Brainscape's Knowledge GenomeTM

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


See full index

Cardio Module > 11. Anti Arrhythmic Drugs Class 1 (a,b &c) > Flashcards

11. Anti Arrhythmic Drugs Class 1 (a,b &c) Flashcards

1
Q

Based on Vaughan-Williams Classification, what are the 4 classes?

A 
Type 1 - sodium channel blockers 
1a intermediate t(recovery)
1b short t(recovery)
1c long t(recovery) 
Type II - beta antagonists 
Type III - drugs that prolong action potential 
Type IV - calcium channel blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 type 1a drugs?

A

Quinidine, procainamide and disopyramide

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

What are the main effects of type 1a?

A
  1. Decreases conduction velocity of bundle of his, perkinje fibers, and ventricles
  2. Prolongs refractory period
  3. Decreases automaticity of Na - makes threshold more positive
  4. Block potassium channels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the effects of quinidine?

A

Blocks Na channels, K channel and Ca channel
Antimuscurinic properties - speed conduction through AV node
Blocks alpha-1 –> vasodilation

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

How is quinidine administered usually? What the IV administration for?

A

Administered PO

IV administration for atrial or ventricular tachycardia

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

What is the black box warning for quinidine?

A

PO: increase mortality in nonlife threatening arrhythmia vs. other AADs; proarrhythmic - QTc prolongation and TdP possible

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

What are the adverse effects of quinidine? What are toxicity symptoms? What should be monitored?

A
  1. TdP, GI upset, immune rxn
  2. Head ache, dizziness, tinnitus
  3. EKG, CBC, LFTs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is procainamide administered?

A

IV or IM

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

What is the black box warning for procainamide?

A

watch for systemic lupus erythematosus and bone marrow depression

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

What is the main indication for procainamide?

A

Use for life threatening ventricular arrhythmias only

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

Does procainamide under go renal metabolism? Hepatic metabolism?

A

yes and yes

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

What are the contraindications of procainamide?

A

SLE, heart block, history of TdP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What should be monitored with procainamide?

A

EKG, BP, antinuclear antibody (ANA), CBC

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

What is the usage for disopyramide?

A

For use in life threatening ventricular arrhythmias only

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

What is the black box warning for disopyramide?

A

Can precipitate CHF in pts w/ left ventricular dysfunction

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

Does disopyramide undergo hepatic and/or renal metabolism?

A

Yes and yes

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

What are the contraindications of disopyramide?

A

Cardiogenic shock, QTc prolongation

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

What are the adverse effects of disopyramide?

A

Anticholinergic effects, TdP, CHF, hypotension, anorexia

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

What should be monitored with disopyramide?

A

EKG, BUN/sCr, LFTs, blood glucose

20
Q

What is the Vaughan-Williams Classification of Antiarrrhythmic Drugs?

A

Categorizing drugs according to their electro physiological effects on their heart (rather than therapeutic target)

21
Q

What are the three type 1b Antiarrhythmic drugs?

A

Lidocaine, mexilitine, to asinine, phenytoin

22
Q

What are the effects of class 1b antiarrhythmic drugs?

A
  • effect tissue w/ frequent rate of depolarization
  • decrease automaticity of Na dependent conductive tissues (ex ectopic pacemakers)
  • decrease AP duration
  • no effect on conduction velocity, but decreases the frequency of firing
  • used to terminate arrhythmias that are caused by ectopic pacemakers
23
Q

What is the primary use of class 1b AADs?

A

Primarily used to terminate arrhythmias that are caused by ectopic pacemakers

24
Q

What is the primary use for lidocaine?

A

Used for ventricular arrhythmias in ACLS

Treatment of choice in acute ischemic ventricular arrhythmias

25
Q

What is the contraindications of lidocaine?

A

3rd degree heart block, don’t want to loose communication between atria and ventricles

26
Q

What are some adverse effect of lidocaine?

A

Tremor, nausea, slurred speech, seizures

27
Q

How is mexilitine similar to lidocaine?

A

It’s an oral lidocaine derivative

28
Q

What is the black box warning for mexilitine?

A

Should only be used to treat life threatening ventricular arrhythmias due to its pro-arrhythmic effect

29
Q

What are some adverse effects of phenytoin?

A

CNS effects, GI symptoms, gingival hyperplasia, hair growth, hypersensitivity

30
Q

What are contraindications of phenytoin?

A

Sinus bradycardia

AV block – phenytoin will worsen AV node block

31
Q

What will barbiturates do to phenytoin metabolism?

A

Barbs will induce phenytoin metabolism by inducing CYP450 expression, will want to increase phenytoin dose

32
Q

What are 3 type 1c AADs?

A

Flecainide, propafenone, moricizine

33
Q

What are the effects of class 1c AADs?

A
  • Slowing of conduction velocity

- Has no effect on automaticity of ectopic pacemakers

34
Q

What are the effect of flecainide?

A
  • decreased conduction velocity
  • blocks K channels
  • blocks Ca channels
35
Q

What is flecainide used to treat?

A

Atrial and ventricular arrhythmias conversion and maintenance of NSR

36
Q

What is the black box warning for flecainide?

A

Do not use with post-MI or LVDF

pts, may increase mortality

37
Q

What are the contraindications of flecainide?

A

2nd and 3rd degree heart block, or LVDF

38
Q

What are some adverse effects of flecainide?

A

Vtach, double vision, HF, dyspnea

39
Q

What are the effects of propafenone?

A
  • decrease conduction velocity
  • block K channels
  • block b-AR receptors: depresses triggered activity (DAD, EAD) decreases heart rate
40
Q

What is the main use of propafenone?

A

Mainly used IV and PO for atrial arrhythmia conversion and maintenance of NSR

41
Q

What are the adverse effects of propafenone? What are they mainly caused by?

A

Mainly caused by b-AR blockage

  • exacerbate HF
  • bronchospasms
  • sinus bradycardia
42
Q

What is the black box warning with propafenone?

A

Only for life threatening arrhythmias, has a significant pro-arrhythmic effect

43
Q

What are some things that should be monitored while on propafenone?

A

EKG - watching for QTc prolongation
LFTS, CCB, electrolytes
All should be measured every 6 months

44
Q

What is the CAST trial?

A

Compared pts with ischemia and potential for SCD due to ventricular arrhythmias on either 1c AADs or placebo

45
Q

What was the findings of the CAST trial?

A

Do not give 1c AADs to individuals post-MI or with LVH

Cardio Module (12 decks)

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