. Flashcards
what toxicities/AEs are associated with Quinidine (class 1A antiarrhythmic)
- cinchonism: a syndrome of tinnitus, headache and dizziness
- thrombocytopenia
- QT prolongation (torsades, syncope)
what toxicities/AEs are associated with procainamide (class 1A antiarrhythmic)
- (chronic use) drug-induced lupus (sx arthralgia, arthritis, pleuritis, pericarditis, parenchymal pulmonary disease)
- QT prolongation (torsades, syncope)
what toxicities/AEs are associated with disopyramide
- acute heart failure (cannot be used in patients with impaired systolic function.)
- anticholinergic side effect sx: dry eyes, dry mouth, urinary retention
- QT prolongation (torsades, syncope)
what toxicities/AEs are associated with lidocaine
neurological side effects: tremor, convulsions (seizure), paresthesias
which drugs are high risk for causing DILE
There are four main drugs that are known for causing drug-induced lupus:
- hydralazine
- isonazid (INH)
- procainamide
- phenytoin/penicillamine
What are the class 1A antiarrhythmics
Quinidine (prom queen)
Procainamide (prom king)
disopyramide (disappear)
tx of choice for Wolff parkinson-white syndrome
procainamide
avoid class 1A antiarrhythmics (Quinidine (prom queen)
Procainamide (prom king)
disopyramide (disappear)) if a patient has _________
heart failure (b/c negative inotropy can lead to heart failure) ESPECIALLY disopyramide
the class IB antiarrhythmics are
mexiletine (mexican flag)
lidocaine (lied to me)
which class of antiarrhythmics is best for heart damaged by ischemia?
class 1B (mexiletine and lidocaine)
what toxicities/AEs are associated with mexilitine
N/V
what are the class 1C antiarrhythmics
flecainide (flakes)
propafenone (purple phone)
indications for using class 1C antiarrhythmic drugs?
Ventricular tachycardia
other arrhythmias that are refractory to other tx (b/c it is most likely to cause an arrhythmia)
what toxicities/AEs are associated with propafenone?
metallic taste (fenny taste)
Beta-1 receptors are predominantly found in
the heart, the kidney, and fat cells.
when are beta blockers contraindicated?
- when pt taking Ca2+ channel blockers (risk of AV block)
- pheochromocytoma
- cocaine toxicity
what is an off-label use for propanalol
Propranolol has the best CNS penetration among all beta blockers and is thus used as an anxiolytic (reduces sympathetic sx of anxiety)
another use is as a local anesthetic
which of the Class II (K blockers) antiarrhythmics is indicated for life threatening V Tach
amiodarone
what toxicities/AEs are associated with dronedarone?
GI disturbances (mn: you get motion sickness flying on a drone)
what toxicities/AEs are associated with class IV antiarrhythmics
hyperprolactinemia, flushing, bradycardia, constipation
more serious: heart block and SA node depression*
therefore, contraindicated in pts with bradycardia and heart failure
dangerous drug interaction with class IV antiarrhythmics
don’t give with beta blockers –> decreases conduction velocity
what toxicities/AEs are associated with adenosine (Misc antiarrhythmic)
flushing, bronchoconstriction, dyspnea, chest pain, hypotension
Digoxin MOA
mimics effect of vagal nerve innervation
what toxicities/AEs are associated with digoxin
atrial tachycardia with AV block
which class IV antiarrhythmic can be used to treat HTN
diltiazem
what side effects are common to all Class IV antiarrhythmics (Ca channel blockers)
constipation, hyperprolactinemia, heart block, bradycardia
what are the calcium channel blockers
Dihydropyridines (selective for Ca2+ channels on vascular smooth muscle so they treat HTN)
Amlodipine
Nicardipine
Nifedipine
Non-dihydropyridines (selective for heart tissue so they treat arrhythmias)
verapamil
diltiazem
what are the indications for Ca channel blockers (by type)
dihydropyridines (-dipine): HTN (main indication), angina, Raynaud’s phenomenon, cerebral vasospasms after subarachnoid hemorrhage
non-dihydropyridines (verapamil and diltiazem): tachyarrhythmias, angina, HTN (diltiazem only)
what side effects are common to all dihydropyridines (-dipine)
reflex tachycardia, vasodilation, gingival hyperplasia
what are the sx of alcohol withdrawal
anxiety, tremors, diaphoresis, and possibly seizures
