cardiac drugs 2

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Expand coronary arteries (nitroglycerin & hydralazine)

Vasodilator

Most common vasodilator drug

Nitroglycerin

Drugs to relieve heart pain (morphine sulfate)

Narcotic analgesics

Common narcotic analgesic

Morphine sulfate

Common antiplatelet agents

Aspirin (ASA), clopidogrel

Drugs that rid body of excess fluid- names & Fx

Diuretics (lasix & midamor)

Drugs that break up clots

Antithrombotics (thrombolytic agents)

Common thrombolytics

Streptokinase, tissue plasminogen activator

Given AFTER antithrombotics to prevent further clot formation

Anticoagulants- when given

Common anticoagulants

Heparin, Warfarin

Positive inotropic drugs that slow heart

Cardiac glycosides

Cardiac glycoside that slows and strengthen heart (positive inotropic, negative chronotropic)

Digitalis

Group of drugs to treat muiltiple heart arrhythmias

Antidysrhythmics

Lidocaine class and uses

Class 1b, alternative to amiodarone, 2nd line for VFib &shock resistant Vtach; 1st line for wide QRS

Sotalol class & uses

Beta blocker & K channel blocker; use in V-tach and A-fib

1st line ADULT Wolff-Parkinson-White

Verapamil or adenosine

1st line for PSVT

Adenosine

Beta blockers class, activity & use

Class II, Negative inotropic, negative chronotropic vasodilators that slow heart in V-tach/V-fib (sotalol & propranolol)

Drug choices to slow, then restore, atrial flutter

Diltiazem/verapamil or digoxin to slow; amiodarone/flecainide to restore rhythm

Phenytoin class & uses

Class 1b, alternative to lidocaine (which is 2nd line to amiodarone)

MI that crosses entire heart muscle, always have abnormal Q

Transmural infarct

LVH calculation

(height of S in V1) + (height of R in V5) > 35 mm

LVH indicators

Large S in V1 & large R in V5

RVH indicators

Large R in V1

Normal axis indicators

Lead 1 and AVF both positive (all upward deflections)

First degree AV block indicators

All Ps have QRS, but PR > 0.20

AV conduction abnormalities can be caused by these drug groups

Beta blockers, calcium blockers & digitalis all can cause this conduction abnormality

Mobitz Type I second degree block (Wenkebach) indicators

PR progresively increases, then QRS drops

Mobitz Type II second degree block

P-P constant, but QRS drops out every 3rd or 4th

High grade second degree block

Every second QRS dropped

Third degree block

Dissociated atria/ventricles.

RBBB etiology

Asymptomatic or anterior MI

RBBB indicators

QRS duration >100 ms, terminal R wave in V1, slurred S wave in leads I and V6

LBBB indicators

QRS >120 ms, QS in V1, monophasic R in leads I and V6

Diagnosing RBBB vs LBBB

WiLLiaM MaRRoW, (LBBB : W in V1 and M in V6; RBBB: M in V1 and W in V6)

1st line for PSVT, narrow QRS tachy w/ pulse

Adenosine

Diltiazem uses

2nd line for PSVT, narrow QRS tachy or non-converting Afib. Rx: Afib, hypertension, angina

1st line bradycardia

Atropine sulfate

2nd line bradycardia

Dopamine

Diltiazem & verapamil group & uses

Calcium blockers that slow heart, re-entry SVT & recurrent narrow QRS tachy

Beta blocker names, negative-inotropes

Atenolol, metoprolol & propranolol

1st line for torsades de pointes VT

Magnesium sulfate

Wenkebach synonym

Mobitz type I (p intervals increase until QRS drops )

Antiplatelet agents (fx, name two)

Prevent platelet adhesion (aspirin & clopidogrel)

ACE fx, names and ending

Angiotensin Converting Enzyme blocker, vasotec, lotensin, "pril"

Lower BP & slow heart by blocking epinephrine

Beta blockers (atenolol, metoprolol & propranolol)

Class & name of drugs that lower BP & weaken heart by blocking calcium entry

Calcium blockers (verapamil & diltiazem) action

Verapamil & diltiazem class & uses

Calcium blockers (class 4) used after adenosine in PSVT & narrow QRS tachy

Diuretics that lower BP & edema

Lasix (furosemide) & amiloride (midamor)

Class & names of drugs that lower cholesterol

Statins (inhibit HMG-CoA reductase) Lipitor, Torvast

Drugs that speed up heart by blocking vagus (Eg=)

Parasympatholytics (Atropine)

Drugs that activate "fight or flight" to speeds heart & raises BP (Eg)

Sympathomimetics (Epinephrine)

Epinephrine 1st & 2nd line uses

1st line all pulseless (Vfib, VT, PEA, asystole) & 2nd line Brady after Dopamine

Amiodarone 1st & 2nd line uses

1st line wide QRS tachy, 2nd line pulseless Vfib, VT

Atropine 1st & 2nd line uses

1st line bradycardia, 2nd line asystole/PEA

Unshockable pulseless arrests

Asystole, PEA

Shockable pulseless arrests

Vfib, VT

Name for polymorphic wide QRS Vtach

Torsades de pointes

Propranolol uses

1st line beta blocker for ALL suspected MI & unstable angina EXCEPT severe brady

1st line trio for STEMI

Beta blocker (propranolol), clopidogrel (anti-platelet) & heparin (thrombolytic)

1st line quartet for NSTEMI or hi-risk angina

Nitroglycerin, Beta blocker (propranolol), clopidogrel (anti-platelet) & heparin (thrombolytic)

Calcium blockers traits and names

Negative inotropics, negative chronotropic, negative dromotropic, increase repolarization. (Verapamil & diltiazem)

Phase 0 of cardiac cycle

Na influx fast depolarization

Phase 1 of cardiac cycle

K efflux

Phase 2 of cardiac cycle

K efflux w/ Ca influx

Phase 3 of cardiac cycle

K efflux

Phase 4 of cardiac cycle

Resting potential (-90)

Class 1 drugs, general

Decrease Na+ influx in phases 0 and 4, depress fast condictive tissue

Class 1a action

Lengthens AP, slow ventricular conduction, prolong repolarization

Class 1a names

Quarter Pounder: Quinidine & Procainamide class

Class 1a uses

Treat PVCs, VT, Wolff-Parkinson-White (WPW) syndrome, wide QRS

Class 1b action

Shortens AP, slow ventricular conduction, hastene repolarization

Class 1b names

Long Playing (LPs): Lidocaine, Phenytoin class

Class 1b uses

Use in PVCs, WPW; treat digoxin overdose

Class 1c action

No change in AP length, slows fast conduction, no change in repolarization. Rx PAfib, PVCs (bigemminy/trigemminy).

Class 1c names

Fries Please!: Flecainide & Propafenonone.

Class 2 action & names

Block beta-1 receptors, reduce Ca influx, propranolol, metoprolol, atenolol

Class 2 names

MAPS: Metoprolol, atenolol, propranolol (sotalol)

Class 2 uses

1st line suspected MIs & uncontrolled angina, Rx tachycardias w/ this class

Class 3 action & names

Class that blocks K channels, slows & strengthen heart, extends repolarization

Class 3 names

(ASK+): Amiodarone, sotalol class (K+ class)

Class 3 uses

Class used for 1st line wide QRS, 2nd line pulseless Vfib, VT Rx: serious dysrhythmias, PVCs

Class 4 action, verapamil and diltiazem

Ca channel blockers, decrease AV conductivity & block re-entry rhythms,

Class 4 names

Veneral Disease (VD): Verapamil, Diltiazem class

Class 4 uses

Class used for 2nd line narrow QRS tachy

Adenosine action

Drug that decreases slow (AV) conduction w/out changing fast conduction

Cardiac glycoside action & Rx

Slow Na/K pump, increase Ca, decrease slow (AV) conduction positive inotropic, Rx CHF

ACE inhibitor names

Drugs end in "-pril," Lotensin, Vasotec

Procainamide complications

Liver inflammation, drug-induced lupus, immune suppression

Quinidine, flecainide, verapamil interactions

These drugs double digoxin effect, impairs renal activity

Amiodarone complications

Lung & liver inflammation, thyroid dysfunction

Beta blocker complications

Not for blacks, asthmatics, Type 1 diabetics

Verapamil complications

Brady, shock,

Digoxin complications

Brady, syncope. Exacerbated by hypokalemia (diuretics)

Drug for low ejection fraction w/ VT

Digoxin because ventricular conduction & positive inotropic

Selectively suppresses His-Purkinje conduction

Lidocaine conduction effects

Drug that selectively suppress SA conductivity

Calcium blockers & beta blockers

Trio for PVCs

ALPs: Amiodarone, lidocaine, procainamide

Drug for digoxin overdose

Lidocaine

1st line CHILD Wollf-Parkinson-White

Digoxin in kids

1st line treatment/cure for WPW syndrome

Catheter (radiofequency) ablation

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