Delusional
Forum Elite
Topics: 41
Posts: 226
|
42 year old female presents with palpitations... On exam: she was founf to have an irregular pulse.. her EKG showed the absence of P waves with a rapid ventricular rate and irregular. The medical cardioversion with Quinidine was suggested. Another drug had to be given to the patient prior to Quinidine...
What is the drug and why does it have to be given prior to Quindine?
|
| mjl1717
Forum Hero
Topics: 955
Posts: 5,451
|
Id give a Rx to slow AV node conduction such as a beta blocker or calcium channelblocker or maybe dig
___________________
Smell the coffee! "Is That an Osler move??"
|
| neevyg
Forum Junior
Topics: 15
Posts: 68
|
i'm guessing b-blocker as well
|
| Ouli Maty
Forum Elite
Topics: 33
Posts: 275
|
Quinidine blocks the M receptors of the heart causing tachycardia and increasing the firing of the AV node.
I think digitalis is classical in atrial fibrillation in order to slow down the AV node before giving Quinidine .
___________________
deep breathing...
|
| IMGPK
Forum Junior
Topics: 9
Posts: 49
|
Anticoagulant, Heparin or Warfarin.
Always anticoagulate before therapeutic cardioversion in Afib to decrease the risk of thromboembolism.
___________________
We need God, He doesnt need US
|
| asmi
Forum Hero
Topics: 1043
Posts: 4,609
|
Buut we can give digitalis prior to qunidine right?
Yes,anticoaglation is must beside them.
|
| IMGPK
Forum Junior
Topics: 9
Posts: 49
|
well, when you think of cardioversion, there is no point in slowing down the heart rate. Besides, Digitalis is contra-indicated before therapeutic or electrical cardioversion because of risks of AV blocks or even asystole.
Re anticoagulation, for acute onset Afib 6-12 hrs before cardioversion (heparin/enoxaparin is used mostly) and for ch. Afib 4-6 weeks (warfarin is used) before attempted cardioversion.
Amiodarone is considered DOC for therapeutic cardioversion these days (UTD).
___________________
We need God, He doesnt need US
|
| meg
Forum Guru
Topics: 62
Posts: 806
|
I thought Amiadarone was a totally last resort... I mean with its so many sideeffects.
|
| IMGPK
Forum Junior
Topics: 9
Posts: 49
|
Right, but most of these SE are with long-term use. For therapeutic cardioversion its pretty much safe.
Its from latest recommendations in UTD, you may not find it in conventional text books yet, so probably not a good choice for exams.
___________________
We need God, He doesnt need US
|
| meg
Forum Guru
Topics: 62
Posts: 806
|
what's UTD ? :roll: I only know of University of Texas at Dallas (UTD)
|
|
|
up-to-date
|
| Ouli Maty
Forum Elite
Topics: 33
Posts: 275
|
http://www.medscape.com/viewarticle/466468_print
http://www.medscape.com/viewarticle/462553_5
I found these interesting to read.
___________________
deep breathing...
|
|
| |
| | | | | | | | | | | | |
