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Anti-Arrhythmia Drugs > 1's > Flashcards

1's Flashcards

1
Q

What do IA block

A

Na channels Ventricular and Supraventricular

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2
Q

What do IB block

A

Na channel Ventricular only

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3
Q

What do IC block

A

Na channels Ventricular and Supraventricular

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4
Q

What are the IA drugs

A

Quinidine
Procainamide
Disopyramide

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5
Q

What are the IB drugs

A

Lidocaine
Mexiletine
Tocainide

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6
Q

What are the IC drugs

A

Flecainide

Propafenone

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7
Q

How do IA act

A 
Slow phase 0 depol	
Prolong phase 3	Slow conduction, 
Prolong AP	
Increase ventricular refractory	
Affect normal tissue
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8
Q

How do IB act

A

Slow phase 0
Decrease phase 4 slope
Decrease AP by shortening repol
Little effect on normal cells

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9
Q

What other class can Quinidine act as

A

III

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10
Q

Can Quinidine cause Arrhythmias

A

Yes

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11
Q

What do we use instead of Quinidine

A

Ca channel blockers

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12
Q

When is Quinidine contraindicated

A

Complete heart block
Caution in prolongued QT,
torsades de pointes,
myocarditis

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13
Q

When do you give quinidine

A

Conversion and prevention of A-fib and flutter Ventricular arrhythmias

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14
Q

Which IA are oral

A

Quinidine Procainamide

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15
Q

What CYP does Quinidine inhibit

A

2D6
3A4
Also p-glycoprotein

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16
Q

Notable Quinidine AE

A

Thrombocytopenic purpura
Cichonism
Increase digoxin conc

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17
Q

What is Cinchonism

A

Blurred vison
Tinnitus
HA
Psychosis

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18
Q

When is Procainamide contraindicated

A 
Hypersensitivity
	Complete heart block	2nd degree AV block	
SLE	
Torsades de pointes	
Caution in HF with HTN
19
Q

When do you give Procainamide

A

Ventricular Arrythmias

Life threatening cases

20
Q

How does Procainamide have class III activity

A

Partially acetylated to NAPA

Prolongs AP duration

21
Q

Most important AE of Procainamide

A

Lupus-like syndrome

22
Q

Stronger -ve ionotrope than quinidine and procainamide

A

Disopyramide

23
Q

Which IAs work mainly on ventricular arrhythmias

A

Quinidine Procainamide

24
Q

Which IA is used for ventricular and supraventricular arrhyt

A

Disopyramide

25
Q

AE for Disopyramide

A

Cardiac failure w/o preexisting dysfunction Severe antimuscarinic effects

26
Q

What other channel does Disopyramide act on

A

K channels

27
Q

What is Lidocaine commonly used for

A

Local anesthetic

28
Q

Which IB has little effect on K

A

Lidocaine

29
Q

What is the DOC for V-tach, V-fib after cardioversion in acu

A

Lidocaine

30
Q

Which IB is IV only

A

Lidocaine

31
Q

Which IB had severe hematological and pulm tox

A

Tocainide

32
Q

Which IB is used for V-tach other than lidocaine

A

Tocainide

33
Q

Which IB has AE in CNS and GI

A

Mexiletine

34
Q

What happens with a toxic dose of Lidocaine

A

Convulsions

Coma

35
Q

Why is Lidocaine IV only

A

FIrst pass

36
Q

Does Lidocaine have LV function effecto or -negative inotrop

A

No

37
Q

Which IC doesn’t affect slope of phase 0 of AP

A

Flecainide

Propafenone

38
Q

Which IC increases threshold potential

A

Flecainide

39
Q

What do you give in life-threatening arrhythmias

A

Flecainide
Propafenone
Procainamide

40
Q

What do you give to maintain normal sinus rhythm in symptoma

A

Propafenone
Amiodarone
Sotalol (and in flutter)
Dofetilide (and in flutter)

41
Q

When do you give Flecainide

A

Refractory PVC or V-tach
Severe supraventricular arrhythmia
Prevent paroxysmal A-fib

42
Q

Contraindication for Flecainide

A

Post-MI PVC

43
Q

AE for Flecainide and Propafenone

A 
Aggravate CHF	
Dizziness,
 blurred vision,
 HA	
N/V/D	
Arrhythmia and V-tach
44
Q

What drugs are involved in Rhythm control of A-fib

A

Class IC Class III IA (more AE)

Anti-Arrhythmia Drugs (5 decks)

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