第二十二章抗心律失常药

,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,*,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,1.,女性，,44,岁。八年来劳累后心慌气短。既往曾患过,“,风湿性关节炎,”,。近日因劳累病情加重，心慌，气短，咯血，不能平卧急诊入院。查体：半卧位，慢性重病容。脉搏,80,次,/,分，血压,13.3/9.33kPa(100/70mmHg),。心向左侧扩大，心律不齐，心率,120,次,/,分，心尖区舒张期雷鸣样杂音，主动脉瓣区收缩期和舒张期杂音。肝肋下,3cm,，下肢轻度浮肿。诊断：风湿性心脏病，二尖瓣狭窄，主动脉瓣狭窄及关闭不全，心房纤颤，心功能不全,II,度。该病人在用强心药治疗的过程中，心率突然减为,50,次,/,分，此时应选用,反馈人数,:0,参与人数,:80,A.,利多卡因,B.,肾上腺素,C.,吗啡,D.,阿托品,E.,苯妥英钠,1,2.,女性，,74,岁。自觉因擦背着凉后两肩和后背阵阵酸痛，每阵,10,分钟左右，不发烧，仍可下床走动。于今晨,1,时许，突然出现心前区剧痛，并向双肩、后背和左臂放射，伴大汗，休息后不见缓解，早,8,点急诊住院。检查：年迈，半卧位，无明显青紫，颈静脉不怒张，肺（,），心略向左侧扩大，心律尚齐，未闻心脏杂音及摩擦音。心电图：病理性,Q,波，,ST,段抬高，,T,波倒置。诊断：急性心肌梗塞。为防止室性心律失常的发生，病人应立即给予的药物是,A.,利多卡因,B.,奎尼丁,C.,胺碘酮,D.,普萘洛尔,E.,苯妥英钠,2,3.,女性，,34,岁，因过度劳累及情绪激动有心悸、胸前区不适、心晕及颈部胀满感，并伴有焦虑或恐惧。心电图：心室率常在,160,250,次,/,分钟；,QRS,波群形态和正常窦性的,QRS,波型一样，间期小于秒；有逆行,P,波。诊断为室上性心动过速，应首选的药是,维拉帕米,普鲁卡因胺,胺碘酮,利多卡因,奎尼丁,投票人数,:38,3,4.Which of the following is an antiarrhythmic agent that has relatively few electrophysiologic effects on normal myocardial tissue but suppresses the arrhythmogenic tendencies of ischemic myocardial tissues?,a.Propranolol,b.Procainamide,c.Quinidine,d.Lidocaine,e.Disopyramide,投票人数,:38,4,5.If quinidine and digoxin are administered concurrently,which of the following effects does quinidine have on digoxin?,a.The absorption of digoxin from the GI tract is decreased,b.The metabolism of digoxin is prevented,c.The concentration of digoxin in the plasma is increased,d.The effect of digoxin on the AV node is antagonized,e.The ability of digoxin to inhibit the Na,+,K,+,-stimulated ATPase is reduced,投票人数,:38,5,6.In a patient who has had attacks of paroxysmal atrial tachycardia,an ideal prophylactic drug is,a.Adenosine,b.Procainamide,c.Lidocaine,d.Nifedipine,e.Verapamil,投票人数,:38,6,7 The first-line drug for treating an acute attack of reentrant supraven-tricular tachycardia(SVT)is,a.Adenosine,b.Digoxin,c.Propranolol,d.Phenylephrine,e.Edrophonium,投票人数,:38,7,8 A 64-year-old male with arteriosclerotic heart disease(AHD)and CHF who has been treated with digoxin complains of nausea,vomiting,and diarrhea.His EKG reveals a bigeminal rhythm.The symptoms and EKG findings occurred shortly after another therapeutic agent was added to his regimen.A drug-drug interaction is suspected.Which agent was involved?,a.Lovastatin,b.Hydrochlorothiazide,c.Phenobarbital,d.Nitroglycerin,e.Captopril,投票人数,:38,8,9 A 66-year-old man had a myocardial infarct.Which one of the following would be appropriate prophylactic antiarrhythmic therapy?,A.Lidocaine.,B.Metoprolol.,C.Procainamide.,D.Quinidine.,E.Verapamil.,投票人数,:0,9,10.Suppression of arrhythmias resulting from a reentry focus is most likely to occur if the drug:,A.Has vagomimetic effects on the AV node.,B.Is a-blocker.,C.Converts a unidirectional block to a bidirectional block.,D.Slows conduction through the atria.,E.Has atropine-like effects on the AV node.,投票人数,:0,10,11.A 57-year-old man is being treated for an atrial arrhythmia.He complains of headache,dizziness,and tinnitus.Which one of the following antiarrhythmic drugs is the most likely cause?,A.Amiodarone.B.Procainamide.,C.Propranolol.D.Quinidine.,E.Verapamil.,投票人数,:0,11,12.A 58-year-old woman is being treated for chronic suppression of a ventricular arrhythmia.After 2 months of therapy,she complains about feeling tired all the time.Examination reveals a resting heart rate of 10 beats per minute lower than her previous rate.Her skin is cool and clammy.Laboratory test results indicate low thyroxin and elevated thyroid-stimulating hormone levels.Which of the following antiarrhythmic drugs is the likely cause of these signs and symptoms?,A.Amiodarone.,B.Procainamide.,C.Propranolol.,D.Quinidine.,E.Verapamil.,投票人数,:0,12,13.,维拉帕米抗心律失常的主要作用机制是,阻滞,Na,+,内流 促进,K,+,外流,阻滞,Ca,2+,内流 阻滞,1,受体,延长动作电位时程,投票人数,:0,13,14.,对室上性心动过速无效的药物是,西地兰 维拉帕米,普萘洛尔 利多卡因,胺碘酮,投票人数,:0,14,15.A 59-year-old female with mild CHF is treated with furosemide.What is its primary mechanism of action?,a.Inhibition of sodium-potassium(Na,+,K,+,)adenosine triphosphatase(ATPase),b.Inhibition of Na,+,K,+,chloride(Cl,)co transporter,c.Inhibition of Na,+,Cl,co-transporter,d.Inhibition of Cl,transporter,e.Inhibition of Ca,2+,divalent cation(Ca,2+,)transporter,投票人数,:0,2024/9/30,15,16.A 59-year-old male with a history of rheumatic heart disease is found to have atrial fibrillation(AF),for which he is treated with digoxin.Treatment with digoxin converts his AF to a normal sinus rhythm and most likely results in a decrease in