46 anti arrhythmic drugs

Question 1

cardiac arrhythmias are categorized by what?

Answer 1

location of origin

Question 2

What are the 2 types of supra ventricular arrhythmias?

Answer 2

atrial and nodal

Question 3

Is torsades de pointes a supraventricular or a ventricular arrhythmias?

Answer 3

ventricular

Question 4

What is the goal of drug therapy for abnormal automaticity cause of arrhythmia?

Answer 4

reduce ectopic pacemaker activity

Question 5

What is the goal of drug therapy for abnormal impulse conduction cause of arrhythmia?

Answer 5

modify conduction or refractoriness in reentry circuits

Question 6

What drugs [decrease? but he changed to increase] phase 4 slope?

Answer 6

beta and Ca channel blockers

Question 7

What drugs increase maximum diastolic potential?

Answer 7

adenosine

Question 8

What drugs increase the threshold?

Answer 8

Na and Ca channel blockers

Question 9

What drugs increase action potential duration?

Answer 9

k channel blockers

Question 10

Drugs can abolish re-entry by what 2 mechanisms?

Answer 10

1. Further slowing depressed conduction (Na or Ca channel block)
2. lengthening refractory period

Question 11

What 2 mechanisms to lengthen refractory period?

Answer 11

Na channel and K channel blockers

Question 12

What is a smart drug?

Answer 12

state and use dependent block

Question 13

TF- depolarization of resting membrane decreases lidocaine block?

Answer 13

False- increases it

Question 14

T-F– tachycardia increases lidocaine block?

Answer 14

True

Question 15

Class I anti arrhythmic mechanism?

Answer 15

Na channel-slow phase 0 depolarization slow conduction

Question 16

Class II anti arrhythmic mechanism?

Answer 16

beta adrenergic receptor block

Question 17

Class III anti arrhythmic mechanism?

Answer 17

K channel block

Question 18

Class IV anti arrhythmic mechanism?

Answer 18

Ca2+ channel block

Question 19

Class IA, IB, IC are unbound with what rate of kinetics? and do what to the action potential?

Answer 19

1. Medium, fast, slow

2. prolong, shorten, minimal effect

Question 20

Class IA drugs also block what?

Answer 20

K channels

Question 21

Procainamide metabolite predisposes to what?

Answer 21

Action potential prolongation, EADS, arrhythmias

Question 22

What patients should we avoid using class IC antiarrhymic drugs?

Answer 22

underlying structural heart disease or post-myocardial infarction

Question 23

What class I anti-arrythmic is a IV only drug?

Answer 23

Lidocaine

Question 24

What class II anti-arrythmic is a IV only drug?

Answer 24

esmolol

Question 25

What class III anti-arrythmic is a IV only drug?

Answer 25

ibutilide

Question 26

Which Class III anti-arrythmic drug does not need to be started in a hospital, what is unique about it? why do we start them in hospitals?

Answer 26

1. amiodarone- does require regular monitoring! accumulates in tissues lipid soluble
2. monitor for acute QT prolongation -torsade de pointes

Question 27

What does dronedarone lack?

Answer 27

lack thyroid and pulmonary toxicity of amiodarone

Question 28

What do Ca channel blockers do to the QRS complex?

Answer 28

slow rate and reduce maximal height

Question 29

What is a strong drug to break up AV node arrhythmia?

Answer 29

verapamil and diltiazem

Question 30

Adenosine activates what receptor and inhibits what?

Answer 30

Ik, Ica

Question 31

Digoxin sensitize parasympathetic efferents and inhibits what channel?

Answer 31

Ica