Atrial Fib treatment

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Atrial Fib treatment

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Bela
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06/07/04 - 09:05 AM

Pt has atrial fibrillation (uneven R-R intervals). What drug would u give him for immediate control of his palpitations? Why?
a) Amiodarone
b) Heparin
c) Digox immune Fab
d) Diltiazam
e) Warfarin

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lmbebo
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06/07/04 - 09:30 AM

my best guess is Amiodarone even though I believe it is not a DOC for this treatment.

If I remember correctly, which I hope I do, it blocks Na+, K+, Ca channels and B receptors

The other choice I thought about was Diltiazem because it is Calcium channel blocker. I decided against it because I didn't think a Calcium channel blocker would slow down the atrium, just decrease its force of contraction. If anything, I think it might be C/I'd because you would have more heart beats going through even quicker?

Bela
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06/07/04 - 09:36 AM

lmbebo,

what increases the PR interval, therefore working against atrial arrhythmias are:
1) Digox
2) Ca channel blockers
3) b blockers
4) Adenosine

Why would u give the pt antibodies against digox when you don't have any digox in the system to begin with? Besides, if anything, u'd give digox (i think).

Answer was diltiazam. Why? Because they said Adenosine takes about 3 weeks to work which baffled me. I thought adenosine's half life was only a few minutes. That's why I posted this question...to see if anyone has an explanation for this.

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lmbebo
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06/07/04 - 01:21 PM

and that would be the reason I probably just failed my test on this ....

Idiopathic
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06/07/04 - 02:45 PM

"Bela" wrote:
Answer was diltiazam. Why? Because they said Adenosine takes about 3 weeks to work which baffled me. I thought adenosine's half life was only a few minutes. That's why I posted this question...to see if anyone has an explanation for this.

They may have meant amiodarone, instead of adenosine. Obviously the half life of adenosine is so very short. Diltiazem is the DOC here, because it would slow conduction through the AV node.

lmbebo
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06/07/04 - 06:00 PM

graded my exam. Of the questions I missed, most where concerning antiarrhtymics :|

I think its more of a issue with my poor understanding of the physiology of cardiac conduction. Its easy to learn what a drug does, but its useless unless you understand the physio behind anything.

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