Exam 3 - SVT Flashcards
What is the drug of choice for abolishing Acute SVT?
Adenosine
If AF PT is hemodynamically stable vs unstable what changes in the short-term goals?
Stable=Go with anticoagulation second
Unstable=Go with rhythm second
Newly discovered persistent AF is treated in what 4 steps?
- Rate control and anticoagulation as needed
- Antiarrythmic drug therapy
- Cardioversion
- Long-term antiarrythmic drug therapy
What med types are used for pharmacological rate control in AF?
Beta-blockers, CCB, Digitalis, Amiodarone, Dronedarone.
What two things used for non-pharmacological rate control?
- Pacing
2. Ablation
What two drugs are preferred for chemical cardioversion?
- Dofetilide
2. Ibutilide
Which three drug types prevent remodeling in AF?
- ACEI
- ARB
- CCB
Which Nonselective/Cardioselective/Mixed Beta-Blockers are used for rate control in AF?
Cardioselective: Atenolol, Metoprolol Succ and Tart
Nonselective: Propanolol, Nadolol
Mixed: Carvedilol, Labetolol
Which CCBs are used for rate control in AF?
Non-DI CCBs (Verapamil, Diltiazem)
Two cases where rate control is very important in AF?
- LV damage
2. Extensive CAD
What are some problems with Antiarrythmic drugs?
Limited efficacy long-term (recurrence likely), adverse drug reactions (may cause arrythmias)
Are Class I drugs used (QPDLFP)? Why or why not?
Very rarely. Old and dangerous; can cause arrythmias.
What percent with AF of people will fall out of NSR due to disease progress? What about those on Amiodarone?
50% will fall out due to disease progression. Amiodarone 2/3 will stay in NSR.
In a PT with persistent or paryoxysmal AF what is the first question to ask with regards to drug selection?
Is there structural heart disease or not
In PTs with AF and no structural heart disease what is the progression of drugs and other therapies?
D.D.F.P.S.->Amiodarone->Catheter Ablation
Dofetilidide, Dronedarone, Flecainide, Propafenone, Sotolol
When is Amiodarone used in AF? What can it cause?
Used for those who have failed previous therapy. Can crash CO.
If AF PT has structural heart disease what must you next determine?
If they have CAD or HF
If AF PT has CAD with structural heart disease what are treatment options
DDS->Amiodarine->Ablation
If AF PT has Heart Failure with structural heart disease what are treatment options?
Amiodarine or Dofetilides->Ablation
Which ion is blocked in the Class 1 drugs? What are the 6 Class 1 antiarrythmics?
Sodium
QPDLFP
What ions blocked in Class I, II, III, and VI
I=Na+
II=Ca++
III=K+
IV=Ca++
What ion is blocked in Class II drugs? What are they?
Calcium.
Beta-blockers.
What ion is blocked in Class III drugs? What are the 5?
Potassium
SAD.ID
Which ion is blocked in Class IV drugs? What are the two?
Calcium.
Verapamil and Diltiazem.