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Management Of Bradycardia And Tachycardia Flashcards

1
Q

What is the first line management of bradycardia?

A

Atropine 500mg loading dose

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2
Q

What is the second line management of bradycardia?

A

Transcutaneous pacing

Isoprenaline

Adrenaline

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3
Q

What is given for bradycardia second line in Beta blocker or CCB overdose?

A

1st line: 500mg atropine

2nd line Glucagon

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4
Q

What is a risk factor for aasystole?

A

Mobitz type II block
Complete heart block
Broad QRS
Over 3s ventircular pauses

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5
Q

What is first line for atria flutter that is haemodynamically stable?

A

Beta blocker

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6
Q

First line drug for asthmatics with tachycardia?

A

Verapamil

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7
Q

First line drug for atrial fibrillation that is unstable?

A

3 synchronised electrical cardioversion

-> th is includes those with features of heart failure

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8
Q

What is second line for afib that is unstable?

A

Amiodarone

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9
Q

What to do if the patient has no adverse features of shock with bradycardia?

A

Check thyorid function and electrolytes

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10
Q

What does regular r-r interval and QRS narrow indicate?

A

AVNRT

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11
Q

What does QRS narrow and irregular R-R interval indicate?

A

Atrial fibrillaiton

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12
Q

What is the primary use of adenosine?

A

To terminate supraventricular tachycardias

Adenosine acts as an agonist of the A1 receptor in the atrioventricular node.

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13
Q

What is the mechanism of action of adenosine?

A

Inhibits adenylyl cyclase, reducing cAMP and causing hyperpolarization by increasing outward potassium flux

This action occurs primarily in the atrioventricular node.

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14
Q

What is the half-life of adenosine?

A

About 8-10 seconds

This very short half-life necessitates careful administration.

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15
Q

What enhances the action of adenosine?

A

Dipyridamole

Dipyridamole is an antiplatelet agent that can enhance the effects of adenosine.

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16
Q

What substance blocks the action of adenosine?

A

Theophyllines

Theophyllines can inhibit the effects of adenosine.

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17
Q

Why should adenosine be avoided in asthmatics?

A

Due to the risk of bronchospasms

Adenosine can induce bronchospasm, which is particularly dangerous for asthmatics.

18
Q

How should adenosine ideally be infused?

A

Via a large-calibre cannula

This is recommended due to adenosine’s short half-life.

19
Q

What are common adverse effects of adenosine?

A

Chest pain, bronchospasm, transient flushing

These effects can occur during adenosine administration.

20
Q

What can enhance conduction down accessory pathways when using adenosine?

A

Increased ventricular rate, such as in WPW syndrome

This can lead to complications during treatment.

21
Q

What is the recommended dose of amiodarone for patients in VF/pulseless VT after 3 shocks?

A

300 mg

This is the initial dose to be administered under these conditions.

22
Q

What is the subsequent dose of amiodarone for patients in VF/pulseless VT after 5 shocks?

A

150 mg

This is given as a follow-up to the initial dose.

23
Q

What is an alternative to amiodarone if it is not available?

A

Lidocaine

Lidocaine may be used based on local decisions or availability.

24
Q

What does the Valsalva manoeuvre describe?

A

A forced expiration against a closed glottis

This action leads to increased intrathoracic pressure affecting the cardiovascular system.

25
What is one use of the Valsalva manoeuvre?
To terminate an episode of supraventricular tachycardia ## Footnote This technique can help restore normal heart rhythm.
26
What is another use of the Valsalva manoeuvre?
Normalizing middle-ear pressures ## Footnote This is particularly useful during changes in altitude.
27
What is the first stage of the Valsalva manoeuvre?
Increased intrathoracic pressure
28
What happens to venous and right atrial pressure during the Valsalva manoeuvre?
They increase, reducing venous return
29
What effect does reduced preload have on cardiac output?
Leads to a fall in cardiac output (Frank-Starling mechanism)
30
What occurs when the pressure is released during the Valsalva manoeuvre?
A further slight fall in cardiac output due to increased aortic volume
31
What is the final outcome of the Valsalva manoeuvre?
Return of normal cardiac output
32
What does the Valsalva manoeuvre describe?
A forced expiration against a closed glottis ## Footnote This action leads to increased intrathoracic pressure affecting the cardiovascular system.
33
What is one use of the Valsalva manoeuvre?
To terminate an episode of supraventricular tachycardia ## Footnote This technique can help restore normal heart rhythm.
34
What is another use of the Valsalva manoeuvre?
Normalizing middle-ear pressures ## Footnote This is particularly useful during changes in altitude.
35
What is the first stage of the Valsalva manoeuvre?
Increased intrathoracic pressure
36
What happens to venous and right atrial pressure during the Valsalva manoeuvre?
They increase, reducing venous return
37
What effect does reduced preload have on cardiac output?
Leads to a fall in cardiac output (Frank-Starling mechanism)
38
What occurs when the pressure is released during the Valsalva manoeuvre?
A further slight fall in cardiac output due to increased aortic volume
39
What is the final outcome of the Valsalva manoeuvre?
Return of normal cardiac output
40
What to give for broad complex tachycardia?
Amiodarone
41
When is synchronised cardioversion used?
Tachycardia
42
What is used second line for atropine failure in symptomatic bradycardia? e
External pacing

Year 3 (349 decks)

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