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28 Cards in this Set
- Front
- Back
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ANTIARRHYTHMIC THERAPY
AUTOMATICITY All cardiac cells have the potential to be? Latent pacemakers fire _____ then the S-A node Causes of ectopic foci? |
l All cardiac cells have the potential to be a pacemaker - if it is not the S-A node initiating an impulse = arrhythmia
l Latent pacemakers fire slower then the S-A node l Causes of ectopic foci: ischemia, acidosis, suppressant drugs |
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ANTIARRHYTHMIC THERAPY
REFRACTORINESS? |
l Responsiveness of a cardiac membrane during recovery of previous activity
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ANTIARRHYTHMIC THERAPY
MECHANISM OF ACTION OF ANTIARRHYTHMICS 2 |
l DECREASE AUTOMATICITY
l INCREASE THE REFRACTORY PERIOD |
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ANTIARRHYTHMIC THERAPY
QUINIDINE l DIFFERENT SALTS |
• SULFATE IS 83% QUINIDINE
• GLUCONATE IS 62% |
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ANTIARRHYTHMIC THERAPY
QUINIDINE l PHARMACOLOGY • |
DECREASE AUTOMATICITY
• INCREASE REFRACTORY PERIOD • Intravenous: dilate vessel (hypotension) • Increase conduction thru A-V node |
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ANTIARRHYTHMIC THERAPY
QUINIDINE ADVERSE REACTIONS 6 l |
ARRHYTHMOGENIC
l TOXICITY: Cinchonism • Tinnitus • Headache • Nausea/vomiting • vertigo |
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ANTIARRHYTHMIC THERAPY
QUINIDINE USAGE 2 |
l ATRIAL TACHYCARDIA
l ATRIAL FIBRILLATION • Use digoxin as adjunct therapy |
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ANTIARRHYTHMIC THERAPY
PROCAINAMIDE l PHARMACOLOGY 3 |
• Decreases automaticity
• Increases refractory period • Slows A-V conduction l |
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ANTIARRHYTHMIC THERAPY ADVERSE REACTIONS
PROCAINAMIDE 3 |
• Lupus-like Syndrome
• Dose Related, Reversible • Arrhythmogenic |
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ANTIARRHYTHMIC THERAPY
PROCAINAMIDE USE 3 |
l Atrial Tachycardia
l Atrial Fibrillation l Ventricular Arrhythmia - intravenous use when lidocaine fails or is contraindicated |
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ANTIARRHYTHMIC THERAPY
DISOPYRAMIDE l PHARMACOLOGY 4 |
• Decrease Automaticity
• Increase Refractory Period • No Effect on A-V conduction • Strong anticholinergic |
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ANTIARRHYTHMIC THERAPY
DISOPYRAMIDE CONTRAINDICATION |
• Congestive Heart Failure
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ANTIARRHYTHMIC THERAPY
DISOPYRAMIDE USE l 2 |
Atrial Tachycardia
l Atrial Fibrillation |
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ANTIARRHYTHMIC THERAPY
LIDOCAINE l PHARMACOLOGY 3 |
• Local anesthetics
• Antiarrhythmic (intravenous use only) • High therapeutic index |
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ANTIARRHYTHMIC THERAPY
LIDOCAINE ADVERSE EFFECTS 3 |
• CNS Toxicity: tinnitus, respiratory depression, seizure
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ANTIARRHYTHMIC THERAPY
LIDOCAINE 2 l |
l Antiarrhythmic Dosing
• Loading Dose • Intravenous infusion |
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ANTIARRHYTHMIC THERAPY
LIDOCAINE USE 2 |
Ventricular Arrhythmias
• Digoxin toxicity arrhythmias |
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ANTIARRHYTHMIC THERAPY
CLASS 1B AND 1C 3 |
l Mexelitine, Tocainide, Flecainide
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ANTIARRHYTHMIC THERAPY
CLASS 1B AND 1C uses |
• Oral agents for ventricular arrhythmias
• pharmacology similar to lidocaine |
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ANTIARRHYTHMIC THERAPY
PROPRANOLOL 2 |
l BETA BLOCKER
l INTRAVENOUS USE AS AN ANTIARRYTHMIC |
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ANTIARRHYTHMIC THERAPY
PROPRANOLOL USE 2 |
atrial tachycardia
• ventricular tachycardia |
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ANTIARRHYTHMIC THERAPY
AMIODARONE l USE - |
VENTRICULAR ARRHYTHMIAS
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ANTIARRHYTHMIC THERAPY
AMIODARONE ARRHYTHMIAS l IV FORM TO TREAT l ADVERSE REACTIONS 3 |
• cataract
• pulmonary fibrosis • hypothyroid |
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ANTIARRHYTHMIC THERAPY
AMIODARONE half life? |
l 45 DAY HALF LIFE
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ANTIARRHYTHMIC THERAPY
3 |
CALCIUM CHANNEL BLOCKER
l INTRAVENOUS PUSH FOR ANTIARRHYTHMIC PROPERTIES l SECOND DOSE CAN BE REPEATED IN 5 MINUTES l 90% EFFECTIVE |
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ANTIARRHYTHMIC THERAPY
USE VERAPAMIL |
l - atrial tachycardia
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ANTIARRHYTHMIC THERAPY
ATROPINE l |
ANTICHOLINERGIC
l INTRAVENOUS PUSH FOR ANTIARRHYTHMIC USE l |
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ANTIARRHYTHMIC THERAPY
USE ATROPINE |
- sinus bradycardia
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