilation relieves pulmonary congestion
- lowers myocardial oxygen demand
- reduces anxiety and chest pain
what is used to treat hypovolaemic shock
- IV fluid
- TXA
- uterotonics (misprostol)
what is used to treat cardiogenic shock
- IV fluids
- Chronotropic drugs (dopamine, dobutamine)
- vasoconstrictors
- noradrenaline
- phenylephrine
what is used to treat neurogenic shock
- IV fluids
- vasoconstrictors
- noradrenaline
- phenylephrine
what is used to treat septic shock
- IV fluids
- inotropic drugs
- antibiotics (benzylpenicillin sodium)
- vasoconstrictors
- noradrenaline
- phenylephrine
what is used to treat anaphylactic shock
- adrenaline
- antihistamines
- steroids
what is oxytocin
synthetic hormone causes uterine contraction
how does ergometrine work
- stimulates alpha 1 and 5HT2 receptors
- causes uterine contraction and vasoconstriction
