Rapid repolarization Plateau Depolarization Resting potential Final repolarization

Rapid repolarization Plateau Depolarization Resting potential Final repolarization

Rapid repolarization Plateau Depolarization Final repolarization Absolute refractory period Relative refractory period Threshold potential Spontaneous depolarization Resting membrane potential

The cardiac action potential

IA Disopyramide Procainamide Ajmaline Quinidine IB Lidocaine Mexiletine Phenytoin IC Propafenone (p. o. ; i. v. inf. – флебит) Flecainide НЛР: Брадикардия, AV блок, (-) инотропен ефект, СЧ смущения, обриви.

Cinchona succirubra • Quinidine (Chinidine®) • Quinine (Chinine®) Rauwolfia serpentina • Ajmaline • Reserpine

Treatment: Lidocaine, Ajmaline

Ventricular fibrillation (камерно мъждене characterized by irregular undulations without clear ventricular complexes.

Ventricular flutter (камерно трептене), a ventricular tachyarrhythmia characterized electrocardiographically by smooth undulating waves with QRS complexes merged with T waves a rate of approximately 250 per minute. If untreate usually progresses to ventricular fibrillation. Ventricular flutter (камерно трептене)

Torsades de Pointes: Treatment Treat hypokalemia if it is the precipitating factor and adm magnesium sulfate in a dose of 2– 4 g i. v. initially. Magnesium is usually very effective, even in the patient w normal magnesium level. If this fails, repeat the initial dos because of the danger of hypermagnesemia (depression neuromuscular function) the patient requires close monit Otherapies include overdrive pacing and isoprenalin Most (75– 82%) torsade de pointes rhythms are started by pause. Pacing at rates up to 140 bpm may prevent the ven pauses that allow torsade de pointes to originate. The patient with torsade who is in extremis should be trea with electrical cardioversion or defibrillation. See: http: //emedicine. medscape. com/article/760667 -tr

Digitalis purpurea (foxglove) Digitoxin Phenytoin Potassium chloride Magnesium aspartate • Digoxinspecific FAB (Fragment Anti. Body): Digibind (38 mg connect 0, 5 mg Digoxin) Digitalis lanata III. ААЛ при дигиталисова интоксик Digoxin

www. medpharm-sofia. eu