Antarrhythmics Flashcards
All antiarrhythmics can precipitate _______
Lethal arrhythmia
All class I drugs do what
Block sodium channels
Which sodium channels do Class IA drugs block?
Effect on refractory period and action potential?
Open and activated Na+ channels
AP lengthened
RP lengthened
Which sodium channels are blocked by Class IB Drugs?
Effect on action potential and refractory period?
Inactivated Na+ channels
Shorten AP
Shorten RP
Which sodium channels are blocked by class I C drugs?
Effect on refractory period and Action potentiak?>
ALL sodium channels
No effect on AP
No effect on RP
What are the 2 class IA drugs
Quinidine
Procainamide
Which drug is class IB drug
Lidocaine
What drug is class I C
Flecainide
What is the MOA of Class II drugs
Reduce adrenergic activity on the heart
Which drugs are class II
Beta blockers
What is the MOA of Class III drugs?
Effect on action potential?
Effect on refractory period?
Blocks K+ channels
AP lengthened**
No effect on RP
What drugs are Class III
Amiodarone
Sotalol
What is the MOA of Class IV drugs
Calcium channel blockers: decrease HR and contractility
Which drugs are Class IV
Verapamil
Diltiazem
(Non-dihydropyridine CCBs)
How do you treat Torsades
Magnesium
What drug is the “broad spectrum” antiarrhtyhmic because it treats supraventricular and ventricular arrhythmias
Quinidine
What are the adverse effects of quinidine
Cardiac toxicity: SA block, AV block, ventricular arrhythmia
Blocks alpha receptors= hypotension and reflex tachycardia
Paradoxical tachycardia
Torsade de pointes
Diarrhea** big deal!
Cinchonism: hearing loss, angioedema vertigo, tinnitus, etc
Any drug that _______________ has the potential to cause Torsade de pointes
Prolongs QT interval
What is the adverse effect of Procainamide?
Drug induced Lupus in slow acetylators
What is the MOA of lidocaine
Blocks ~inactivated~ Na+ channels
=preferentially affects damaged tissue= more receptors are inactivated
What is the DOC for acute VENTRICULAR arrhythmias?
Lidocaine****
If you see VENTRICULAR arrhythmia on a question the answer is lidocaine
What is the main adverse effect of lidocaine
Seizures/convulsions