EKG drugs

Question 1

1st line symptomatic bradycardia?

Answer 1

atropine (anticholinergic)- increases conduction velocity within AV node

Question 2

symptomatic bradycardia: what two things do you try after 1st line?

Answer 2

temporary transcutaneous pacing, then try beta 1 agonist epi or dopamine

Question 3

treatment of chronic symptomatic bradycardia?

Answer 3

permanent pacemaker

Question 4

1st line for Afib?

Answer 4

metoprolol or CCBs (diltiazem or verapamil)

Question 5

treatment for unstable Afib patient?

Answer 5

cardioversion

Question 6

1st line for Atrial flutter?

Answer 6

metoprolol or CCBs (diltiazem or verapamil)

Question 7

treatment for unstable Atrial flutter patients?

Answer 7

cardioversion

Question 8

treatment for sinus tachy with hyperthyroidism?

Answer 8

metoprolol and CCBs (diltiazem or verapamil)

Question 9

how is metoprolol helping supraventricular arrhythmias?

Answer 9

decreasing conducting velocity through AV node and increasing the refractory period

Question 10

first line treatment for 1st degree block?

Answer 10

usually not treated unless symptomatic bradycardia, then use atropine

Question 11

first line treatment for 2nd degree block, Mobitz I?

Answer 11

usually no treatment required but if symptomatic, treat same as symptomatic brady (atropine)

Question 12

what two things will atropine do in the heart?

Answer 12

increasing conducting velocity within AV node and SA node

Question 13

CCB’s are never used as treatment for what arrhythmia?

Answer 13

VT

Question 14

what are digoxin’s effects?

Answer 14

vagal effects on SA and AV node

Question 15

what type of pt gets digoxin?

Answer 15

patient with afib who has HF (because med is a positive inotrope that increases contractility)

Question 16

digoxin slows what two things?

Answer 16

HR and AV conducting velocity

Question 17

what are the two vagal maneuvers?

Answer 17

carotid massage (right side stimulates SA node/left side stimulates AV node) and Valsalva (slow down HR)

Question 18

first line treatment for PSVT?

Answer 18

vagal maneuvers

Question 19

2nd and 3rd lines for PSVT?

Answer 19

2nd- adenosine (slows conduction through AV node)

3rd- metoprolol and CCBs

Question 20

first line treatments for stable monomorphic VT?

Answer 20

amiodarone 1st…then procainamide or sotalol

maybe cardioversion

Question 21

unstable PSVT patients treated with?

Answer 21

cardioversion (or patients also no responsive to AV node blocking drugs)

Question 22

how do you treat sinus tachy? what are three main underlying causes?

Answer 22

treat the underlying cause first: volume depletion, CHF, hyperthyroidism in elderly

Question 23

goal of PSVT treatment?

Answer 23

block conduction through AV node, which terminates the re-entry circuit

Question 24

cardioversion in a stable atrial flutter patient…you must consider what?

Answer 24

risk of systemic embolization from atrial thrombi and need for anticoagulation

Question 25

treatment for unstable monomorphic VT?

Answer 25

cardioversion

Question 26

treatment for pulseless VT?

Answer 26

defibrillation

Question 27

treatment for stable polymorphic VT with normal QT interval?

Answer 27

three antiarrhythmic drugs as stable monomorphic

Question 28

treatment for unstable or pulseless polymorphic VT?

Answer 28

defibrillation

Question 29

torsades treatment 1st line? then if patient is also unstable or pulseless?

Answer 29

IV magnesium

then defibrillation

Question 30

initial treatment for V fib?

Answer 30

defibrillation per ACLS

** after shock, if not responsive them add epi and amiodarone

Question 31

treatment for Mobitz II

Answer 31

can initially use atropine but will usually need to go to pacing or epi/dopamine

Question 32

treatment for 3rd degree block?

Answer 32

usually pacemaker

Question 33

treatment for asystole?

Answer 33

ACLS protocol for cardiac arrest (CPR with epi)

Question 34

treatment for PEA?

Answer 34

same as asystole (CPR and epi to maintain BP)

Question 35

only drug to help increase survival?

Answer 35

metoprolol (used acutely for MI)