133 Tachydysrythmias Flashcards

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1
Q

What is the age for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

18 years old

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2
Q

What is the LOA for the medications in the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

unaltered
Altered go directly to cardioversion

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3
Q

What is the SBP for all medications for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

Normotensive

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4
Q

What treatments are available for narrow complex arrythmias in the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

Valsalva, adenosine, cardioversion

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5
Q

What treatments are available for wide complex arrythmias in the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

amiodarone, lidocaine, cardioversion

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6
Q

What must the HR be to treat in the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

narrow: 150
wide 120

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7
Q

What is added in the modified valsalva

A

Raising legs for 15 seconds

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8
Q

What class of medication is Adenosine?

A

Class 5 antiarrythmic

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9
Q

What does adenosine do to calcium and potassium?

A

Block calcium going into the cell
Causes Potassium to leave the cell

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10
Q

Where does adenosine work?

A

At the AV node

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11
Q

What does adenosine do to depolarization, conduction, and refractory periods?

A

Lengthens depolarization
Slows conduction, prevents re-entry in the AV node
Prolonges refractory periods

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12
Q

What does adenosine do to the coronary arteries

A

Vasodilates

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13
Q

What class of medication is amiodarone?

A

Class 3 antiarrythmic

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14
Q

Which classes of antiarrythmics does amiodarone have properties of?

A

Class 1-4

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15
Q

What are class 1 anti-arrythmics?

A

Sodium blocker

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16
Q

What do class 1 anti- arrythmics do?

A

Blocks Sodium in non-nodal cells
Decrease automaticity
Decrease conduction speed

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17
Q

What do class 2 anti-arrythmics do?

A

Betablocker to non- nodal cells

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18
Q

What do class 3 anti-arrythmics do?

A

Blocks potassium out of nodal cell
Delays phase 3 of the cardiac cycle
Lengthens action potential
Increases refractory period

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19
Q

What do class 4 anti-arrythmics do?

A

Calcium blocking
Decreases vascular resistance
Increases inotropy

20
Q

What are the contraindications for the valsalva maneouver?

A

Sinus tach
Atrial Fibrillation
Atrial Flutter

21
Q

What are the contrindications for adenosine?

A

Carbamazepine (Tegretol)
Bronchoconstriction on exam
Dipyidamole (aggrenox/ Persante)
Sinus Tach
Atrial fibrillation
Atrial Flutter

22
Q

What is the other name for Carbamazepine?

A

Tegretol

23
Q

What is the other name of dipyridamol?

A

Aggrenox
Persantine

24
Q

What class of anti-arrythmic is lidocaine?

A

1b (sodium channel blocker.)

25
Q

How does Lidocaine work?

A

Increases the time for myocyte to reach threshhold potential

Decreases ventricular irritability

Terminates reentry pathways

26
Q

What dose of adenosine is given for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

6mg then 12 mg

27
Q

How often is adenosine given for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

2 minute interval

28
Q

How many doses of adenosine is given for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

2

29
Q

When must we patch for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

To give amiodarone, lidocaine, or cardiovert

30
Q

What is the first dose of lidocaine for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

150mg

31
Q

How many doses of lidocaine is given for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

2

32
Q

What is the interval to given lidocaine for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

10 minutes

33
Q

What is the ONLY route for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

IV

34
Q

What is the first dose of lidocaine for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

1.5mg/kg up to 150

35
Q

What is the second dose of lidocaine for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

0.75mg/kg up to 150mg

36
Q

How often can lidocaine be given for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

Every 10 minutes

37
Q

How many doses of lidocaine do we have for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

3

38
Q

What are the joule settings for synchronized carioversion for the TACHYDYSRYTHMIA MEDICAL DIRECTIVE?

A

100
200
Max

39
Q

What is phase 2 called of the cardiac cycle?

A

Plateau phase

40
Q

What is phase 3 called of the cardiac cycle?

A

Repolarization phase

41
Q

What is phase 4 called of the cardiac cycle?

A

Resting potential

42
Q

What happens in phase 0 of the cardiac action potential cycle?

A

Fast sodium channels open
Rapid sodium in

43
Q

What happens in phase 1 of the cardiac action potential cycle?

A

Potassium channels open
Potassium out, chloride out

44
Q

What happens in phase 2 of the cardiac action potential cycle?

A

Calcium in
Potassium out

45
Q

What happens in phase 3 of the cardiac action potential cycle?

A

Caclium channels close
Potassium out

46
Q

What happens in phase 4 of the cardiac action potential cycle?

A

Sodium slow in
Potassium out

47
Q

What treatments can be done in the TACHYDYSRTHYHTMIA MEDICAL DIRECTIVE prior to a treat and release?

A

Valsalva
Adenosine