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1
Q

what toxicities/AEs are associated with Quinidine (class 1A antiarrhythmic)

A
  1. cinchonism: a syndrome of tinnitus, headache and dizziness
  2. thrombocytopenia
  3. QT prolongation (torsades, syncope)
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2
Q

what toxicities/AEs are associated with procainamide (class 1A antiarrhythmic)

A
  1. (chronic use) drug-induced lupus (sx arthralgia, arthritis, pleuritis, pericarditis, parenchymal pulmonary disease)
  2. QT prolongation (torsades, syncope)
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3
Q

what toxicities/AEs are associated with disopyramide

A
  1. acute heart failure (cannot be used in patients with impaired systolic function.)
  2. anticholinergic side effect sx: dry eyes, dry mouth, urinary retention
  3. QT prolongation (torsades, syncope)
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4
Q

what toxicities/AEs are associated with lidocaine

A

neurological side effects: tremor, convulsions (seizure), paresthesias

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5
Q

which drugs are high risk for causing DILE

A

There are four main drugs that are known for causing drug-induced lupus:

  • hydralazine
  • isonazid (INH)
  • procainamide
  • phenytoin/penicillamine
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6
Q

What are the class 1A antiarrhythmics

A

Quinidine (prom queen)
Procainamide (prom king)
disopyramide (disappear)

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7
Q

tx of choice for Wolff parkinson-white syndrome

A

procainamide

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8
Q

avoid class 1A antiarrhythmics (Quinidine (prom queen)
Procainamide (prom king)
disopyramide (disappear)) if a patient has _________

A 
heart failure (b/c negative inotropy can lead to heart failure) 
ESPECIALLY disopyramide
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9
Q

the class IB antiarrhythmics are

A

mexiletine (mexican flag)
lidocaine (lied to me)

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10
Q

which class of antiarrhythmics is best for heart damaged by ischemia?

A

class 1B (mexiletine and lidocaine)

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11
Q

what toxicities/AEs are associated with mexilitine

A

N/V

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12
Q

what are the class 1C antiarrhythmics

A

flecainide (flakes)
propafenone (purple phone)

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13
Q

indications for using class 1C antiarrhythmic drugs?

A

Ventricular tachycardia
other arrhythmias that are refractory to other tx (b/c it is most likely to cause an arrhythmia)

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14
Q

what toxicities/AEs are associated with propafenone?

A

metallic taste (fenny taste)

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15
Q

Beta-1 receptors are predominantly found in

A

the heart, the kidney, and fat cells.

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16
Q

when are beta blockers contraindicated?

A
  • when pt taking Ca2+ channel blockers (risk of AV block)
  • pheochromocytoma
  • cocaine toxicity
17
Q

what is an off-label use for propanalol

A

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

18
Q

which of the Class II (K blockers) antiarrhythmics is indicated for life threatening V Tach

A

amiodarone

19
Q

what toxicities/AEs are associated with dronedarone?

A

GI disturbances (mn: you get motion sickness flying on a drone)

20
Q

what toxicities/AEs are associated with class IV antiarrhythmics

A

hyperprolactinemia, flushing, bradycardia, constipation
more serious: heart block and SA node depression*
therefore, contraindicated in pts with bradycardia and heart failure

21
Q

dangerous drug interaction with class IV antiarrhythmics

A

don’t give with beta blockers –> decreases conduction velocity

22
Q

what toxicities/AEs are associated with adenosine (Misc antiarrhythmic)

A

flushing, bronchoconstriction, dyspnea, chest pain, hypotension

23
Q

Digoxin MOA

A

mimics effect of vagal nerve innervation

24
Q

what toxicities/AEs are associated with digoxin

A

atrial tachycardia with AV block

25
Q

which class IV antiarrhythmic can be used to treat HTN

A

diltiazem

26
Q

what side effects are common to all Class IV antiarrhythmics (Ca channel blockers)

A

constipation, hyperprolactinemia, heart block, bradycardia

27
Q

what are the calcium channel blockers

A

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

28
Q

what are the indications for Ca channel blockers (by type)

A

dihydropyridines (-dipine): HTN (main indication), angina, Raynaud’s phenomenon, cerebral vasospasms after subarachnoid hemorrhage
non-dihydropyridines (verapamil and diltiazem): tachyarrhythmias, angina, HTN (diltiazem only)

29
Q

what side effects are common to all dihydropyridines (-dipine)

A

reflex tachycardia, vasodilation, gingival hyperplasia

30
Q

what are the sx of alcohol withdrawal

A

anxiety, tremors, diaphoresis, and possibly seizures

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