Cardio Concepts

Front 1

Positive SA node influence

Back 1

B-adrenergic

Front 2

Negative SA node influence

Back 2

Vagal

Front 3

His-Perkinje influence

Back 3

B-adrenergic causes increased automaticity

Front 4

3 things to slow pace of the heart?

Back 4

1. MDP more negative
2. Phase 4 depol. slower
3. Threshold more positive

Front 5

EAD

Back 5

Early After Depolarization
-spon. depol. during phase 3
(muscle stretching, hypoxia)

Front 6

DAD

Back 6

Delayed After Depolarization
-spon. depol. during phase 4
(B-adr, card. gly., extracellular ca)

Front 7

1st degree AV block

Back 7

long PR interval, benign

Front 8

2nd degree AV block

Back 8

occasional missed beat

Front 9

Mobitz I AV block

Back 9

heart misses QRS-ventricular beat

Front 10

Mobitz II AV block

Back 10

QRS missed-at bundle of His

Front 11

3rd degree AV block

Back 11

atrial beats do not go through AV node, waves independent of each other

Front 12

Atrial flutter

Back 12

250-350 bpm, very rapid
**TX=propranolol, verapamil

Front 13

Atrial fibrillation

Back 13

fibers stim too rapidly--no contraction
**TX=propranolol, anticoagulant

Front 14

Supraventricular arrhythmia

Back 14

rapid premature contractions
TX: propranolol, verapamil
ACUTE TX: adenosine

Front 15

Ventricular tachycardia

Back 15

180 bpm, dangerous, may lead to ventricular fib.
TX: lidocaine

Front 16

Ventricular fibrillation

Back 16

no effective pumping, extremely dangerous, requires defibrillation
TX: epinephrine

Front 17

Automaticity

Back 17

cells spontaneously reach threshold and fire action potentials (SA node=normal)

Front 18

Excitability

Back 18

tendency to fire at a given stimulus

Front 19

Autonomic effects

Back 19

w/ drugs: change heart rate, stroke volume and total peripheral resistance

Front 20

Treatment goals of anti-arrhythmia drugs (1)

Back 20

1. Suppress abnormal automaticity (reduce ectopic pacemaking)

Front 21

Treatment goals of anti-arrhythmia drugs (2)

Back 21

2. Correct abnormal impulse conduction (prevent reentry of impulses)

Front 22

Type I drugs

Back 22

Block sodium channels

Front 23

Type II drugs

Back 23

Block sympathetic effects
(Beta blockers)

Front 24

Type III drugs

Back 24

Prolong refractory period
(Potassium channel blockers)

Front 25

Type IV drugs

Back 25

Block calcium channels

Front 26

Sodium channel blocker actions

Back 26

1. reduce automaticity
2. reduce excitability
3. reduce reentry

Front 27

Beta blocker actions

Back 27

1. reduce automaticity
2. reduce excitability
3. reduce contractility
4. reduce reentry

Front 28

IA Key

Back 28

inhibit sodium channels in active or damaged tissue

Front 29

IB Key

Back 29

have greater effects on damaged myocardium

Front 30

IC Key

Back 30

very slow off rates

Front 31

II Key

Back 31

block sympathetic effects through inhibition of b-ad receptors
***dizziness, ED

Front 32

Potassium channel blockers

Back 32

1. increases refractory period
2. little or no effect on automaticity or excitability

Front 33

III Key

Back 33

prevent repolarization of channels
***can induce arrhythmias

Front 34

Calcium channel blockers

Back 34

1. reduce automaticity
2. minimal effects on excitability

Front 35

IV Key

Back 35

targets SA and AV nodal pacemaking cells
***reflex tachycardia

Front 36

Adenosine treatment

Back 36

PSVT, WPW syndrome
*causes no beat for a few seconds

Front 37

CAST trial

Back 37

BAD: encainide, flecainide, moricizine
GOOD: beta blockers

Front 38

CHF

Back 38

^ heart rate & O2 consumption
\/ stroke volume
heart swells, fluid accumulation

Front 39

Digoxin MOA

Back 39

^ intracellular Ca and contraction
**low K, high dig binding
TARGET=sod/pot pump

Front 40

Control HR-sympathetic

Back 40

cardiac B1-increases cAMP

Front 41

Control HR-parasympathetic

Back 41

cardiac M2-decreases cAMP

Front 42

RX for CHF

Back 42

inotropic agents w/ vasodilator w/ diuretic

Front 43

Angina

Back 43

chest pain caused by coronary blood flow that is inadequate to meet the O2 demands of the myocardium

Front 44

Angina RX goals

Back 44

improve heart blood flow and reduce myocardial O2 requirement

Front 45

RX classes for angina

Back 45

K channel openers
nitrates
ca channel blockers
ACE inhibitors
beta blockers

Front 46

potassium channel openers

Back 46

diminished contraction, vasodilate

Front 47

Nitric oxide

Back 47

crucial mediator of VSMC tone

Front 48

nitrates

Back 48

(generation of cGMP) relax arterial and venous smooth muscle
**can develop tolerance

Front 49

calcium channel blockers-angina

Back 49

vasodilate-reduce afterload
**SE's: hypotension

Front 50

ACE-I

Back 50

lower blood pressure
**SE's: cough (bradykinins in lungs), hypotension

Front 51

ang II receptor blockers

Back 51

lowers blood pressure
** hypotension but no cough

Front 52

beta blockers-angina

Back 52

takes work off heart by b1 and ang-ren system, decreases O2 req of heart
***do not use in diabetes, COPD

Front 53

Hypertension def

Back 53

DBP is above 90 mmHg

Front 54

primary (essential) hypertension

Back 54

95% of cases
**worsened by obesity, smoking, and not enough exercise

Front 55

secondary htn

Back 55

5% of cases
**OCP's, pregnancy, renal disease

Front 56

complications of htn

Back 56

CHF, renal failure, stroke

Front 57

non-RX TX of htn

Back 57

lose weight, reduce salt, reduce alcohol, stop smoking, do exercise

Front 58

1st 3 RX's for HTN

Back 58

ACE, ARB, aldosterone antagonists

Front 59

2nd 3 RX's for HTN

Back 59

diuretics, ganglionic blockers, beta blockers

Front 60

3rd 4 Rx's for HTN

Back 60

alpha blockers, vasodilators, alpha 2 agonists in CNS, noradrenergic neuron blockers

Front 61

ganglionic blockers

Back 61

blocks autonomic system through nicotinic receptor
**used in emergency