Pt is comatose, had a seizure. BP 80/40 Can you name the drug overdose? Pt is comatose, had a seizure. BP 80/40 Can you name the drug overdose? Which Phase(s) was/were affected by the last drug? Which Phase(s) was/were affected by the last drug? This patient took a downer last night, today is having this rhythm. If it gets worse, what Rx? This patient took a downer last night, today is having this rhythm. If it gets worse, what Rx? 1) the plant? 2) The rhythm? 3) The treatment(s)? 1) the plant? 2) The rhythm? 3) The treatment(s)? Can you name the lead singer in this band? Pt is drowsy, has a dry mouth Anything suspect here? Pt is drowsy, has a dry mouth Anything suspect here? Name this rhythm. (Hint: it comes in brief runs) Another hint.. Now, name 2 drugs that can cause it. Another hint.. Now, name 2 drugs that can cause it. Which Phase(s) was/were affected by the last drug? Which Phase(s) was/were affected by the last drug? Which was produced by the last drug? Which was produced by the last drug? A A B B The patient has BP 70/40. History of hypertension. Rx? The patient has BP 70/40. History of hypertension. Rx? Expected BP and HR? This patient took No-Doz. What is the rhythm? Rx? When George made a tea from these seed pods, he developed hallucinations and had trouble urinating. What was his heart rate? (Fast or slow) When George made a tea from these seed pods, he developed hallucinations and had trouble urinating. What was his heart rate? (Fast or slow) Harry accidentally drank a mouthful of his Rogaine . All of the following are true EXCEPT one: A.Harrys HR is probably fast B.Harry needs to go to the ER C.Harry needs IV fluids D.Harry needs a hair transplant E.Harrys BP is probably elevated HR 38/min, BP 158/105 Treatment? HR 38/min, BP 158/105 Treatment? Child drinks bottle of Visine. Expected HR = Expected BP = Child drinks bottle of Visine. Expected HR = Expected BP = What electrolyte abnormality is likely? Last rhythm just got worsetreatment? What drug may be contraindicated? Last rhythm just got worsetreatment? What drug may be contraindicated? TCA overdose with wide QRS interval TCAs & Type Ia antiarrhythmics Block Phase 0 and Phase 3 TCAs & Type Ia antiarrhythmics Block Phase 0 and Phase 3 Chloral hydrate OD with PVCs. Best Rx = beta blockers 1) the plant = Foxglove 2) The rhythm = junctional 3) The treatment(s) = atropine, Digibind 1) the plant = Foxglove 2) The rhythm = junctional 3) The treatment(s) = atropine, Digibind Lee Harvey and the Oswalds? Rightward axis of the t-40 msec Torsades 2 drugs that can cause it = quinidine; droperidol, etc Phase 3 Early afterdepolarizations (A) A A B B Verapamil OD Rx Calcium Expected BP and HR = elevated Contains ephedrine & caffeine Expected BP and HR = elevated Contains ephedrine & caffeine Caffeine a fib or MAT Rx beta blocker When George made a tea from these seed pods, he developed hallucinations and had trouble urinating. What was his heart rate? = Fast (anticholinergic) When George made a tea from these seed pods, he developed hallucinations and had trouble urinating. What was his heart rate? = Fast (anticholinergic) Harry accidentally drank a mouthful of his Rogaine . All of the following are true EXCEPT one: A.Harrys HR is probably fast B.Harry needs to go to the ER C.Harry needs IV fluids D.Harry needs a hair transplant E.Harrys BP is probably elevated HR 38/min, BP 158/105 Rx = vasodilator (eg, Nipride, phentolamine) HR 38/min, BP 158/105 Rx = vasodilator (eg, Nipride, phentolamine) Child drinks bottle of Visine. Expected HR = slow Expected BP = decreased (poss transient incr) Child drinks bottle of Visine. Expected HR = slow Expected BP = decreased (poss transient incr) What electrolyte abnormality is likely? Hyperkalemia What electrolyte abnormality is likely? Hyperkalemia Last rhythm just got worsetreatment? What drug may be contraindicated? If DIGOXIN involved, AVOID Calcium Last rhythm just got worsetreatment? What drug may be contraindicated? If DIGOXIN involved, AVOID Calcium