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Kirim Ukai Arrhytmia

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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

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