Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

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
Side effects of amiodarone
``` Pneumonitis Hypotension (vasodilation) Hypo or hyperthyroidism (high iodine content) Photosensitivity Rash ```
25
Initial dose of amiodarone
300 mg IV | Or 5 mg/kg
26
Adenosine is an ____ that acts as a potent _____ and decreases
Endogenous nucleoside Coronary dilator Myocardial O2 demand
27
Is adenosine short or long acting?
Short | Half time is .6-1.5 sec
28
Adenosine stimulates supraventricular _____ leading to
Potassium channels Hyperpolarization, decreased depolarization These channels are not present in ventricular myocytes
29
Adenosine is used to identify/treat ____ but ineffective for
AV nodal supraventricular tachycardias (re entrant tachy, atrial tachy) AFib, AFlutter, ventricular tachycardia
30
Doses of adenosine
Starting = 6 mg IV 12 mg 12 mg
31
Adenosine causes transient heart block (AV node), causing ______. It is a danger in patients with
Brief ventricular asystole | Heart block or sick sinus syndrome (have a pacemaker available)
32
Side effects of adenosine
``` Flushing Dyspnea Chest pain Bronchospasm Metallic taste ```
33
Can be used for controlled hypotension as an infusion or pharmacological stress testing
Adenosine
34
Calcium channel blockers bind to _____ leading to decreased intracellularly calcium. The effects are
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
Calcium channel blockers shoudk be used with caution in patients with
Impaired LV function or hypovolemia
36
All calcium channel blockers are highly ____ and metabolized by
Protein bound | Liver
37
Calcium channel blockers potentiate the effect of
Neuromuscular blocking drugs
38
Calcium channel blockers have potent
Local anesthetic activity (inhibition of Na ion flux) | Increased risk of LA toxicity
39
IV dosing of calcium channel blockers
Commonly given as a bolus + continuous infusion
40
First line medication of supraventricular tachydisrhythmias | Blocks calcium channels of AV node
Diltiazem (cardizem) - benzothiazapine
41
Diltiazem (cardizem) has some role in the control of
Chronic hypertension by peripheral arterial vasodilation
42
Elimination half life of diltiazem (cardizem)
4-6 hours | 20 hours for metabolites
43
Side effects of diltiazem (cardizem)
Dizziness Headaches Flushing Gingival hyperplasia
44
Verapamil is a phenylalkylamine used for the treatment of
Supraventricular tachydisrhythmias | By AV node depression leading to bradycardia
45
Treatment of angina pectoris and hypertension by coronary and peripheral artery vasodilation
Verapamil
46
Treatment of migraines and cluster headaches
Verapamil
47
Side effects of verapamil
``` Hypotension Constipation Headaches Flushing Gingival hyperplasia ```
48
Elimination half time of verapamil
6-12 hrs
49
Dpihydropyridine calcium channel blockers
``` Nifedipine (procardia) Nimodipine (lipid soluble analogue) Nicardipine (cardene) Clevidipine (cleviprex) Amplodipine (norvasc) ```
50
Nifedipine is used for the treatment of
Angina pectoris, especially coronary vasospasm | By coronary and peripheral artery vasodilation
51
Nimodipine crosses
Blood brain barrier | Prevention of cerebral vasospasm
52
Nicardipine has no effects on
SA or AV node
53
Nicardipine is used for the treatment of
Angina and hypertension | By coronary and peripheral artery vasodilation
54
What are tocolytics? Which drugs is an example?
Medications that suppress premature contractions | Nicardipine
55
IV infusion dose of nicardipine
5 mg/hr increase by 2.5 mg/hr every five minutes up to 15 mg/hr
56
Clevidipine is in a
Lipid emulsion
57
Dihydropyridine calcium channel blocker that is metabolized by plasma/tissue esterases
Clevidipine | Half time is 1 min
58
Dose of clevidipine
Starting: 1-2 mg/hr | Up to 16 mg/hr
59
Oral preparation similar to nifedipine/nicardipine
Amlodipine
60
Which calcium channel blockers cause coronary and peripheral vasodilation?
Verapamil Nifedipine Nicardipine Clevidipine

Pharmacology II for Anesthesia (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions