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[image]Which class of antidysrythmics and what ion is affected? |
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describe class I antiarrythmics |
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Class I are Na blockade 1a: prolong repolarization 1b: shorten repolarization 1c: repolarization unchanged |
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dilantin is what type of antiarrythmic |
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class 1b which shortens repolarization |
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lidocaine is what class of antiarrythmic |
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class 1b which shortens repolarization |
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procainamide is what class of antiarrythmic |
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class 1a which prolongs repolarization |
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which antiarrythmic is a class Ic |
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which antiarrythmic class is a beta adrenoreceptor antagonist |
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adenosine has such a short half life because it is metabolized by |
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vascular endothelial cells |
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adenosine effects can be blocked by |
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a person on digatlis is having arrythmias you can help treat these by giving |
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magnesium (remember digatalis results in increased Ca, so increase Ca can cause arrythmias) |
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will hypo or hyper kalemia result in digoxin toxicity |
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describe the effects of digitalis on the myocytes and conduction system of the heart in relation to ECG |
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1. hyperpolarization 2. prolonged PR interval 3. T wave flattening or inversion 4. Reduced AV conduction |
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what is the side effect of verapamil |
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major depression of AV node and negative chornotorpy on SA node more than diltazepam |
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verapamil and dilatizepam are in what CCB classes |
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1. Verapamil is a phenylalkylamine 2. diltazepam is a benzothiazepine |
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class I anti arrythmics are used to treat what three conditions |
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1. acute and chrnoic SVT 2. slow atrial rate in AFIB 3. suppress tachydysryhtmis associated iwth WPW |
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Class II cardiac antidysrhythmics work by |
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1. depressing automaticity at nodal tissue 2. decreasing conduction speed of cardiac impulses |
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digoxin induced cardiac dysrhthmias are best treated wtih what five drugs |
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1. lidocaine 2. procainamide 3. dilantin 4. propanolol 5. DC countershock |
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what drug has shown to be very effective in treating dysrhtymias associated with digoxin toxicity |
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what antidysrthimc class may also have local anesthetic activity |
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what four drugs should be avoided with a patient on digoxin |
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1. sux (increase PNS) 2. Quinidine - increases levels of digoxin 3. Beta agonist (like epi, levo - can cause increase risk of cardiac dysrhtms.) 4. Calcium Cl or Calcium Carrbonate since they may preciptiate arrthym |
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what is the risk with giving dilantin to a hyperglycemic patient |
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dilantin paritally inhibits insulin release and therefore makes hyperglycemia worse. |
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what cardiac anti-arrhtymias should you consider for a mitral valve prolapse that causes dysrhtymias |
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1. esmolol 2. amiodarone 3. lidocaine |
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3x main effects of digitalis |
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1. increase inotoropy 2. decrease heart rate 3. slows propagation through AV node |
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what phase of the cardiac cycle does digitalis effect |
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phase 4. by decreasing automaticity and lowers heart rate. Automaticity is reflected in the slope of phase 4. |
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signs of digitalis toxicity |
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1. atrial or Ventricular dysrhtymias 2. Prolong PR 3. GI disturbances |
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what three electrolyte disturbances enhance digitalis toxicity |
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1. hypokalemia 2. hypercalcemia 3. hypomagnesemia
If those are present than big risk for digitalis toxicity. |
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how does hypokalemia enhance digitalis toxicity |
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hypokalemia allows incrased binidng of digitalis to the Na-K ATPase pump in cardiac cells, resulting ina n excessive drug effect. |
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why should hyperventilation be avoided during anesthesia for a patient who is taking digitalis |
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hyperventilation may cause hypokalemia, and hypokalemia increases likilihood for digitalis toxicity. |
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plasma concentrations of potassium decreases how much for how much change in PaCO2 |
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decrease K 0.5 mEq/L for every 10 mmHg decrease in paCO2 |
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what two CCB are good for treating coronary artery vasospasm |
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1. nifedipine 2. diltiezpam |
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How do CCB affect drugs we use in anesthesia |
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potentiates the actions of nondepolarizers |
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verapamil is contraindicated in what six patient groups |
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1. WPW 2. Sick sinus syndrome 3. AV block 4. HF 5. Pts on beta blockers (synergistic) 6. pts on digitalis. |
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why is verapamil a poor choice when treating patients with WPW |
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verapamil may increase conduction velocity in the accessory tract and increase heart rate excessively |
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which is better for peirpheral vasodilatition verapimil or diltizaem |
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describe five cardiovascular effects of histamine |
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1. relaxes smooth muscles of arterioles and small blood vessels 2. increase capillary permeability causing edema 3. increases contracility of heart 4. increase HR 5. acts on the adrenal medulla to stimulate release epi and norepi. ' 6. vasoconstricts bronchial smooth muscle |
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