kirim ukai arrhytmia
TRANSCRIPT
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ARITMIA
PATOFISIO-
LOGIFARMAKO-
TERAPI
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OBJECTIVES
1. MENJELASKAN TUJUANSASARAN
STRATEGI TERAPI - PROGNOSIS
2. MENJELASKAN MEKANISME KERJA OBAT
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Cardiovascular System: Heart
Conduction #1
No Nama
apex
atrioventricular bundle
atrioventricular node
left atrium
left ventricle
left and right bundle
branches
purkinje fibers
sinoatrial node
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Komponen sistem konduksi
(elektrik) jantung:
A. Noduspace makerterdiri dari 4 jenis
nodes, kerja nodes tersebut bergantian yang
paling dominan yang mengatur yaitu yang
memiliki frekuensi yang paling cepat dan
paling kuat. Pacemaker (PM) melakukan
perangsangan terhadap otot jantung terjadi
depolarisasi mendahului otot kontraksikembali repolarisasi dan otot kembali
relaksasi.
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TAMBAHAN
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TAMBAHAN
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TAMBAHAN
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RANGSANG JANTUNG
Keadaan normal: pusat pembuat rangsang
jantung (pacemaker) ada di NSA nodus
sinoatrial atau sinus.
Aritmia : NSA tidak normal atau
meningkatnya frekuensi dan/atau kekuatan
pacemaker ektopik --- ritme jantung
sementara atau jangka panjang diatur olehpacemaker ektopik
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Jenis-jenis Aritmia
Pacemaker: primer vs. ektopik;
normal vs. abnormal
Pacemaker: jenis
atrial--- aritmia atrial
NSA ---- artimia sinusal
NAV ----aritmia junctional
ventrikelaritmia ventrikuler
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Aritmia
Aritmia 100-250x/m, ritme atrium = ventrikel.
Frekuensi 250-350x/m terdiri: frek atrium 300x/m; dan
frek ventrikel berupa atrial flutter rapid ventricle response;
atrial flutter normal ventricle response; atrial flutter slow
ventricle response.
Atrial fibralasi >350x/m risikostasis di atrium, agregasi
trombosit thrombus, thrombus bila terlepas dr tmp
menempelembolistroke. Bila terjadi di ventrikel
pengaruh hemodinamika kr ggg kontraksi.
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BRADIARITMIA
Terjadi kr depresi, kegagalan pembentukan
impuls dan kegagalan konduksi AV. Biasanya
asimptom tidak perlu terapi (stabil
hemodinamik). Perlu terapi bila terjadi
hipoperfusisirkulasi serebral dan koroner
tidak adekuat.
Terapi akut: atropin IV 0.6(max 3mg);isoprenalin infus 0.5-10mcg/min (hati2
pada IHD)
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Treatment goals
Prevent blood clots from forming to reduce
stroke risk
Control your heart ratewithin a relatively
normal range
Restore a normal heart rhythm, if possible
Treat heart disease/condition that may be
causing arrhythmia
Reduce other risk factors for heart disease
and stroke
http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/All-About-Heart-Rate-Pulse_UCM_438850_Article.jsphttp://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Coronary-Artery-Disease---Coronary-Heart-Disease_UCM_436416_Article.jsphttp://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Coronary-Artery-Disease---Coronary-Heart-Disease_UCM_436416_Article.jsphttp://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Coronary-Artery-Disease---Coronary-Heart-Disease_UCM_436416_Article.jsphttp://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Coronary-Artery-Disease---Coronary-Heart-Disease_UCM_436416_Article.jsphttp://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/All-About-Heart-Rate-Pulse_UCM_438850_Article.jsp -
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TERAPI
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Manage risk factors
an arrhythmia increases risk of heart attack,
cardiac arrest and stroke. Control other risk
factors:
Reduce high blood pressure
Control cholesterol levels
Lose excess weight
Eat a heart-healthy diet
Avoid tobacco smoke
Enjoy regular physical activity
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Substances to avoid
Caffeine
Tobacco
Alcohol
Cold and cough medications Appetite suppressants
Psychotropic drugs (used to treat certain mental illnesses)
Antiarrhythmics (paradoxically, the same drugs used to
treat arrhythmia can also cause arrhythmia. Yourhealthcare team will monitor you carefully if you're taking
antiarrhythmic medication.)
Beta-blockers for high blood pressure
Cocaine, marijuana and speed or methamphetamines
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Medications
1. Antiaritmia
Amiodarone (Cordarone)
Bepridil Hydrochloride (Vascor)
Disopyramide (Norpace)
Dofetilide (Tikosyn)
Dronedarone (Multaq)
Flecainide (Tambocor)
Ibutilide (Corvert)
Lidocaine (Xylocaine)
Procainamide (Procan, Procanbid)
Propafenone (Rythmol) Propranolol (Inderal)
Quinidine (many trade names)
Sotalol (Betapace)
Tocainide (Tonocarid)
2. CCB
3. Beta-blockers
4. Anticoagulants
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MANAGEMENT OF ARRYTHMIA
Aritmia (bradikardia)
Takikardia
Atrialfibralasi
Coronary Bypass
Pacemaker
Catheter Ablation
Antikoagulan
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TAMBAHAN
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TERIMA KASIH