Psych and CV Flashcards
phases of myocardial AP
o - rapid depol (fast in Na)
1 - repol (outward K
2 palteau - inward Ca
3 repol - fast K rectifiers (outflow K)
4 resting potential
physiologic CV risk factors in depression
autonomic system dysfunction > loss in HR variabiltiy
inflammation+platelet reactivity >5H5 platelets reduced > clotting
Hypothalamic-pituitary-adrenal axis dysregulation > heightened arousal state + cortisol
CATIE study on metabolic syndrome
schz diagnosis associtated with 34% increased risk of mortalitiy following MI
normal QT men and women
440, 450
QT elongation without metabolic inhibition, high risk drugs
Thioridazine
Citaloproam
Ziprasidone
Haloperidol
Quetiapine
tangent measure of QT
tangent of steepest T wave slope and baseline (lead II or V5)
QTc = QT/sqrtRR from preceding RR interval
Tricyclic antidepressents
(many neurotransmitter effects)
Amitriptyline
Nortriptylinr
Chlorpromazine
Imipramine
Desipiramine
Doxepin
(All naughty cyclists inspire DDs)
lithium interactions
thiazide diuretics increase levels
loop diuertics + ACEi - varied risk of toxicity
Beta blocker and SSRI interactions
Metroprolol metabolized by 2D6, inhibitedby Proxetine
Clonidine a2 agonist, Mirtazapine a2 antagonist >mirtazapine displaces and reduces antihypertensive effect
metabolically neutral antipsychotics
apriprazole
ziprasidone
lithium excretion
renal
special concern for more lipophilic beta blockers that cross BBB
atenolol
esmolol
sotalol
Increased risk for weight gain antipsychotics
Clozapine, Olanzapine highest
elevated for risperidone
treatment tricyclic toxicity
IVF bolus
Vasopressor support if refractory to
**Sodium Bicarb **
risk factors for TdP
Genetic LQTS
Age >65
Female
Circadian Rhythm
CV Disease
Bradycardia, HypoK, Mg,
