Appropriate management at this time includes
A) Epinephrine
B) Metoprolol
C) Nitroglycerin
D) Adenosine
E) Lidocaine
Answer:
D. (Adenosine)
Discussion: The most important step to make when a narrow QRS tachycardia is noted is whether the patient is experiencing signs and symptoms related to the rapid heart rate. These symptoms include
hypotension, shortness of breath, shock, decreased level of consciousness, or chest pain suggestive of coronary ischemia. Determining whether a patient’s symptoms are related to the tachycardia depends on several factors, including age and the presence of underlying cardiac disease.
Paroxysmal supraventricular tachycardia (PSVT) with a heart rate of 200 bpm may be tolerated by a healthy young adult with no or few symptoms (e.g., palpitations). However, a heart rate of 120 bpm may precipitate angina in an elderly patient with significant coronary heart disease.
Adenosine is approved by the Food and Drug Administration (FDA) in the United States only for the intravenous management of PSVT in which the atrioventricular (AV) node is involved. For intravenous adenosine administration, the patient should be supine and should have electrocardiographic and blood pressure monitoring. The drug is administered by rapid intravenous injection over 1 to 2 seconds at a peripheral site, followed by a normal saline flush. The usual initial dose is 6 mg, with a maximal single dose of 12 mg.
The most common side effects of adenosine are facial flushing (18%), palpitations, chest pain, and
hypotension. Transient asystole is a rare complication. Another important side effect of adenosine is that it may precipitate atrial fibrillation (AF). In patients with Wolff–Parkinson–White syndrome (WPW), AF can progress into ventricular fibrillation. As a result, caution should be used when giving
adenosine if WPW is a possible mechanism, and emergency resuscitation equipment should be available.
ReplyDeleteI feel so excited today because it's just a year since I got my breakthrough from Herpes.I was diagnosed of HSV1 on the 12/4/2015 and latter i got affected with the HSV2. That was my 2nd outbreak after i lost my ex fiance that got me affected with the virus. I was so scared when he died and what i heard about the Herpes virus as he's deathly and such has no cure. I feel so pity and and a disgrace to my personality,in my career and my family to have been in with the deathly sickness, and that would makes my love ones siblings stay far from me. I was going to my regular church activities when i begin to hear testimonies of how people get cure online, i never gave it a thought till my cousin Stephanie who was affected with HIV told me, Lenny you need not to worry cos i met i man today online , i traditional herbal healer whom two of her friends confirmed he cure them with his herbal herbs that i should give it a try. I saw the interest in her and she did contact the herbal doctor again in my present, luckily for me he picked and show up himself, behold he was at about to attain to some patients that have came back with appreciation of how he cure them from Cancer, HIV, and off much too the herpes he cured an 18 years old daughter.
I was so happy that day, i wanted to be there but the distance was a barrier to me. I told him how the virus had eaten me up and and a truly believe there's cure for herpes. He told me me with assurance that my case wont be different and he had been curing lots of people With his herbal medicine and most people due contact him from the States and preperd the medicine and made use of the DHL to reach him.
Honestly speaking Dr. Akpu power his a great and gifted herbalist,His destined to herbs.
He made me do away with the medical prescription,the acyclovir (Zovirax), famciclovir(Famvir), and valacyclovir (valtrex). you don't know him because you haven't meet this man try and contact him yourself Dr. Akpu in Africa is popularly known in his City,and you can request for his address yourself. I'm so happy now cos,I and my cousin had been confirmed negative till date..the Lord is good in my life. Dr. Akpu sent me his herbal medicine that heal me too, 🙏 🙏 Dr. Akpu for giving me another life.
Contact Dr.akpu for all kids of sickness@
Dr.akpupowerherbscenter@gmail.com