dysrhythmias

Question 1

what is useful for SVT

Answer 1

IV adenosine

Question 2

adenosine target

Answer 2

G protein-coupled adenosine A1 receptor

Question 3

adenosine moa

Answer 3

Inhibits adenylyl cyclase enzymes = less cAMP, This promotes opening of adenosine-sensitive potassium channels and increased K+ efflux – as a result cells in the atrioventricular node of the heart become hyperpolarised. This slows the rate of rise of the pacemaker potential

Question 4

adenosine overall aim

Answer 4

slow AVN conduction

Question 5

adenosine adverse effects

Answer 5

chest pain, dyspnoea, bronchospasm and nausea

Question 6

how to resolve adenosine adverse effects

Answer 6

will resolve when the drug is metabolised

Question 7

amiodarone target

Answer 7

Na channel, Ca channel and α-adrenoceptors

Question 8

amiodarone overall effect

Answer 8

prolongs the cardiac action potential seen as an increase in the QT interval on the ECG

Question 9

common adverse effect of amiodarone

Answer 9

Corneal microdeposits

Question 10

bad adverse effects of amiodarone

Answer 10

Thyoid disorders – hypothyroidism, hyperthyroidism 
Pulmonary fibrosis 
Phototoxicity 
Peripheral neuropathy 
Optic neuritis/neuropathy (blindness) 
Hepatotoxicity
Slate-grey skin discolouration

Question 11

what should patients avoid after starting amiodarone

Answer 11

exposure to direct sunlight

Question 12

digoxin drug class

Answer 12

cardiac glycoside

Question 13

digoxin target

Answer 13

Na+ K+ ATPase membrane pump

Question 14

digoxin moa

Answer 14

Increase intracellular sodium = rise in intracellular calcium through the Na+ Ca2+ exchanger on cardiac myocytes. Phases 4 and 0 of the cardiac action potential are prolonged leading to an increase in end diastolic volume.

Question 15

digoxin affect on the heart

Answer 15

Positive inotropic effect

negative chronotropic

Question 16

digoxin treats

Answer 16

AF and AF

Question 17

digoxin therapeutic window

Answer 17

narrow

Question 18

digoxin toxicity symptoms

Answer 18

Confusion; Loss of appetite; Nausea, vomiting, diarrhoea; Evidence of cardiotoxicity – palpitations, arrhythmias, conduction disturbances; Blurred or yellow vision

Question 19

lidocaine is used for

Answer 19

anaesthetic

Question 20

lidocaine blocks

Answer 20

sodium channels

Question 21

lidocaine works on what phase of the cardiac cycle

Answer 21

0

Question 22

lidocaine can treat

Answer 22

VT

Question 23

Flecainide acts on

Answer 23

sodium channels in the purkinje fibers

Question 24

Flecainide blocks

Answer 24

sodium channels

Question 25

sotalol moa

Answer 25

adrenergic beta-antagonist

Question 26

anticholinergic

Answer 26

atropine

Question 27

atropine inhibits

Answer 27

muscarinic acetylcholine receptor

Question 28

atropine treats

Answer 28

bradychardia