Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology II for Anesthesia > 02 - Antiarrhythmics and Ca-Channel Blockers > Flashcards

02 - Antiarrhythmics and Ca-Channel Blockers Flashcards

0
Q

Digoxin reduces ventricular rate by

A

Slowing conduction through the AV node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Digoxin is a ______ that is used to manage _______ with rapid ventricular rate

A 
Cardiac glycoside
Supraventricular tachydisrhythmias (ATach, AFlutter, AFib)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Digoxin ______ parasympathetic nervous system activity and _____ SA node activity. There is some risk of

A

Increases
Decreases
Ventricular fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Digoxin is used for treatment of CHF, but no longer a

A

First line therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is digoxin a positive inotropic agent?

A

It inhibits the Na-K-ATP transport system, which increases intracellular Na -> increases intracellular Ca -> increases contractility

Can cause K depletion with diuretics -> toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What percent of digoxin is protein bound?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Digoxin has a ____ therapeutic range with therapeutic effects at ____ of the fatal dose

A

Narrow
35%

Therapeutic range: 0.5-2.5 ng/mL
Toxic range > 3 ng

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Symptoms of digoxin toxicity

A

NV
Vision changes (yellow/green halos)
Atrial/ventricular dysrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment of digoxin toxicity

A

Identify/correct inciting cause (hypoK, hypoMg, hyperCa)
Treat dysrhythmias (phenytoin, lidocaine, atropine)
Artifial pacing if complete heart block present
Fab fragments (digitalis antibodies)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Quinidine _____ digoxin from tissue binding sites

A

Displaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sympathomimetics can precipitate ____ when used with digoxin

A

Dysrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Class I antiarrhythmic drugs are _____.

A

Sodium channel blockers

They decrease myocardial depolarization rate and conduction velocity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Examples of class I antiarrhythmic drugs?

A 
Quinidine
Procainamide
Lidocaine
Phenytoin
Flecainide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lidocaine is particularly effective for _____ and suppression of

A

Ventricular tachycardia, PVCs

Dose: 2 mg/kg IV, then 1-4 mg/min infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

There is risk of ____ with lidocaine which is worse during hypoxia and acidosis

A

CNS toxicity (depression, apnea, seizure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Class II antiarrhythmic drugs are

A

Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Class III antiarrhythmic drugs are

A

Potassium channel blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Examples of class III antiarrhythmics?

A

Amiodarone
Sotalol
Bretylium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do class III antiarrhythmic drugs prolong cardiac depolarization and action potential duration?

A

They decease the proportion of when the myocardium is excitable in the cardiac cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Amiodarone prolongs the refractory period in

A

All cardiac tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Amiodarone also has the effects of

A 
Class I (Na channel blocking)
Class II (beta blocking)
Class IV (Ca channel blocking)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Most effective drug for SVT, PVCs, VTach, and defibrillation resistant VFib

A

Amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The elimination half life of amiodarone is ____ because of

A

29 days

Large volume of distribution and extensive protein binding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Amiodarone may have some effect on

A

Conversion of AFib

Also procainamide, quinidine, flecainide, sotalol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Side effects of amiodarone

A 
Pneumonitis
Hypotension (vasodilation)
Hypo or hyperthyroidism (high iodine content)
Photosensitivity
Rash
25
Q

Initial dose of amiodarone

A

300 mg IV

Or 5 mg/kg

26
Q

Adenosine is an ____ that acts as a potent _____ and decreases

A

Endogenous nucleoside
Coronary dilator
Myocardial O2 demand

27
Q

Is adenosine short or long acting?

A

Short

Half time is .6-1.5 sec

28
Q

Adenosine stimulates supraventricular _____ leading to

A

Potassium channels
Hyperpolarization, decreased depolarization

These channels are not present in ventricular myocytes

29
Q

Adenosine is used to identify/treat ____ but ineffective for

A

AV nodal supraventricular tachycardias (re entrant tachy, atrial tachy)
AFib, AFlutter, ventricular tachycardia

30
Q

Doses of adenosine

A

Starting = 6 mg IV
12 mg
12 mg

31
Q

Adenosine causes transient heart block (AV node), causing ______. It is a danger in patients with

A

Brief ventricular asystole

Heart block or sick sinus syndrome (have a pacemaker available)

32
Q

Side effects of adenosine

A 
Flushing
Dyspnea
Chest pain
Bronchospasm
Metallic taste
33
Q

Can be used for controlled hypotension as an infusion or pharmacological stress testing

A

Adenosine

34
Q

Calcium channel blockers bind to _____ leading to decreased intracellularly calcium. The effects are

A

L type voltage gated calcium channels

Decreased myocardial contractility
Decreased HR
Decreased SA node activity and/or AV node conduction
Vascular smooth muscle relaxation

35
Q

Calcium channel blockers shoudk be used with caution in patients with

A

Impaired LV function or hypovolemia

36
Q

All calcium channel blockers are highly ____ and metabolized by

A

Protein bound

Liver

37
Q

Calcium channel blockers potentiate the effect of

A

Neuromuscular blocking drugs

38
Q

Calcium channel blockers have potent

A

Local anesthetic activity (inhibition of Na ion flux)

Increased risk of LA toxicity

39
Q

IV dosing of calcium channel blockers

A

Commonly given as a bolus + continuous infusion

40
Q

First line medication of supraventricular tachydisrhythmias

Blocks calcium channels of AV node

A

Diltiazem (cardizem) - benzothiazapine

41
Q

Diltiazem (cardizem) has some role in the control of

A

Chronic hypertension by peripheral arterial vasodilation

42
Q

Elimination half life of diltiazem (cardizem)

A

4-6 hours

20 hours for metabolites

43
Q

Side effects of diltiazem (cardizem)

A

Dizziness
Headaches
Flushing
Gingival hyperplasia

44
Q

Verapamil is a phenylalkylamine used for the treatment of

A

Supraventricular tachydisrhythmias

By AV node depression leading to bradycardia

45
Q

Treatment of angina pectoris and hypertension by coronary and peripheral artery vasodilation

A

Verapamil

46
Q

Treatment of migraines and cluster headaches

A

Verapamil

47
Q

Side effects of verapamil

A 
Hypotension
Constipation
Headaches
Flushing
Gingival hyperplasia
48
Q

Elimination half time of verapamil

A

6-12 hrs

49
Q

Dpihydropyridine calcium channel blockers

A 
Nifedipine (procardia)
Nimodipine (lipid soluble analogue)
Nicardipine (cardene)
Clevidipine (cleviprex)
Amplodipine (norvasc)
50
Q

Nifedipine is used for the treatment of

A

Angina pectoris, especially coronary vasospasm

By coronary and peripheral artery vasodilation

51
Q

Nimodipine crosses

A

Blood brain barrier

Prevention of cerebral vasospasm

52
Q

Nicardipine has no effects on

A

SA or AV node

53
Q

Nicardipine is used for the treatment of

A

Angina and hypertension

By coronary and peripheral artery vasodilation

54
Q

What are tocolytics? Which drugs is an example?

A

Medications that suppress premature contractions

Nicardipine

55
Q

IV infusion dose of nicardipine

A

5 mg/hr increase by 2.5 mg/hr every five minutes up to 15 mg/hr

56
Q

Clevidipine is in a

A

Lipid emulsion

57
Q

Dihydropyridine calcium channel blocker that is metabolized by plasma/tissue esterases

A

Clevidipine

Half time is 1 min

58
Q

Dose of clevidipine

A

Starting: 1-2 mg/hr

Up to 16 mg/hr

59
Q

Oral preparation similar to nifedipine/nicardipine

A

Amlodipine

60
Q

Which calcium channel blockers cause coronary and peripheral vasodilation?

A

Verapamil
Nifedipine
Nicardipine
Clevidipine

Pharmacology II for Anesthesia (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions