Question

Define and discuss what arrhythmias are and how can this impact activity?

List types of hypertensive medications and describe what each does. What are indications and contraindications for hypertension medications?

Answer 1

1) An arrythmia is also known as dysrhythmia, as the name suggest it is an irregular or abnormal heart beat or in other words arrhythmia refers to change from the normal sequence of electrical impulses. Types of arrhythmias:-

• Atrial fibrillation- Upper heart chamber contract irregularly.Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complication
• Bradycardia- Too slow heart rate.What’s considered too slow can depend on the age and physical condition. Elderly people, for example, are more prone to bradycardia.
• Conduction disorder- heart does not beat normally. Conduction is how electrical impulses travel through the heart, which causes it to beat. Some conduction disorders can cause arrhythmias, or irregular heartbeats.
• Premature contraction- Early heart beat.Occasional premature contractions are normal, and are common in children and teenagers. Usually, no cause can be found and many go away on their own.
• Ventricular fibrillation- disorganised contraction of lower chamber of heart.Ventricular fibrillation, or V-fib, is considered the most serious cardiac rhythm disturbance.Disordered electrical activity causes the heart’s lower chambers (ventricles) to quiver, or fibrillate, instead of contracting (or beating) normally. This prohibits the heart from pumping blood, causing collapse and cardiac arrest.
• ​​​​​Tachycardia- Heart rate too fast.

Effect of arrythmia on activity- When the heart doesn't beat properly, it can't pump blood effectively. When the heart doesn't pump blood effectively, the lungs, brain and all other organs can't work properly and may shut down or be damaged.

2) Types of hypertensive medicines-

• Thiazides- ​​​​​​Thiazide diuretics are used as monotherapy or they are used in combination with other antihypertensive drugs. Thiazide diuretic inhibits reabsorption of sodium and chloride mostly in distal tubes. Indication- Heart Failure, Advanced age, Systolic Hypertension. Containdication- Gout.
• Angiotension Converting Enzyme (ACE)Inhibitor- ACEIs block the action of the renin angiotensin system (RAS). Renin is released from the kidney during low blood pressure, low salt intake or diuretic usage and generates angiotensin II, which constricts blood vessels, retains salt and water by the kidneys and raises blood pressure. Therefore, these drugs target important hypertensive mechanisms. Indication- Heart failure or LV dysfunction, previous MI, diabetic or other nephropathy, protenuria. Contraindication- pregnancy, bilateral renal artery stenosis, hyperkalemia.
• Angitensin Receptor Blokers (ARBs)- ARBs also block the renin angiotensin system (RAS), similar to ACEIs, but have a different mechanism of action by blocking the actions of angiotensin II in the tissues rather than the generation of angiotensin II.  Indication- associated cough, diabetic or other nepropathy, congestive heart failure. Contraindication-​​​​​​ pregnancy, bilateral renal artery stenosis, hyperkalemia.
• Beta blocker, Alpha blocker and Sympatholitic drugs- They act on a part of the nervous system that controls blood pressure, known as the sympathetic nervous system. Blockade of the sympathetic nervous system reduces blood pressure by relaxing blood vessels, and decreasing the rate and force of contraction of the heart. Indication-Angina, previous MI, Heart failure, Tachycardia, Migrane. Contraindication- Asthma, COPD , heart block.
• Calcium Channel Blocker- They act directly on the blood vessels to cause relaxation. Indication- Advanced age, systolic hypertension, cyclosporine-induced hypertension. Contraindication- Heart block.