Therapeutics: Arrhythmia 4

Card Set Information

Author:
kyleannkelsey
ID:
267620
Filename:
Therapeutics: Arrhythmia 4
Updated:
2014-03-23 19:35:30
Tags:
Therapeutics Arrhythmia
Folders:
Therapeutics: Arrhythmia 4
Description:
Therapeutics: Arrhythmia 4
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user kyleannkelsey on FreezingBlue Flashcards. What would you like to do?


  1. What drugs are CI with Dobutamide?
    • Absolutely CI: HCTZ, SMX/TMP, verapamil, QT prolonging agents
    • Hold Class I or III antiarrhythmics for at least 3 half lives, amiodarone for 3 months
  2. Which Afib maintenance drugs are safe in LVD?
    Amiodarone, Dofetilide
  3. What is the Dosing for Ibutilide rhythm maintenance therapy?
    • 80-160 mg BID
    • CrCl 40-60 ml/min = QD
    • CrCl <40 ml/min = CI
  4. What is the dose for Dronedarone?
    400 mg PO BID
  5. What drugs are first line for for maintenance of Sinus rhythym in a patient with Minimal/no heart disease?
    1st Line: Dronedarone, flecainide, propafenone, sotalol
  6. What drugs are first line for for maintenance of Sinus rhythym in a patient with HTN and LVH (left ventricular hypertrophy/structural heart disease)?
    1st Line: Amiodarone
  7. What drugs are first line for for maintenance of Sinus rhythym in a patient with HTN and no LVH?
    1st Line: Dronedarone, flecainide, propafenone, sotalol
  8. What drugs are first line for for maintenance of Sinus rhythym in a patient with Coronary artery disease (CAD)?
    1st Line: Dofetilide, dronedarone, sotalol
  9. What drugs are first line for for maintenance of Sinus rhythym in a patient with Heart Failure?
    1st Line: Amiodarone, dofetilide
  10. What are all the options for anticoagulation at discharge for an Afib patient?
    • ASA + clopidogrel
    • Left atrial appendage (LAA) closure
    • Oral Anticoagulant/Antithrombotic:
    • Warfarin With LMWH bridging
    • Dabigatran
    • Rivaroxaban
    • Apixaban
  11. CHADS2 stands for what?
    • C: CHF
    • H: HTN
    • A: Age = or > 75
    • D: DM
    • S: Stroke or TIA
    • All are 1 point except S = 2
  12. Each CHADS 2 score point is equal to what increase in risk?
    1.5x
  13. What are the doses for Dabigatrin?
    • 150 mg po BID
    • If CrCl 15-30 ml/min, lower to 75 mg po BID
  14. What is the dosing for Rivaroxaban?
    • 20 mg po daily with evening meal
    • If CrCl 15-50 ml/min, reduce to 15 mg
    • Avoid if CrCl <15 ml/min
  15. What is the dosing for Apixaban?
    • 5 mg BID
    • If CrCl 15-29 ml/min - use with caution
    • If CrCl < 15 ml/min – CI
    • 2 or more of the following, reduce to 2.5 mg BID:
    • >80 years, <60 kg, Scr >1.5
  16. What is a high risk CHADS2 score?
    5-6
  17. What is a moderate risk CHADS2 score?
    3-4
  18. How would you bridge warfarin if needed for Afib?
    • Enoxaparin 1mg/kg BID
    • Initiate first day of held warfarin dose
    • Last dose given 24 hours prior to surgery
    • Resume:
    • 24 hours post-surgery if low risk of bleeding
    • 48-72 hours post-surgery if high risk of bleeding
  19. Which Antiarrhythmics tend to cause Monomorphic Vtach?
    Class IC antiarrhythmics (Flecainide and Propafenone)
  20. What is the treatment for Acute hemodynamically stable monomorphic tachycardia?
    • Adenosine 6 mg IVP followed by a second dose of 12 mg if needed
    • Consider amiodarone 150 mg IV over 10 min then start IV drip
    • Procainamide infusion is an alternative
    • Prep for cardioverson
  21. What is the treatment for Acute hemodynamically UNstable monomorphic tachycardia?
    immediate synchronized cardioversion
  22. What anticoagulation should be used in an Afib patient with >2 moderate risk factors?
    • Oral anticoagulation/antithrombotic (Grade 1A)
    • Aspirin 81-325 mg/D plus clopidogrel 75 mg/D (Grade 1B)
  23. What anticoagulation should be used in an Afib patient with 1 moderate risk factor?
    • Oral anticoagulation/antithrombotic (Grade 1B)
    • Aspirin 81-325 mg/D plus clopidogrel 75 mg/D (Grade 2B)
  24. What anticoagulation should be used in an Afib patient with 0 moderate risk factors?
    No antithrombotic therapy or ASA 81-325 mg/D (Grade 2B)
  25. How is Acute management of a thermodynamically UNstable torsades de pointes patient achieved?
    • Immediate cardioversion
    • Correct abnormal serum electrolyte
    • Magnesium 1-2 g diluted in 10 ml D5W IV push over 15 min
    • D/C offending agent
  26. How is Acute management of a thermodynamically Stable torsades de pointes patient achieved?
    • Correct abnormal serum electrolyte
    • Magnesium 1-2 g diluted in 10 ml D5W IV push over 15 min
    • D/C offending agent
  27. What are the potential offending agents for torsades de pointes?
    • Class IA, III antiarrhythmics
    • Erythromycin, clarithromycin, quinolones, azole antifungals
    • Haloperidol, phenothiazines, TCAs
    • Diuretics (electrolyte disturbances)

What would you like to do?

Home > Flashcards > Print Preview