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Pharmacology > 2 Angina and Arrhythmia > Flashcards

2 Angina and Arrhythmia Flashcards

1
Q

What is angina?

A

Angina is pain that occurs in the chest

region during ischemic heart disease.

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2
Q

What are the 3 types of organic nitrates? Which would you use for an acute attack?

A

• Nitrogliycerine* acute

  • Isosorbide Dinitrate
  • Isosorbide Mononitrate
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3
Q

How do organic nitrates work?

A

Dilate systemic vascular system to decrease preload of the heart

By dilating the systemic peripheral
arterioles, they decrease afterload on the heart

A decrease in cardiac preload and
afterload decreases the amount of work the heart must perform, and myocardial oxygen demand decreases

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4
Q

What are the side effects of organic nitrates?

A
  • Headache
  • Dizziness
  • Orthostatic hypotension
  • Nausea
  • tolerance
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5
Q

What are the side effects of calcium channel blockers?

A 
• Headache
• Flushing – feeling of warmth
• Dizziness
• Peripheral edema
• Nausea
• Increase risk of cancer
• “ipine” – rapid ↓ in peripheral vascular
resistence and BP
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6
Q

What is stable angina?

A

Ischemia has a known onset.

Cause and effect.

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7
Q

What is variant angina?

A

Vasospasm when you get up in the morning.

aka: prinzmetal ischemia

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8
Q

What is prinzmetal ischemia?

A

Vasospasm when you get up in the morning.

aka: variant angina

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9
Q

What is an unstable angina?

A

Has no known cause, seems random in onset

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10
Q

Which type of arrhythmia is life threatening?

A

Ventricular

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11
Q

How many classes of antiarrhythmia drugs are there?

A

4

  • Class I : Sodium channel blockers – Subclass A-C
  • Class II: Beta blockers
  • Class III: Drugs that prolong repolarization
  • Class IV: Calcium channel blockers
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12
Q

What is the mechanism of action for class I antiarrhythmia drugs?

A

• these drugs bind to membrane sodium
channel in excitable tissue in the myocardium

  • Normalize the rate of sodium entry into and normalize the rate of cardiac cell firing
  • Helps to stabilize the cardiac cell membrane
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13
Q

Class 1A Antiarrhythmia drugs

A

• Produce a slowing of depolarization and
action potential throughout the myocardium
• Prolong repolarization of the cardiac cell

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14
Q

Class IB antiarrhythmia drugs

A

• Minimal ability to slow depolarization and
cardiac conduction
• Shorten cardiac repolarization
• Drugs are primarily used to treat ventricular arrhythmias – V-tach and PVC’s

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15
Q

Class IC antiarrhythmia drugs

A
  • Decrease the rate of depolarization and cardiac conduction
  • Have little effect on repolarization
  • Used to treat ventricular arrhythmias – V-tach and PVC’s
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16
Q

Adverse side effects of Class I antiarrhythmia drugs

A
  • Increase rhythm disturbances
  • Aggravate other cardiac rhythm abnormalities
  • Produces serious arrhythmias in pts with heart failure, myocardial ischemia, and structural heart disease
  • Dizziness
  • Visual disturbance
  • nausea
17
Q

What are class I antiarrhythmia drugs?

A

Sodium channel blockers

18
Q

What are class II antiarrhythmia drugs?

A

Beta blockers

19
Q

What is the mechanism of action of class II antiarrhythmia drugs?

A
  • Decrease the excitatory effects of the sympathetic nervous system and related catecholamines on the heart
  • Decreases automaticity and prolongs the refractory period, slowing the heart
  • Slow conduction through myocardium, esp. AV node
  • Most effective in treating atrial tachycardias
20
Q

What are the side effects of class II antiarrhythmia drugs?

A
  • Beta -1 in heart and beta - 2 in lungs
  • Increase bronchoconstriction in pts with lung Dz. ( use beta – 1 drug)
  • Slows cardiac conduction
  • Severe adverse effects rare
21
Q

What are class III antiarrhythmia drugs?

A

Drugs That Prolong Repolarization

22
Q

What are the mechanisms of action of class III antiarrhythmia drugs?

A 
• Delay repolarization of cardiac cells 
• Slows and stabilizes heart rate 
• Inhibits potassium efflux during
repolarization 
• Used to treat v-fib, v-tach,SVT 
• Safe
23
Q

What are the adverse effects of class III antiarrhythmia drugs?

A

• Initial increase in ventricular arrhythmias –
torsades de pointres – which can be fatal
• Pulmonary toxicity
• Liver damage

24
Q

What are class IV antiarrhythmia drugs?

A

Calcium channel blockers

25
Q

What is the mechanism of action of class IV antiarrhythmia drugs?

A

• Blocks calcium entry into myocardial and
vascular smooth muscle
• Alters excitability and conduction of cardiac tissues
• Decrease rate of discharge of the SA node and inhibits conduction velocity through the AV node
• Used in treating artial arrhythmias – SVT, a- fib

26
Q

What are the side effects of class IV antiarrhythmia drugs?

A

Bradycardia
Dizziness
Headache

27
Q

What is preload?

A

Anything the heart has to pump against

Pharmacology (24 decks)

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