Anti-arrhythmia

Question 0

Subgroup of class 1 based on AP duration

Answer 0

1A prolong AP
1B shorten AP
1C no effect on AP

Question 1

MOA of class 1 anti-arrhythmic drugs?

Answer 1

Block Na channels, decrease phase 0, dec excitability and conduction velocity
Block conduction in ischemic cells and slow abnormal pacemakers

Question 2

Define use or state dependency of class 1 anti-arrhythmic drugs

Answer 2

Significantly depress ischemic tissues, negligible effects on normal tissue

Question 3

Class 1 Mnemonic

Answer 3

I am the Queen who proclaimed diso’s pyramids

Quinidine. Procainamide. Disopyramide.

Question 4

Class 1A anti-arrhythmic also used against malaria?

Answer 4

Quinidine

Question 5

Quinidine AE?

Answer 5

Torsades de pointes

Cinchonism (HA, vertigo, tinnitus)

Question 6

Drug not given with quinidine because may inc toxicity?

Answer 6

Digoxin (quinidine decreases clearance of drug)

Question 7

Class 1A anti-arrhythmic used especially AFTER an MI?

Answer 7

Procainamide

Question 8

Procainamide AE?

Answer 8

Drug induced lupus

HIPP - Hydralazine. Isoniazid. Procainamide. Penicillamine.

Question 9

Class 1A anti-arrhythmic with anticholinergic (dry mouth, urinary retention, constipation) side effects?

Answer 9

Disopyramide

Question 10

Antidote to reverse drug induced arrhythmias?

Answer 10

Sodium lactate

Question 11

Class 1B mnemonic

Answer 11

I buy mexican tacos from lily

1B: Mexiletine. Tocainide. Lidocaine.

Question 12

DOC for ventricular arrhythmias POST-MI?

Answer 12

Lidocaine - least cardiotoxic

Question 13

Class 1B AE?

Answer 13

Agranulocytosis

Question 14

Anti-arrhythmic with no ECG changes, no effect on QT interval or AP duration?

Answer 14

Class 1C
Propafenone
Flecainide
Encainide

Question 15

Class 1C often used for?

Answer 15

Refractory arrhythmia

Question 16

Class 2 MOA?

Answer 16

Beta blocker - reduce cAMP
PR prolonged
Act on phase 4

Question 17

Class 2 used in post MI prophylaxis against sudden death?

Answer 17

Propranolol

Non selective beta blocker

Question 18

Class 3 act on what phase?

Answer 18

Phase 3
Block K channels, prolong repolarization, prolong AP
INCREASE QT INTERVAL

Question 19

Class 3 mnemonic

Answer 19

AIDS
Amiodarone
Ibutilide
Dofetilide
Sotalol

Question 20

Most efficaceous of all anti-arrhythmic drugs, used in refractory arrhythmia?

Answer 20

Amiodarone

Dec K efflux, dec SA node, dec CV, inc refractory period

Question 21

Amiodarone AE?

Answer 21

Microcrystalline deposits in the skin and cornea, hypo or hyperthyroid

Question 22

Class 3 anti-arrhythmic used in treatment and prophylaxis of AFib? Cause TDP.

Answer 22

Dofetilide

Question 23

Class 3 with class 2 effects?

Answer 23

Sotalol

AE: Excessive beta block

Question 24

Amiodarone toxicity?

Answer 24

PPTTCS

Pulmo fibrosis. Paresthesia. Thyroid. Tremors. Cornea. Skin deposits

Question 25

DOC for paroxysmal SVT?

Answer 25

Adenosine

Increase K, marked hyperpolarization, block CV