EKG drugs Flashcards
1st line symptomatic bradycardia?
atropine (anticholinergic)- increases conduction velocity within AV node
symptomatic bradycardia: what two things do you try after 1st line?
temporary transcutaneous pacing, then try beta 1 agonist epi or dopamine
treatment of chronic symptomatic bradycardia?
permanent pacemaker
1st line for Afib?
metoprolol or CCBs (diltiazem or verapamil)
treatment for unstable Afib patient?
cardioversion
1st line for Atrial flutter?
metoprolol or CCBs (diltiazem or verapamil)
treatment for unstable Atrial flutter patients?
cardioversion
treatment for sinus tachy with hyperthyroidism?
metoprolol and CCBs (diltiazem or verapamil)
how is metoprolol helping supraventricular arrhythmias?
decreasing conducting velocity through AV node and increasing the refractory period
first line treatment for 1st degree block?
usually not treated unless symptomatic bradycardia, then use atropine
first line treatment for 2nd degree block, Mobitz I?
usually no treatment required but if symptomatic, treat same as symptomatic brady (atropine)
what two things will atropine do in the heart?
increasing conducting velocity within AV node and SA node
CCB’s are never used as treatment for what arrhythmia?
VT
what are digoxin’s effects?
vagal effects on SA and AV node
what type of pt gets digoxin?
patient with afib who has HF (because med is a positive inotrope that increases contractility)
digoxin slows what two things?
HR and AV conducting velocity
what are the two vagal maneuvers?
carotid massage (right side stimulates SA node/left side stimulates AV node) and Valsalva (slow down HR)
first line treatment for PSVT?
vagal maneuvers
2nd and 3rd lines for PSVT?
2nd- adenosine (slows conduction through AV node)
3rd- metoprolol and CCBs
first line treatments for stable monomorphic VT?
amiodarone 1st…then procainamide or sotalol
maybe cardioversion
unstable PSVT patients treated with?
cardioversion (or patients also no responsive to AV node blocking drugs)
how do you treat sinus tachy? what are three main underlying causes?
treat the underlying cause first: volume depletion, CHF, hyperthyroidism in elderly
goal of PSVT treatment?
block conduction through AV node, which terminates the re-entry circuit
cardioversion in a stable atrial flutter patient…you must consider what?
risk of systemic embolization from atrial thrombi and need for anticoagulation
treatment for unstable monomorphic VT?
cardioversion
treatment for pulseless VT?
defibrillation
treatment for stable polymorphic VT with normal QT interval?
three antiarrhythmic drugs as stable monomorphic
treatment for unstable or pulseless polymorphic VT?
defibrillation
torsades treatment 1st line? then if patient is also unstable or pulseless?
IV magnesium
then defibrillation
initial treatment for V fib?
defibrillation per ACLS
** after shock, if not responsive them add epi and amiodarone
treatment for Mobitz II
can initially use atropine but will usually need to go to pacing or epi/dopamine
treatment for 3rd degree block?
usually pacemaker
treatment for asystole?
ACLS protocol for cardiac arrest (CPR with epi)
treatment for PEA?
same as asystole (CPR and epi to maintain BP)
only drug to help increase survival?
metoprolol (used acutely for MI)
