Anti-arrhythmias

Question 1

Quinidine

Answer 1

Type Ia (Na blocker)
from bark of cinchona
Use-dependent
causes diarrhea, thrombocytopenia, prolongs QT.
Used to treat atrial fibrillation and ventricular tachycardia.

Question 2

Type 1a drugs

Answer 2

Na channel blockers. (intermediate) used in wolf-Parkinson-white. ventricular arrythmias
Quinidine, procainamide, disopyramide

Question 3

type Ib drugs

Answer 3

Na channel blockers (fast). treatment after MI. ventricular tachycardia.
Lidocaine, mexilitene

Question 4

Type Ic drugs

Answer 4

Na channel blocker. (slow). atrial fib, recurrent tachyarrythmias of conduction system. Flecainide, Propafenone

Question 5

Type III drugs

Answer 5

K blocking drugs. wolff-parkinson white, vent tachycardias and atrial fib, atrial flutter and atrial fib. also 1 beta blocker=Setalol, Dofetilide, Dronedarone, Ibutilide

Question 6

Procainamide

Answer 6

Class Ia Na blocker. atrial fibrillation, ventricular tachycardia, and wolff-parkinson-white syndrome. VT “storm” treatment - lots of ventricular tachycardia.

Question 7

Disopyramide

Answer 7

Ia sodium channel blocker.
Vagolytic-increases heart rate so they aren’t dragging. can cause urinary retention (prostate) and cause renal excretion. used in younger women

Question 8

Lidocaine

Answer 8

Ib agent. ONLY intravenous, very narrow therapeutic range, shortens QT interval
metabolized in liver

Question 9

Mexilitene

Answer 9

‘oral form of lidocaine’

Type Ib drug, shortens QT. Useful in automatic ventricular arrhythmias. use with food, metabolized in liver

Question 10

Propafenone

Answer 10

Ic drug. sodium channel blocker. works well in women. good for atrial arrhythmias. Heart rhythm drug that can increase INR on patients with warfarin!!

Question 11

Flecainide

Answer 11

Ic blocker.
great in healthy and young children.
NOT used in flutter.

Question 12

Sotalol

Answer 12

Class III blocker. blocks K+ and Beta blocker

be careful in women-late torsades - long QT two weeks later.

Question 13

Dofetilide

Answer 13

K+ channel blocker – Class III
Must be started in the hospital, a lot of interactions
used in healthier people on less medicaitons

Question 14

Dronedarone

Answer 14

Class III. K+ blocker. was supposed to replace amiodaroneonly for peroxismal atrial fibrillation

Question 15

Amiodarone

Answer 15

Class I, II, III, and Ca+ blocking properties. predictable toxicities: lungs, thyroid, liver, retina.

Question 16

Ranolazine

Answer 16

Antianginal drug. Na, K, and Ca+ channel blocker. used in trial

Question 17

Class of drugs with different actions, metabolism and lipid solubility

Answer 17

Beta blockers

Question 18

What beta blocker has the longers half life?

Answer 18

nadolol. long half life, few side effects. hydrophillic

Question 19

intrinsic sympatomimetic activity

Answer 19

partial agonists that block effects when there is high signals but not when there is low signaling

Question 20

Beta blocker used in eye drops

Answer 20

Timolol.

Question 21

pindolol is good in

Answer 21

younger people.

Question 22

propranolol

Answer 22

enters the CNS. can be used against tremors

Question 23

Acebutolol

Answer 23

long acting drug, sympatomimetic activity, has HIGH dose

Question 24

Labetolol

Answer 24

alpha and Beta blocker. VERY useful for hypertension. decreases heart contractionand rate and has high vasodilation.

Question 25

Carvedilol

Answer 25

Alpha and beta blocker. Main use in heart failure.

Question 26

where are beta blockers metabolized or removed?

Answer 26

kidneys and liver

Question 27

insulin resistance, weight gain, reduced thermic effects of food, inhibits lipolysis,

Answer 27

metabolic effects of Beta Blockers.

Question 28

beta-blockers have ________

Answer 28

cardioprotective mechanisms. can stabilizeatherosclerotic plaques for example. decrease oxgen consumption.

Question 29

what advantage does carvedilol have over other beta blockers?

Answer 29

increases insulin sensitivity.

Question 30

Esmolol

Answer 30

very fast acting, used in urgent treatment

Question 31

Recurrent AF and AFL

Answer 31

sotalol

Question 32

Labetalol

Answer 32

used in pheochromocytoma. ISA plus alpha blockade

Question 33

Verapamil

Answer 33

Calcium channel blocker. very potent AV nodal blockade

Question 34

Diltiazem

Answer 34

Renal metabolism. calcium channel blocker. synergistic effect with beta blockers

Question 35

Atrial flutter

Answer 35

runs counterclockwise around the Right atrium

Question 36

mahein fibers?

Answer 36

anterograde pathway that bypasses normal bundle down to right purkinje fibers

Question 37

atrial fibrillation starts in pulmonary veins in _____

Answer 37

muscle sleeves

Question 38

2 types of atrial tachycardia

Answer 38

Automatic, Re-entrant, and

Question 39

junctional tachycardia

Answer 39

treat with verapamil, beta blockers, flecainide

Question 40

Innappropriate sinus tachycardia

Answer 40

Almost always young women, Beta-blockers

Question 41

What are some options to slow hearts that are extremely tachycardic

Answer 41

valsalva, carotid sinus massage, ice water for young children.
Drugs: adenosine +saline bolus, verapamil, diltiazem, metoprolol
Cardioversion.

Question 42

Multifocal atrial tachycardia

Answer 42

VERAPAMIL!!!!!

Question 43

If the rate is 150/min….

Answer 43

its atrial flutter until proven otherwise