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24 Cards in this Set

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Arrythmia
any disorder of rate, impulse formation, or conduction in the heart.
80
50
Highly lethal arrythmias have ___ % mortality in the first year if not treated; ___ % mortality with treatment.
Bradycardia
Tachycardia
Flutter
Fibrillation
A-V block
P.V.C. (premature ventricular contraction)
What are the 6 common arrythmic disorders?
P.V.C. (premature ventricular contraction)
If 1 _____/hr increased mortality risk; If 10 _____/hr see 20% mortality the first year.
Quinidine
prototype antiarrythmic drug

org. for malaria

dangerous, but effective.

chiefly a cardiac depressant
antiarrythmic
What kind of drug is Quinidine?
malaria
cardiac depressant
QUINIDINE

prototype antiarrythmic drug

org. for _________

dangerous, but effective.

chiefly a _______ _________
cardiac depressant
decreased excitability, conduction velocity, and contractility; appears more effective on His & Purkinje than on SA node. Prolongs effective refractory period. (good)
anticholinergic
atropine-like

action on AV node

so prevents cardiac slowing with muscarinic drugs.

DANGER when used to treat flutter or fibrillation b/c atrial flutter may be transmitted to ventricles.
cardiac depressant
anticholinergic
What are the mechanisms of action for quinidine?
AV
muscarinic
ventricles
anticholinergic

atropine-like

action on ___ node

so prevents cardiac slowing with ________ drugs.

DANGER when used to treat flutter or fibrillation b/c atrial flutter may be transmitted to _________.
1. atrial fibrillation
2. atrial flutter
3. ventricular tachycardia
4. premature systoles
What are the therapeutic uses for Quinidine?
atrial fibrillation
therapeutic use (quinidine)

converts to normal sinus rhythm

hospital setting
electrical conversion more commonly used than drug

sometimes used to prevent reoccurance of fibrillation
when digitalis fails to work
When is quinidine used to treat atrial flutter?
ventricular tachycardia
common complication of myocardial infarction

electroshock also used experimentally, automatic implantable defibrillators have been tried with some success

Lidocaine used in hospitals if episodes repeatedly occur
premature systoles
aka PVC

usually only treat if think will lead to more serious arrythmias (tachycardia, flutter, fibrillation)
cinchonism
What are the side or toxic effects of quinidine?
aspirin
cinchonism has the same symptoms that may be found in _______ poisoning.
GI: nausea extremely common
Ears: ringing
Eyes: blurred vision
CNS: nothing
What are the MILD SYMPTOMS of cinchonism for quinidine? (GI, Ears, Eyes, CNS)
GI: vomiting, diarrhea, abdominal pain

Ears: decreased hearing

Eyes: night blindness

CNS: headache
What are the more toxic SYMPTOMS of cinchonism for quinidine? (GI, Ears, Eyes, CNS)
low BP, respiratory depression, respiratory arrest, and low temp
What are the most toxic signs of cinchonism for quinidine?
1. complete AV block
2. cardiac failure
3. allergy to drug or idiosyncracy does occur
4. due to anticholinergic properties: caution: glaucoma, urinary retention
5. Serum potassium must be normal (hypokalemia decreases drug effectiveness, hyperkalemia increases it)
What are the contraindication or cautions for quinidine?
complete
allergy
glaucoma
normal
1. ________ AV block
2. cardiac failure
3. ________ to drug or idiosyncracy does occur
4. due to anticholinergic properties: caution: ________, urinary retention
5. Serum potassium must be ______(hypokalemia decreases drug effectiveness, hyperkalemia increases it)
Quinidine
Lidocaine
Beta blockers
Ca++ channel blockers
What are the antiarrythmic drugs that we need to know?