Quiz 37: Pharmacotherapy of Dysrhythmias

Nursing

The neighbor of Mr. Hibbert is receiving digoxin for fast heartbeat as his heart is not able to contract to the maximum level with greater intensity. Mr. Hibbert asks that why had he not been given the same drug (digoxin). The reason for this is as follows: • The rhythm of Malcolm's has been altered and this is known as dysrhythmia from which Malcolm is suffering. The drug digoxin will just increase the contractions of the heart and will not heal the dysrhythmic heart. Also it may worsen the condition. Thus, the exact medication to deal with the atrial fibrillation in Malcolm's case is Diltiazem (a calcium channel blocker).

The calcium channel is the pathway in the plasma membrane that aids in carrying calcium ions inside and outside the cells. There are three types of calcium channels in the human body. These are as follows: • L-type calcium channels (long lasting) • P-type calcium channels/ Q-type calcium channels • N-type calcium channels (neural/Non-L) The L-type of calcium channels are voltage gated that controls the contraction of skeletal and smooth muscles. It also regulates aldosterone and cortisol secretion from the adrenal glands. All the calcium channel blockers block this L-type of calcium channels.

The normal ECG (electrocardiogram) of a patient is as follows: img The ECG of a patient with atrial fibrillation like Jada would be as follows: img The ECG similar to that of Jada makes it clear that the most affected part of the ECG is the unclear P-waves and also the graph comes out to be fibrillating. The distance between the consecutive complexes also varies due to fibrillation.

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