intro to arrhythmias Flashcards

1
Q

What are the 3 ways of which depolarizations deviate from normal?

A

Rate of impulse
Impulse site of origin
Conduction (transport of impulse)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are ions flow controlled by?

A

Gates

  • voltage sensitive
  • Can be modulated by ion conc. and metabolic conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which parts of the heart are sodium dependent?

A

Atrial, Purkinje and ventricular cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which cells of heart are calcium dependent?

A

SA and AV node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Is the SA node repolarization controlled by I(k)?

A

Nope its controlled by different potassium channels and thus drugs that Block I(k) tend to have no affect on SA node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the key factor of pathophysiology of arrhythmias and drugs to treat them?

A

relation between resting potential of a cell and the number of the action potential that can be evoked

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is I(K)?

A

Its rapid I(kr) and Slow I(Ks) added to one another.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is considered the refractory period?

A

The time between the end of phase 0 and the end of phase 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens when you black Na channels?

A

Number of channels available at optimal conditions are decreased

  • unavailable due to inactivation gate closure and drug blockage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the resting membrane potential of after Na channel blockers?

A

-55
which All Na+ channels are inactivated
- Increase refractory period of cell
- prolongs recovery time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the resting membrane potential of Av and Sa nodes?

A

-50– (-70) which is why they can depolarize even with a Na channel blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the factors that can lead to arrhythmias?

A
Ischemia 
Drug tox
Hypoxia
Acidosis/Alkalosis
Electrolyte abnormalities
Overstretching of cardiac fibers
Excessive catecholamine exposure
Autonomic influences
Scarred or diseased tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 2 factos that lead to arrhythmias?

A

Impulse formation

Impulse conduction problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 2 characteristics of impulse formation?

A

Diastolic and action potential interval

  • diastolic is more important
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Vegal discharge and what other drug will do what to diastolic interval?

A

Alter slope
Hyperpolerize

Achetylcholine and B-Adrenorecptor blocking drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What can increase slope of diastolic interval?

A
Hyperkale
B-adrenoceptor stimulation
Positive chronotropic drugs
Fiber stretch
Acidosis
17
Q

What is afterdepolarization?

A

Membrane voltage oscillations that result in transient abnormal depole of cardiac myocytes during phase 2,3,4,

Early and Delayed

18
Q

What happens in early afterdepolarization? Consequences?

A

Open Ca channel Last phase 2
Open Na channel Early phase 3
Inhibit K channel

Exacerbated by slow heart.

  • Torsades des pointes or tachys
19
Q

What happens in delayed afterdepolarization? Conseqences?

A

Elevated cytosolic Ca when cell is almost completely repolarized. Overloads SR and release Ca to cause depole.

Exacerbated by fast heart

20
Q

What is reentry?

A

Impulse reenters and excites areas of the heart more than once

can be called circus movements

21
Q

What needs to happen for reentry to occur?

A
  • some type of block’

- Conduction time must exceed refractory period

22
Q

What is the bundle of Kent?

A

Called Wolff-Parkinson-White syndrome

Abnormal electrical accessory connection between atria and ventricle.

allows impulse to be conducted without going through the AV node

23
Q

name some Class 1A drugs?

A

Quinidine
Procainamide
Disopyramide

24
Q

Name some Class 1B drugs?

A

Lidocaine

Mexilitine

25
Name some class 1C drugs?
Flecainide | Propafenone
26
What are the K channel blockers?
Amiodarone Defetilide Ibutilide
27
What er the Ca channel blockers?
Verapamil | Diltiazem
28
What are the B-Adrenergic blockers?
Propranolol Acebutolol Esmolol Satalol
29
What are state dependent drugs?
Only bind in activated or inactivated but not RESTED channels
30
What is inversely related to dose?
Channel specificity | - More drug you give the more spillover there is to secondary channels