Sapna Gupta, Associate Professor
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CH 251, Respiratory DrugsSkeletal Muscle Relaxants, Antihypertensive Drugs, Angina Pectoris, Cardiac Arrhythmias, Congestive Heart Failure, Coagulation Disorders and Hyperlipidia, Endocrine Pharmacology, Male and Female Hormones, Thyroid and Parathyroid, Diabetes

Final Exam Objectives


CARDIAC ARRHYTHMIAS 

Deviation from normal heart beat (rhythm of the heart).

At rest the interior of cell is negative, as action potential occurs interior becomes positive (depolarizes) from the influx of  sodium ions. Efflux of potassium ions cause repolarization i.e. the interior once again becomes negative.

Certain cardiac cells initiate and maintain the spontaneous rhythm of the heart – these are the pacemaker cells.

Cause of cardiac arrhythmia:

1)      abnormal  impulse generation: caused by injury or disease

2)      abnormal pulse conduction: due local damage or diseases

3)      simultaneous abnormalities of impulse generation and conductance: see above

There are many types of arrhythmia : see table 23.1 (pg 327) for more info. 

Therapy

Explanation

Example

Adverse Effects

SODIUM CHANNEL BLOCKERS

Inhibit Na ion channels from opening up

Class I A: quinidine

Class I B: lidocaine

Class I C: encainide

Dizziness, nausea,

BETA BLOCKERS

Slow heart rate hence slowing conduction

metropolol,

acebutolol

Patients with poor heart pumping may have problems

DRUGS THAT PROLONG REPOLARIZATION

Delay repolarization hence time delay in current, giving time to heart to stabilize

bretylium

amiodarone

Pulmonary toxicity, liver damage

CALCIUM CHANNEL BLOCKERS

Inhibit calcium ion influx hence preventing excitability

verapamil

diltiazem

Very slow heart rate, dizziness


 

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