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Pharm II > Anti-arrhythmia > Flashcards

Anti-arrhythmia Flashcards

1
Q

MOA for Class IA drugs (Quinidine, Procainamide)?

A

1˚ - Preferentially block open or activated Na channels; lengthen the duration of action potential
2˚ - Block K channels increase effective refractory period)

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2
Q

MOA for Class IB drugs (lidocaine)?

A

Block inactivated sodium channels, shorten duration of action potential (decrease effective refractory period)

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3
Q

MOA for Class IC drugs (Flecainide)?

A

Binds to all sodium channels, no effect on duration of action potential (no effect on effective refractory period)

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4
Q

MOA for Class II drugs (B-blockers)?

A

Reduce adrenergic activity on the heart

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5
Q

MOA for class III drugs (Amoidarone, sotalol)?

A

K+ channel inhibitors (increase effective refractory period)

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6
Q

MOA for class IV drugs (Verapamil, diltiazem)

A

L-type Ca Channel blockers, decrease HR and contractility

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7
Q

What broad spectrum drug is used to tx acute or chronic supraventricular or ventricular arrhythmias?

A

Quinidine

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8
Q

What drug has a low therapeutic index can can easily cause:

  1. Cardiac toxicity (SA/AV block, ventricular arrhythmia
  2. Blocks alpha receptors –> sever HTN, reflex tachycardia
  3. Paradoxical Tachycardia (reflex to vasodilation)
  4. Tosades de pointes
A

Quinidine

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9
Q

What drug causes widening of QRS, and QT intervals. This can lead to what?

A

Quinidine

Quinidine syncope

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10
Q

Cinchonism and diarrhea are adverse effects of what drug?

A

Quinidine

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11
Q

What drug can cause Lupus erythematous in slow slow acetylators: NAT2 gene?

A

Procainamide (class IA)

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12
Q

What is DOC for ventricular arrhythmias?

A

IV Lidocaine (class IB)

Has least amount of negative inotropic effects, slows conduction

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13
Q

Adverse effects of Lidocaine (2)

A
  1. Bradycardia

2. Convulsions

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14
Q

What drug is last ditch effort for supra-ventricular/life threatening ventricular arrhythmias, but ALSO can cause arrhythmias?

A

Flecainide (class IC)

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15
Q

BB hack!

A

Drugs that start w/ A-M = B1 specific blockers
- Metoprolol, Esmolol
Drugs that start w/ N-Z = non-specific BB
- Propranolol

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16
Q

What IV B1-blocker is 2nd line for Paroxysmal supraventricular tachycardia?

A

Esmolol (Class II)

17
Q

What is DOC for ventricular arrhythmias?

A

Amiodarone (Class III)

Also effective against both supreventricular arrhythmiass

18
Q

T or F: Amiodarone can cause torsades de pointes?

A

FALSE

No Torsades de pointes

19
Q

Pulmonary fibrosis, yellow-brown corneas, grey-blue skin and thyroid dysfunction are side effects of what drug?

A

AmIODarone

Increases IODine –> color changes and thyroid dysfunction

20
Q

What class III med blocks K+ but also is a non-selective B-blocker?

A

Sotalol

21
Q

What class III med is effective in treating ventricular and supraventricular arrhythmias BUT causes torsades de pointes?

A

Sotalol

22
Q

What drug is only effective in the atria but is used to tx reentrant SVT, PSVT and Afib/flutter

A

Verapamil and Diltiazem (class IV)

  • Only effective in SVT b/c that is where Ca is important for rate
23
Q

Adverse effects of Verapamil and Diltiazem? (2)

A
  1. Constipation

2. Avoid use w/ B-blocker –> Heart block

24
Q

Increased K conductance that hyperpolarizes and resets the heart is MOA for what drug?

A

Adenosine

25
Q

DOCs for acute PSVT (1-3 in order)

A
  1. Adenosine
  2. Esmolol
  3. CCVs
26
Q

DOCs for chronic PSVT?

A
  1. BB

2. CCBs

27
Q

DOC for acute PSVT and WPW syndrome?

A

Adenosine

28
Q

What drug is has a t1/2 of 10 seconds and is effective only against reentry arrhythmias

A

Adenosine

29
Q

What is DOC for Torsades de pointes?

A

Magnesium (unknown MOA, IV only)

30
Q

What happens if you give pt w/ normal Mg levels Mg?

A

Anti-arrhythmic effect

31
Q

What medication is used in the management of seizures associated w/ severe toxemia or pregnancy (eclampsia)

A

Magnesium

32
Q

T or F: Hyperkalemia and hypokalemia are pro-arrhythmic?

A

TRUE

33
Q

T or F: Lidocaine, adenosine, and magnesium are IV only?

A

TRUE

So used only in acute therapy

34
Q

What happens when you used anti-arrhythmic agents at high doses? (2)

A
  1. Depress conduction in normal tissues

2. Produce drug induced arrhythmias (potentially lethal)

35
Q

What is causes reentry arrhythmias?

A

Infarct blocks normal conduction pathway, the conduction then enters in retrograde direction, causing reentry of arrhythmia into circuit

Others: obstacle to homogenous conduction or prolonged conduction time allows for more excitable tissues

36
Q

T or F: Any drug that is used to tx and arrhythmia can cause an arrhythmia?

A

TRUE

Pharm II (13 decks)

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