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Drug Mech Final > Anti-arrhythmia > Flashcards

Anti-arrhythmia Flashcards

1
Q

What class of drugs are in Class 1?

A

Sodium channel blockers

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2
Q

What class of drugs are in Class 2?

A

Beta-blockers

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3
Q

What class of drugs are in Class 3?

A

Potassium channel blockers

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4
Q

What class of drugs are in Class 4?

A

Calcium Channel Blockers

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5
Q

Name the drugs in Class 1A

A
  • Quinidine
  • Procainamide
  • Disopyramide
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6
Q

Name the drugs in Class 1B

A
  • Lidocaine

- Mexiletine

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7
Q

Name the drugs in Class 1C

A
  • Flecainide

- Propafenone

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8
Q

What is the MOA of the Class 1A drugs?

A

Prolong the duration of the action potential and the effective refractory period

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9
Q

True or False: Class 1B drugs have no significant effects on the duration of action potential?

A

True

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10
Q

What is the MOA of Lidocaine?

A

Blocks activated and inactivated sodium channels and selectively depresses conduction in depolarized cells as a result of slower dissociation kinetics

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11
Q

Name the toxicities of the Class 1B drugs

A
  • Hypotension (at high doses)

- Tremor, nausea, hearing disturbances, and convulsions (dose-related and short lived)

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12
Q

True or False: Class 1A drugs are safer than Class 1B drugs?

A

False; class 1B is safer

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13
Q

What is the route of administration for lidocaine?

A

IV

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14
Q

Which sodium channel blocker is the least cardiotoxic?

A

Lidocaine

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15
Q

Prophylactic use of lidocaine may (increase or decrease?) mortality?

A

Increase

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16
Q

True or False: Lidocaine is effective in arrhythmias with acute MI?

A

True

17
Q

What is the MOA of the class 1C drugs?

A

Minimal effects on the duration of the action potential

18
Q

What is the beta-blocker is used in the Class 2 drugs?

A

Esmolol

19
Q

What is the MOA of Esmolol?

A

Reduce the beta-adrenergic activity of the heart

Some will prolong the cardiac action potential

20
Q

True or False: Beta-blockers are less effective than sodium channel blockers

A

True

21
Q

True or False: Beta-blockers are sympatholytic drugs?

A

True

22
Q

Beta-blockers prevent recurrent infarction and sudden death in patients recovering from _________

A

acute MI

23
Q

Name the drugs in Class 3

A
  • Amiodarone
  • Dronedarone
  • Sotalol
  • Dofetilide
  • Ibutilide
24
Q

What is the MOA of potassium channel blockers?

A

Prolong the duration of the action potential by blocking potassium channels in cardiac muscle resulting in prolonging the effective refractory period

25
Q

What is the MOA of amiodarone?

A

Prolongs the action potential by blocking potassium channels—blocks sodium channels which contributes to prolongation—weak adrenergic and calcium channel blocking agent which slows the HR and AV node conduction

26
Q

Name the toxicities of Class 3 drugs

A
  • Bradycardia and heart block in patients with preexisting SA or AV node disease
  • Dose-related pulmonary toxicity
  • Alters blood levels of thyroid hormone
27
Q

How do Class 3 drugs alter blood levels of thyroid hormone?

A

blocks the peripheral conversion of thyroxine (T4) to triiodothyronine (T3) and is a potential source of iodine

28
Q

True or False: Amiodarone exhibits actions of all 4 classes but its predominant effect is sodium channel blocking?

A

False; potassium channel blocking

29
Q

Amiodarone’s broad spectrum of actions account for (high or low?) efficacy and (high or low?) incidence of drug-induced arrhythmias

A

high; low

30
Q

True or False: Amiodarone is not use-dependent?

A

True

31
Q

Name some facts about Dronedarone

A
  • Non-iodinated form of amiodarone
  • less lipophilic
  • shorter half-life
  • less effective and less toxic than amiodarone
32
Q

Name the class 4 drugs

A
  • Verapamil

- Diltiazem

33
Q

What is the MOA of the calcium channel blockers?

A

Block the cardiac calcium current by blocking the calcium channel resulting in slowing conduction in the SA and AV nodes

34
Q

What is the MOA of verapamil?

A

Blocks the L-type calcium channels, it’s blocking action is use-dependent, prolongs the AV and SA node and the effective refractory period overall causing peripheral vasodilation

35
Q

Name the toxicities of Class 4 drugs

A
  • Cardiotoxicity (dose-related)
  • Hypotension and ventricular fibrillation when given to patients with ventricular tachycardia
  • AV block (high-doses) in patients with AV nodal disease
  • Sinus arrest in patients with AV nodal disease
  • Constipation
  • Nervousness
  • Peripheral edema

Drug Mech Final (7 decks)

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