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101 terms

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