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Therapeutics > Exam 2 lecture 6 > Flashcards

Exam 2 lecture 6 Flashcards

1
Q

where are the depolarizations of the heart generated

A

in the sinus node (SA node)

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2
Q

Where is the SA node located

A

upper portion of right atrium

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3
Q

When depolarization is generated it is conducted across _____ to _______. What does this lead to?

A

when depolarization is generated it is conducted across INTERNODAL PATHWAY to AV NODE.

This leads to atrial contraction.

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4
Q

where is the AV node located

A

lower portion of right atrium

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5
Q

Depolarization travels from AV node to _____

A

bundle of HIS

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6
Q

Atrial depolarization is represented by what wave

A

P wave

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7
Q

which phase is depolarization? WHat is the ion used?

A

Phase 0, Na current

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8
Q

What ions are used in QRS complex? Which phase is it?

A

K+
Phase 1
also called ventricular depolarization

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9
Q

early part of QRS represents______

A

ventricular depolarization

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10
Q

PR interval is often used as a measure of what

A

AV nodal conduction time.

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11
Q

Which drugs lengthen PR interval and slow AV nodal conduction

A

BB
diltiazem
verapamil

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12
Q

QT represents

A

Ventricular repolariztion

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13
Q

T waves represent

A

phase 3 repolarization

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14
Q

PR interval represents

A

conduction time through AV node

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15
Q

how to estimate HR

A

300
150
100
75
60

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16
Q

When is a PR interval considered to be too long

A

0.2

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17
Q

What is QTc? Do men or women have longer QTc?

A

Corrected QT interval
Women have slightly longer QTc

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18
Q

What is considered a long QTc interval? what does that lead to?

A

greater than or equal to 500 ms
increased risk of drug induced arrhythmia known as torsades de pointes

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19
Q

Torsades de pointes can cause sudden cardiac death T/F

A

True

20
Q

What are the 5 supraventricular arrhythmias

A

Sinus bradycardia
AV block
Sinus tachycardia
A-Fib
Supraventricular tachycardia

21
Q

What is sinus bradycardia? mechanism?

A

HR<60BPM
reduced automaticity of the SA node

22
Q

sinus bradycardia risk factors

A

MI or ischemia
abnormal sympathetic or parasympathetic tone
hyper kalemia and hypermagnesemia

23
Q

What drugs could cause sinus bradycardia

A

Digoxin
BB
CCBs
Amiodarone

24
Q

Symptoms of sinus bradycardia

A

Hypotension
Dizziness
Syncope

25
Q

treatment of sinus bradycardia

A

Tx only necessary when pt is symptomatic

Atropine -0.5-1 mg IV Q 5 mins

26
Q

max dose of atropine dose

A

3 mg

27
Q

Treating sinus bradycardia if unresponsive to atropine

A

Dopamine 5-20 mcg/kg/min
Epinephrine 2-10 mcg/min or 0.1-0.5 mcg/kg/min
Isoproterenol 20-60 mcg IV bolus

28
Q

Atropine adverse effects

A

Tachycardia, dry mouth

29
Q

treatment of sinus bradycardia after heart transplant and spinal cord injury

A

Aminophylline- 6mg/kg IV over 20-30 mins

Theophylline

heart transplant- 30 mg followed by oral dose of 5-10 mg/kg/day

spinal cord injury- Oral dose of 5-10 mg/kg/day titrated to effect

30
Q

long term treatment of sinus bradycardia

A

Permanent pacemaker

31
Q

What can be another long term treatment if pt is unwilling to use pacemaker

A

theophylline oral 5-10 mg/kg/day

32
Q

atrial activity in A-fib

A

Chaotic and disorganized- no atrial depolarizations

33
Q

ventricular rate of A-fib

A

120-190 bpm

34
Q

rhythm of A-fib

A

irregularly irregular

35
Q

Know what the waves look like for A fib

A
36
Q

P waves in A-fib

A

absent

37
Q

A- fib stages

A

Stage 1- no A-fib (has risk factors)
stage 2- pre- Afib
stage 3- Atrial fibrilations
Stage 4- Permanent A fib

38
Q

explain stage 2 a fib

A

pre- a fib
ECG findings show structural or electrical findings that dispose pt to A fib

39
Q

What are the different stages of stage 3 A fib

A

3A- paroxysmal AF
3B- Persistent AF
3C- long standing persistent AF
3D- Successful AF ablation

40
Q

explain A fib 3A

A

paroxysmal AF

AF that is intermittent and terminates within less than 7 days of onset

41
Q

Explain A fib 3B

A

Persistent AF
AF that is continuous and sustains for more than 7 days and requires intervention

42
Q

explain A fib 3C

A

longstanding persistent AF
AF that is continous for more than 12 months in duration

43
Q

Explain a FIB 3D

A

Successful AF ablation
freedom from AF after intervention

44
Q

explain stage 4 A fib

A

Permanent A fib
no further attempts at rhythm control after discussion between patient and clinician

45
Q

A fib mechanism

A

-Abnormal atrial/pulmonary vein automaticity
-atrial re entry

46
Q
A

Therapeutics (38 decks)

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