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24 Cards in this Set
- Front
- Back
phases of myocardial AP
phase 0 |
resting potential
-90 mV Na + channels open, Na rushes in |
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phases of myocardial AP
phase 1 |
depolarization phase
this is peak potential (+10mV) Na channels close |
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phases of myocardial AP
phase 2 |
Plateau, refractory period
Ca channel opens, rushes in K channel opens, rushes out |
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phases of myocardial AP
phase 3 |
refractory period, repolarization
Ca channel closes |
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avoid which antidepressant in patients at risk for QT prolongation
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citalopram
|
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before starting meds for non-life threatening arrhythmia, check what
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check electrolytes and run a tox screen
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class 1a antiarrhythmic meds
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quinidine, procainamide, disopyramide
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class 1b antiarrhythmic meds
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lidocaine, mexilentine, phenytoin
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class 1c antiarrhythmic meds
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flecainide, propafenone
|
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class II antiarrhythmic meds
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BB, esmolol and propanolol
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class iii antiarrhythmic meds
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amiodarone, dofetilide, dronedarone, ibutilide, sotalol
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class iv antiarrhythmic meds
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diltiazem and verapamil
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class I antiarrhytmics work by..
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blocking Na+ channels, the sub classes determine length of blocking
1a - intermediate 1b- fast blockers 1c- long na channel blockers |
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quinidine
class? BBW SE |
1a
BBW- may increase mortality SE- LOTS of diarrhea, stomach cramping, tinnitus (cinchonism) strong anti-cholinergic |
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procainamide
class metabolite? BBW SE |
1a
active metabolite- N-acetyl procainamide (NAPA) BBW- fatal blood dyscrasias (agranulocytosis) may cause drug induced lupus SE- hypotension, NVD, lupus |
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disopyramide
SE |
strong anti-cholinergic
xerostomia, constipation |
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disopyramide interacts with
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digoxin (decrease dig by 50%) and grapefruit juice
|
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what arrhythmias are class 1b used for
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ventricular arrhythmias, no supra ventricular (A.Fib)
|
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class ii antiarrhythmics used to tx
and how |
they block beta and indirectly block Ca channels in SA and AV nodes
used to slow ventricular rates in supraventricular tachycardias |
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class iii antiarrthymic - ihate this word- meds
how do they work |
block K channels
|
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amiodarone
BBW SE dosing longer than 2 hours, must be administered in.. t1/2 |
BBW- Liver tox, and can cause arrhythmia
SE- hypotension, hypo/hyperthyroidism, optic neuritis, ataxa, pulmonary fibrosis must be admin in non PVC container-glass or polyolefin t1/2=55 days!! |
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dronaderone
brand? SE |
dronaderone
like amiodarone- hepatic failure, renal failure, pulmonary fibrosis, increased SCr hypoK, hypoMg |
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Sotalol
Monitor |
SCr, BUN, K
CI- in <40ml/min and K <4 |
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AGENTS not in the Vaughan-Williams classification for arrthymias
|
adenosine
digoxin (lanoxin) a. fib therapeutic rang 0.8-2 ng/ml antidote- digibind or digifab |