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46 Cards in this Set
- Front
- Back
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What is the DOC for Paroxyxsmal Supraventricular Tachs?
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Verapamil
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What are uses for AHA's?
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Reetrant Supraventricular Tach, & control of rapid ventricular response due to atrial flutter/fibrillation
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What occurs as a result of the hypotensive effects of AHA drugs?
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A small reflex inc in SA node firing
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Which drug has some Na+ channel activity? What can it predispose pt's to?
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Bepridil. Torsades de pointes
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This drug is not currently approved for antiarrhythmic indications?
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Bepridil.
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What other effect does bepridil have?
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It slows repolarization (prolonged QT interval) - may induce Torsades
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AHA's should not be used for these conditions?
(when a sick hippo is shockingly coughing cards) |
SSSyndrome, 2nd/3rd degree AV block, hypotension, CHF.
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IV verapamil should not be used with what drugs? Why?
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B-blockers. The depress cardiac contractility and AV conduction.
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What are the AHA drugs?
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The Ca+ channel blockers: nefedipine, bepridil, verapamil, and diltiazem. They are Antianginal, AntiHypertensive, and AntiArrhythmic
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What is the mechanism of the AHA drugs?
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Reduce depolarization by blocking Ca+, neg. inotropy, depressed automaticity, reduced conduction velocity
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How do AHA drugs affects the AV node? AV and SA node conduction?
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Prolong ERP. Depresses their conduction.
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How does AHA work in atrial flutter or fibrillation?
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It slows the ventricular rate.
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What does they convert?
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Supraventricular Tachs to normal sinus rhythm.
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What is the action of of AIDS drugs?
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They prolong phase 3 repolarization, and lengthen the QT interval
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What are the cardiac effects of amiodorone?
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Slows sinus rate and AV conduction. Inc. repolarization and refractoriness
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What are the extracardiac effects of amiodorone? What is its boxed warning?
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Dilitation (peripherally), alpha blockade, & ca+ channel blockade. Pulmonary toxicity
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What are the fx's of pulmonary toxicity?
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Interstitial pneumonitis, alveolitis, and pulmonary fibrosis
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What is another extracardiac effect that involves the cornea, liver, thyroid, and skin
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Microcrystals of drug are deposited into all the tissue.
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What is amiodarone used for?
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Life threatening recurrent ventricular arrhythmias or recurrent unstable ventricular tachycardia
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It may be used as a preferred alternative in what other cases?
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pulseless ventricular tach, atrial fib, refractory paroxysmal supraventricular tach, multifocal atrial tach, and monomorphic/polymorphic ventricular tach
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This drug has beta-blocking activity (nonselective, nonsympathomimetic, low lipid solubility)
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Sotalol
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Sotalol demonstrates these affects which are seen w/ B-blockers
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fatigue, bradycardia, dyspnea
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It is potentiated by these drugs?
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Class I agents, phenothiazines, and TCA's
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Pt's on Sotalol have an increased incidence of this arrhythmia?
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torsades de pointes
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What is Sotalol used to treat?
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Life-threatening ventricular arrhythmias
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Sotalol achieves normal sinus rhythm in these 2 arrhythmias?
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atrial fibrillation and atrial flutter
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Sotalol interferes with what ions and how?
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Na+. It delays repolarization by activation of a slow inward current.
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What is the half life of Amiodarone? Ibutilide?
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1 month; 6 hours
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What is ibutilide used for? What is its action?
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Recent onset of atrial fibrillation/flutter. Converts to normal sinus rhythm.
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What is the boxed warning for Ibutilide?
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Life-threatening arrhythmias (polymorphic ventricular tachycardia)
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This drug blocks the rapid component of the delayed rectifier potassium
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Dofetilide
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What is a serious side affect of dofetilide?
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Torsades!
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What is Dofetilide used for?
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Atrial fib/flutter conversion to normal sinus rhythm.
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Why is the affect on the SA node and AV nodes by Verapamil important?
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They depend on Ca+ current for activation
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Why does Bepridil predispose pt's to torsades?
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It slows repolarization (prolongs QT)
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What is the therapeutic use of Ca+ channel blockers?
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for Reeentrant supraventricular tachycardia
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This drugs has indirect vagomimetic actions?
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digitalis
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How does digitalis work? What 2 phases does it affect and how?
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It depresses the Na+ pump and produces arrhythmias. Phase O is diminished. Phase 4 depolarization is increased.
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What are two uses for digitalis?
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CHF, and atrial tachycardias
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This drugs produces a bradycardia that is resistant to atropine?
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Adenosine
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What are the two activities of adenosine?
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Reduces SA node automaticity and depresses AV nodal conduction
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What are the 3 electrophysiology mechanisms of Adenosine?
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Inc K+ conductance, reduces c-AMP slow Ca+ channel conduction, antagonizes catecholamines
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What is the half life of Adenosine?
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10 seconds
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What are the main side effects of Adenosine?
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dyspnea, flushing, retrosternal chest pain, and transient asystole
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What does Adenosine treat?
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Paroxysmal Supraventricular Tach to normal sinus rhythm
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What to drugs interact with Adenosine and how?
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Dipyridamole; potentiation.
Methylxanthines; are adenosine receptor antagonist and affect its effects in the AV node |
