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pharmacology
02-10-2005, 11:35 PM
A 71-year-old female is seen by a cardiologist, who obtains an electrocardiogram that reveals the presence of atrial fibrillation. The cardiologist wants to decrease conduction through the atrioventricular node. Which of the following medications would he most likely prescribe?

A. Atropine
B. Digoxin
C. Lidocaine
D. Procainamide
E. Quinidine

stepanida
02-11-2005, 09:59 PM
B.

pharmacology
02-12-2005, 01:40 PM
A 71-year-old female is seen by a cardiologist, who obtains an electrocardiogram that reveals the presence of atrial fibrillation. The cardiologist wants to decrease conduction through the atrioventricular node. Which of the following medications would he most likely prescribe?

A. Atropine
B. Digoxin
C. Lidocaine
D. Procainamide
E. Quinidine

good!

The correct answer is B. The effect of digoxin on the myocardium is dose-related and involves both a direct and indirect action on the cardiac muscle. The indirect actions involve a vagomimetic action, which decreases the conduction rate through the atrioventricular node (AV node), and a depression of the sinoatrial node. Digoxin is indicated for the treatment of atrial fibrillation, especially when the ventricular rate is elevated. Digoxin is also indicated for the treatment of congestive heart failure and atrial flutter, although electrical cardioversion is often the treatment of choice for atrial flutter.

Atropine (choice A) is an anticholinergic agent that has been used in the treatment of atrioventricular heart block to increase conduction through the AV node when increased vagal tone is a major factor in the conduction defect.

Lidocaine (choice C) is an antiarrhythmic agent indicated for the treatment of ventricular arrhythmias. Lidocaine has a variable effect on AV node conduction. For the most part, conduction through the AV node remains unchanged.

Procainamide (choice D) is a class IA antiarrhythmic agent indicated for the treatment of ventricular arrhythmias. It often causes AV node conduction to be slightly increased.

Quinidine (choice E) is indicated for the conversion of atrial fibrillation/flutter. However, quinidine exerts an indirect anticholinergic effect that will decrease vagal tone and may facilitate conduction in the AV node.

pharmacology
02-22-2005, 06:19 PM
Atrial Fibrillation with moderate ventricular response
http://www.emedu.org/ecg/images/afib_1a.jpg http://www.emedu.org/ecg/line.gif
Atrial Fibrillation with rapid ventricular response
http://www.emedu.org/ecg/images/afib_2a.jpg







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