Exam 2 lecture 9

Question 1

polymorphic vs monomorphic VT

Answer 1

polymorphic- torsades de pointes
monomorphic vt- ventricular tachycardia

Question 2

mechanism of VT

Answer 2

increased ventricular automaticity
re entry

Question 3

most common risk factors for ventricular tachycardia

Answer 3

MI and HFrEF

Question 4

drugs that can cause VT

Answer 4

flecanide
propafenone
digoxin

Question 5

prognostic significance of VT

Answer 5

sustained VT may lead to VF which is life threatening
pts with sustained VT are at risk for syndrome of sudden cardiac death

Question 6

Drugs for VT

Answer 6

procainamide
Amiodarone
Sotalol
Verapamil
BB

Question 7

procainamide VT treatment loading and maintenance dose

Answer 7

loading- 10-17 mg/kg IV at 20-50 mg/min
maintenance- 1-4 mg/min continous IV

Question 8

Amiodarone VT treatment loading and maintenance dose

Answer 8

Loading- 150 mg IV over 10 mins
maintenance- 1mg/min continous IV for 6 hrs, then 0.5 mg/min for 18 hrs

Question 9

sotalol VT treatment loading and maintenance dose

Answer 9

Loading- 75 mg IV every 12 hrs
no maintenance dose

Question 10

verapamil VT treatment loading and maintenance dosing

Answer 10

Loading- 2.5-5 mg IV every 15-30 min at 1-3 mg/min

Question 11

BB VT treatment loading and maintenance dose

Answer 11

Esmolol, metoprolol and propanolol IV same dose as A fib

Question 12

VT treatment with structural heart disease

Answer 12

elective DCC
IV procainamide
IV amiodarone

if VT not terminated do DCC

Question 13

How to treat VT with no structural heart disease

Answer 13

verapamil sensitive VT- verapamil
outflow tract VT-BB

if not terminated use DCC

Question 14

how to prevent recurrence of ventricular tachycardia

Answer 14

ICD withwither amiodarone or sotalol

Question 15

dose of amiodarone to give with ICD for prevention of recurrence of VT

Answer 15

400 mg po QD

Question 16

dose of sotalol to give with ICD for prevention of recurrence of VT

Answer 16

80-160 mg PPO QD

Question 17

Ventricular arrythmias

Answer 17

PVC
VT
VF

Question 18

Ventricular fibrillation VF QRS complex

Answer 18

not recognizable

Question 19

VF electrical activity

Answer 19

irregular, disorganized, chaotic

Question 20

what does asystole mean

Answer 20

abscense of electrical activity

Question 21

most common cause of VF

Answer 21

MI

Question 22

can drugs terminate VF?

Answer 22

no
they facilitate defibrillation, they alone can not terminate VF
defibrillation is needed

Question 23

d/c between DCC and defibrillation

Answer 23

DCC is synchronized
defibrilation is not synchronized

Question 24

what are the 3 drugs used to treat VF with defibrilator

Answer 24

Epinephrine- 1 mg IV
Amiodarone- 300 mg IV
lidocaine- 1- 1.5 mg/kg IV

Question 25

algorithim for termination of VF

Answer 25

CPR x 2 min/ obtain IV access

defibrillation shock

CPR X2 min

epinephrine 1 mg IV/Io

defibrilation shock

cpr x 2 min

amiodarone 300 or lidocaine 1-1.5

defibrillation shock

CPR

epinephrine

defibrillation shock

CPR x 2 min

Amiodarone 150 or lidocaine 0.5- 0.75 (hlaf of previous dose)