anti-arrhythmia drugs

Question 1

quinidine

Answer 1

function: decreased myocardial contraction, decreased cardiac conduction
adverse effect: Wided QT and PR - slowed conduction possible cardiac arrest, smooth muscle depression, irritation of GI
indications: supra ventricular and ventricular arrhythmia
class: IA

Question 2

procainamide

Answer 2

Procan
class IA
most frequently used IA
indications: same as quinidine, more for ventricular arrhythmias
therapeutic effects: same as quinidine, with less adverse effects
adverse effects: hypotension (especially IV), skin rash

Question 3

lidocaine

Answer 3

xylocaine
class IB
indications: ventricular arrhythmia
decreases automaticity
only parenteral administration, very short acting
adverse effects: rapidly metabolized by the liver - possible impaired liver function with high levels
high doses: CNS depression and stimulation

Question 4

flecainide and Propafenone

Answer 4

Tambocor & rhythmol
class IC
indication: last ditch antiarrhythmics, usually for supra ventricular rhythms
therapeutic effects: decreased in cardiac conduction (phase 0)
adverse effects: heart failure, heart block, bradycardia

Question 5

propanolol

Answer 5

inderal
non-selective
indication: supra ventricular and ventricular arrhythmias
therapeutic effects: decreased HR, slowed AV conduction, prolonged refractory period
adverse effects: hypotension, bradycardia, bronchoconstriction

Question 6

esmolol

Answer 6

brevibloc
indications: emergency situations - SNS activity in heart is dangerous
therapeutic effects: depresses chronotropy and inotropic effects of SNS, rapidly metabolized
adverse effects: OD: bradycardia, hypotension, delayed AV conduction (too much could cause heart blocks)

Question 7

amiodarone

Answer 7

Cordarone
class III
has some blocking effects of K+ ( Na+ and Ca2+)
some beta and alpha blocking
indications: powerful supra ventricular and ventricular anti arrhythmic (common ACLS drug), very long half life (1-3months) - used carefully
therapeutic effects: prolonged refractory period, decreased HR and AV conduction
adverse effects: long half-life
ataxia, thyroid dysfunction, pulmonary fibrosis, hypotension
cardiac toxicity: bradycardia, heart block, heart failure, proarrhythmias ie// tornadoes des pointes

Question 8

Verapamil and Diltiazem

Answer 8

isoptin & cardizem
class IV
indications: arrhythmias originating in AV node, other supra ventricular tachycardia, also effective antihypertensives
therapeutic effects: primary: decreases and slows conduction through AV node
secondary: slows firing of SA node
adverse effects: high doses may lead to heart blocks, decrease myocardial; contractility (bad for CHF pt), hypotension, constipation

Question 9

adenosine

Answer 9

Adenocard
indications: terminate SVT
duration 15-30sec
therapeutic effects: decrease calcium activity at AV node (and some at SA node), slowing conduction, fewer signals to the ventricles (slower ventricular HR)
adverse effects: transient systole, transient bronchospasm, feeling of impending doom

Question 10

metoprolol

Answer 10

lopressor

beta blocker - selective

Question 11

atenolol

Answer 11

tenormin

beta-blocker - selective

Question 12

verapamil

Answer 12

isoptin

CCB

Question 13

diltiazem

Answer 13

cardizem

CCB

Question 14

amlodipine

Answer 14

norvasc

CCB

Question 15

nifedipine

Answer 15

adalat

CCB