bradycardia Class IV Calcium Channel Blockers diltiazem Cardizem verapamil

Bradycardia class iv calcium channel blockers

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bradycardia Class IV: Calcium Channel Blockers → diltiazem (Cardizem) → verapamil (Calan) Decrease automaticity of SA node, delay AV node conduction; reduce myocardial contractility Bradycardia, prolonged PR interval, AV block Other antidysrhythmic drugs: → adenosine (Adenocard) → digoxin (Lanoxin) → dronedarone (Multaq) [classes I-IV properties present in this drug) → magnesium → decrease conduction through AV node, reduce contractility of SA node → suppresses atrial dysrhythmias through an unknown mechanism → prolonged PR interval, AV block → Prolonged QT interal
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→ decreases the impulse conduction through AV node → AV block Permanent pacemaker: Implanted totally within the body Pacing leads are placed transvenously to the right atrium and/or one or both ventricles and attached to the power source Temporary pace maker Transvenous pacemaker consists of a lead or leads that are threaded transvenously to the right atrium and/or right ventricle and attached to the external power source Pacemakers: Post-procedure care OOB once stable Limit arm and shoulder activity Monitor insertion site for bleeding and infection Patient teaching important Do not take pulse/IV/BP on effected arm Use cell phone on opposite side of pacemaker NO MRIs ACUTE CORNOARY SYNDROME It all starts with CAD Atherosclerosis CAD Acute Coronary Syndrome (MI) o Unstable o ST will be elevated o Cardiac cath allows us to visualize block and fix problem o Iodine allergies!! They will feel a warm flush o Hold metformin, blood thinners o Post-op priority bleeding, have them lay down for 4-6 hr Valve replacement o Stenosis/regurgitation o Long-term valves o Lifelong anticoagulants o NO MRI, airport security as magnetic o Infections are harder to treat Infective Endocarditis o ABX before any invasive procedures o Causes: Mechanical valves, IV drug users
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o Janeway lesions(not painful, on palms) and Osler’s nodes (painful fingertips) ACE Inhibitors(-pril) o Dry cough, prevent remodeling of the heart RESPIRATORY Pulmonary edema Patho? o Fluid in alveoli and interstitial spaces in lungs o Acute decompensated HF o Complication of heart and lung diseases What causes it? o HF (Most common L-HF secondary to CAD) o Overhydration o Low albumin, nephrotic syndrome, hepatic disease o ARDS What are the symptoms? o Increase pulmonary venous pressures o Increase RR, decreased pO2, o Increase HR and BP o Anxious o Cold and clammy o Severe dyspnea o Frothy, blood tinged sputum o Crackles/wheezing/rhonchi o JVD o BNP >500 o Dysrhythmias Treatments? o Funds and MS1 interventions o Lasix o BiPAP, mechanical ventilation o Hemodynamic monitoring o Morphine/Nitro/Inotropic support/Anticoag. o Ventricular assist device or intraaortic balloon pump Pleurisy Inflammation of pleura RF: Chest trauma, malignancies, chest tube insertion, pneumonia, and TB CXR can diagnose
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S/S: Pain on inspiration, pleural friction rub TX: Steroids and NSAID’s Interventions: TCDB Pleural Effusion Collection of fluid in pleural space
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  • Spring '17
  • collins
  • Cardiology, Atrial fibrillation, Cardiac electrophysiology

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