Arrhythmia shock

Symptoms of overdose include nausea, vomiting, transient visual or auditory deficits, drowsiness, and seizures followed by severe cardiac arrhythmias, shock, or cardiorespiratory arrest. Hypotension may be severe and intractable, producing metabolic acidosis and end-organ failure. Cardiac conduction disturbances include complete atrioventricular dissociation, QRS and QT prolongation, severe bradycardia, and ventricular fibrillation. Acute ingestions of 30-50 mg kg of chloroquine in adults and as little as 300 mg in children are potentially fatal. 

Complications of cocaine use frequently involve cardiovascular events. At higher doses it increases heart rate because of an overall systemic increase in sympathetic tone. At toxic doses, cocaine causes cardiac failure due to a direct effect on myocardial contractility. Cocaine is also pyrogenic, and hyperthermia is observed frequently in cocaine poisoning. Death is usually related to arrhythmias, shock, or convulsions. 

Methamphetamine may alter insulin requirements. Symptoms of overdose include increasing restlessness, tremor, hyperreflexia, tachypnea, confusion, aggressiveness, hallucinations, and panic fatigue and depression usually follow the excitement stage. Other symptoms may include arrhythmias, shock, alterations in blood pressure, nausea, vomiting, diarrhea, and abdominal cramps death is usually preceded by convulsions and coma. 

Aconite Aconitum spp 1 Nausea, vomiting, arrhythmias, shock... 

Definition Commercial prod. Is the monohydrate Empiricai C2K2O4 C2K2O4 H2O Formuia (COOK)2 H2O Properties M.w. 166.22 Monohydrate Colorless transparent cryst. odorless sol. in water efflorescent in warm dry air dec. when heated m.w. 184.24 dens. 2.13 loses water 160 C Toxicoiogy LDLo (oral, woman) 1 g/kg toxic by inh. and ing. human systemic effects by ing. (cardiac arrhythmias, shock, Gl changes) ... 

Implantable tachyrhythmia devices, available for some years, address far less dangerous atrial tachyarrhythmias and fibrillation. The technical barriers to counteracting ventricular tachyarrhythmias and fibrillation using massive shocks have been formidable and are compounded by the possibiUty of causing the very problem the shock is designed to overcome. Newer tachyrhythmia devices are being readied that can safely regulate arrhythmias across the hiU spectmm. 

The term anaphylactic shock describes a severe generalized type I allergic reaction associated with cardiovascular shock, airway constriction and heart arrhythmias, which, if left untreated, may cause death. 

Injection shock, bronchospasm during anesthesia, cardiac standstill and arrhythmias Inhalation acute bronchial asthma, emphysema, bronchitis, bronchiectasis... 

During phase I, each seizure causes a sharp increase in autonomic activity with increases in epinephrine, norepinephrine, and steroid plasma concentrations, resulting in hypertension, tachycardia, hyperglycemia, hyperthermia, sweating, and salivation. Cerebral blood flow is also increased to preserve the oxygen supply to the brain during this period of high metabolic demand. Increases in sympathetic and parasympathetic stimulation with muscle hypoxia can lead to ventricular arrhythmias, severe acidosis, and rhabdomyolysis. These, in turn, could lead to hypotension, shock, hyperkalemia, and acute tubular necrosis. 

The answer is a. (Hardman, p 224.) Epinephrine is the drug of choice to relieve the symptoms of an acute, systemic, immediate hypersensitivity reaction to an allergen (anaphylactic shock). Subcutaneous administration of a 1 1000 solution of epinephrine rapidly relieves itching and urticaria, and this may save the life of the patient when laryngeal edema and bronchospasm threaten suffocation and severe hypotension and cardiac arrhythmias become life-endangering. Norepinephrine, isoproterenol, and atropine are ineffective therapies Angioedema is responsive to antihis-... 

Complications of MI include cardiogenic shock, heart failure, valvular dysfunction, various arrhythmias, pericarditis, stroke secondary to left ventricular (LV) thrombus embolization, venous thromboembolism, and LV free-wall rupture. 

Cardiopulmonary arrest in adults usually results from arrhythmias. The most common arrhythmias are ventricular fibrillation (VF) and pulseless ventricular tachycardia (PVT), often in patients after myocardial infarction (MI) or pulmonary embolism (PE). In children, cardiopulmonary arrest is often the terminal event of progressive shock or respiratory failure. 

The indications for pulmonary artery catheterization are controversial. Because there is a lack of a well-defined outcome of data associated with this procedure, its use is presently best reserved for complicated cases of shock not responding to conventional fluid and medication therapies. Complications related to catheter insertion, maintenance, and removal include damage to vessels and organs during insertion, arrhythmias, infections, and thromboembolic damage. 

There is evidence that y-aminobutyric acid A receptors may be modified during SE and become less responsive to endogenous agonists and antagonists. Two phases of GCSE have been identified. During phase I, each seizure produces marked increases in plasma epinephrine, norepinephrine, and steroid concentrations that may cause hypertension, tachycardia, and cardiac arrhythmias. Muscle contractions and hypoxia can cause acidosis, and hypotension, shock, rhabdomyolysis, secondary hyperkalemia, and acute tubular necrosis may ensue. 

In sinus bradycardia or incomplete heart block, lidocaine administration for the elimination of ventricular ectopy without prior acceleration in heart rate (eg, by atropine, isoproterenol or electric pacing) may promote more frequent and serious ventricular arrhythmias or complete heart block. Use with caution in patients with hypovolemia and shock, and all forms of heart block. 

Toxicity Toxicity is characterized by an exaggeration of parasympathomimetic effects which may include the following Headache visual disturbance lacrimation sweating respiratory distress Gl spasm nausea vomiting diarrhea AV block tachycardia bradycardia hypotension hypertension shock mental confusion cardiac arrhythmia tremors. 

WARNING Exacerbation of ischemic heart Dz w/ abrupt D/C Uses HTN MI Action p-Adrenergic receptor blocker, pj, P2 Dose HTN 10-20 mg bid, up to 60 mg/d MI 10 mg bid Caution [C (1st tri D if 2nd or 3rd tri), +] Contra CHF, cardiogenic shock, bradycardia, heart block, COPD, asthma Disp Tabs SE Sexual dysfxn, arrhythmia, dizziness, fatigue, CHF Interactions t Effects W/ antihyper-tensives, ciprofloxacin, fentanyl, nitrates, quinidine, res pine t bradycardia and... 

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