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Pharm 1 > Anti-arrhythmic > Flashcards

Anti-arrhythmic Flashcards

1
Q

What is the MOA for a class 1 anti-arrhythmic drug

A

Sodium channel blocker

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2
Q

What class is Quinidine (Quinidex)

A

Class 1a

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3
Q

What are the indications for Quinidine (quinidex)

A

A-flutter, A-fib, AV and ventricular arrhythmias

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4
Q

What are the side-effects of Quinidine (Quinidex)

A

Potentially pro-arrhythmic, nausea, vomiting, diarrhea. Cinchonism

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5
Q

What are the symptoms of cinchonism

A

Visual changes, altered sensorium, N/V, psychosis

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6
Q

What rhythm may result from Quinidine use

A

Torsade de Pointes

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7
Q

What class is Mexiletine (Mexitil)

A

Class 1b

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8
Q

What is the MOA of Mexiletine (mexitil)

A

Blocks open sodium channels thereby shortening phase 3 repolarization

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9
Q

What is the most common side effect of all anti-rhythmic drugs

A

a different dysrhythmia

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10
Q

what class is Flecainide (Tambocor)

A

Class 1c

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11
Q

What is the indication for flecainide (Tambocor)

A

supraventricular tachycardia dysrhythmias, including Wolff-Park-White syndrome

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12
Q

What class is atenolol (Tenormin)

A

Class 2

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13
Q

What is the MOA for atenolol (tenormin)

A

Beta 1 blockade reduces sympathetic effects on myocardium. Reduced phase 4 depolarization and decreased automaticity in the SA node, AV node and the Purkinje fibers

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14
Q

What are the side effects for atenolol

A

nightmares, impotency, depression, bradycardia, hypotension

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15
Q

What class is amiodarone (cordarone)

A

Class 3

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16
Q

What is the MOA of amiodarone (Cordarone)

A

Potassium channel blockade. Prolongs phase 3

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17
Q

What are the side-effects of amiodarone (Cordarone)

A

Dizziness and light headedness. Pulmonary fibrosis possible. Blue-gray coloring of skin can occur as a result of iodine deposition

18
Q

What are the indications of Amiodarone (cordarone)

A

ventricular arrhythmias

19
Q

What class is verapamil (Isoptin, Calan)

A

Class 4 (calcium channel blocker)

20
Q

What are the indications for verapamil (and other Ca channel blockers

A

atrial dysrhythmias, like A-fib

21
Q

What is the MOA of Verapamil

A

Calcium channel blockade causes a slowing of phase 4 depolarization, resulting in slowed AV conduction.

22
Q

What is adenosine used for

A

Adenosine is recommended as the initial drug of choice for PSVT (paroxysmal supraventricular tachycardias)

23
Q

What is the MOA of adenosine

A

acts directly on sinus pacemaker cells and vagal nerve terminals. right at that SA node! Within seconds decreases rate and force of contraction

24
Q

How is adenosine administered

A

Available for IV administration only

25
Q

How long does the action of adenosine last

A

15 seconds

26
Q

What are the side effects of adenosine

A

Low toxicity but often causes transient hypotension and chest pain

27
Q

What class is atropine

A

anti-arrythmic

28
Q

what are the indications of atropine

A

to treat bradycardia

29
Q

what is the MOA of atropine

A

Anticholinergic agent - Atropine is a competitive inhibitor of the muscarinic acetylcholine receptors thus it can be thought of as a parasympatholytic

30
Q

What are the side effects of atropine

A

dry mouth, dry eyes, dilated pupils, blurred vision

31
Q

How is atropine delivered

A

IV, PO, and endotracheal tube

32
Q

When is it appropriate to use atropine

A

In an emergency setting when there is life threading bradycardia and hypotension

33
Q

What is atropine an antidote for

A

organophosphate poisoning from pesticides or nerve gas

34
Q

What is the antidote to atropine

A

physostigmine

35
Q

What are signs of atropine toxicity

A

decreased secretions; flushed, dry, warm skin, visual changes and delirium with hallucinations.
“Dry as a bone, red as a beet, hot as a hare, blind as a bat, mad as a hatter.”

36
Q

What drug class is Digoxin

A

Cardiac glycoside

37
Q

What is the difference between digoxin and digitoxin

A

Compared to digoxin, digitoxin has longer half life (~ 7 days), is absorbed more readily, is more highly protein bound and is more extensively metabolized before excretion.

38
Q

What effect does digoxin have on the heart

A

It slows the rate yet increases the contractility by inhibiting the Na/K ATPase pump

39
Q

What are the indications of digoxin

A

CHF, failing other heart drugs

40
Q

What are the signs of digitalis intoxication

A

Halos around light, flickers, dots, blurred vision, N/V, diarrhea, bradycardia, heart block,

41
Q

What increases the risk of digitalis intoxication

A

low potassium esp in those on potassium wasting diuretic

42
Q

What is the antidote to digitalis intoxication

A

administering specific immune antibodies, known as Digoxin immune Fabs

Pharm 1 (14 decks)

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