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Pharmacology > Anti-Arrhythmic Drugs > Flashcards

Anti-Arrhythmic Drugs Flashcards

1
Q

Action Potential: Pacemaker AP

A

Phase 4
* Spontaneous depolarization (Pacemaker potential)
* Slow opening of Na Channel

Phase 0
* Rapid depolarization
* Ca channel opening

Phase 3
* Repolarization phase
* K channel opening

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2
Q

Action Potential: Cardiac Muscle Cells

A

Phase 4
* Resting Membrane Stae
* Outward leak K+

Phase 0
* Upstroke phase
* Depolarization Phase
* ↑ Na influx

Phase 1
* Partial repolarization
* Rapid opening & closing of K Channel

Phase 2
* Plateau Phase
* ↑ Ca influx
* ↑ K efflux

Phase 3
* Repolarization Phase
* ↑ K efflux

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3
Q

Arrythmia

A

Abnormal Heart Rhythm
<60 bpm
>100 bpm

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4
Q

Therapeutic Goals

A
  1. Block Na channels
  2. Block sympathetic activities
  3. Prolong effective refractory period (by blocking K channels)
  4. Block Ca channels
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5
Q

Vaughan-Williams Classification

A

Class I: Na-channel Blockers
Class II: B-blockers
Class III: K-channel blockers
Class IV: Ca-channel blockers

Na Bi Ka Ca

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6
Q

MOA of Class IA Drugs

A

Moderate Na+ Channel Blockers
Prolong action potential duration, QRS Complex, QT Interval

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7
Q

Class IA Anti-Arrhythmia

A

Quinidine
Procainamide
Disopyramide

Quini is PromDI
Double Quarter Pound

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8
Q

Clinical Use of Class IA Anti-Arrhythmia

A

For ventricular arrhythmia

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9
Q

S/Es of Class IA Drugs

A

Torsades De Pointes

Quinidine - Cinchonism, Thrombocytopenia, Diarrhea
Procainamide - SLE-like symptons
Disopyramide - Anticholinergic Symptoms

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10
Q

Class IB

A

Mild Na+ Channel Blockers
Shorten Action Potential, QRS Complex, QT Interval

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11
Q

Class IB Drugs

A

Tocainamide
Mexilitine
Lidocaine
Phenytoin

To Make Love Please

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12
Q

S/E of Phenytoin

A

Gingival Hyperplasia
Nystagmus

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13
Q

DOC in the treatment in Ventricular Fibrillation

A

Lidocaine

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14
Q

Class IC

A

Strong Na-channel blockers
No effect in the action potential duration
Prolong QRS Complex, QT Interval

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15
Q

Class IC Drugs

A

Moracizine
Flecainide
Propafenone
Encainide

More Fries Papa Enchong

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16
Q

Class II Antiarryhthmics

A

Esmolol
Metoprolol
Propranolol (Inderal)
Acebutolol

All B-blockers except Sotalol

17
Q

MOA of Class II Antiarryhthmics

A

Reduce Heart rate
Prolong AV Node Conduction & Refractory Period

18
Q

Treat Supraventricular Tahcycardia (SVT) and Ventricular Tachycardia

A

Class II Antiarrhythmics

19
Q

MOA of Class III Antiarrhythmics

A

Block K+ Channels
Prolong Action Potential, QRS Complex, and QT interval

20
Q

1st treatment in Ventricular Tachycardia & Atrial Fibrillation

A

Class III Antiarrhythmics

21
Q

Class III Antiarrhythmics

A

Amiodarone
Bretylium
Ibutilide
Dofetilide
Sotalol

22
Q

Class III Antiarrhythmic with broadest spectrum and longest DOA

A

Amiodarone

32% Iodine

22
Q

Adverse effects of Class III Antiarrhythmics

A

Amiodarone:
Hepatotoxicity
Pulmonary fibrosis
Wolff-Chaikoff Effect (hypothyroid → hyperthyroidism)
Cardiotoxic
Bluish gray skin
Cornea micro deposits

23
Q

Class IV Antiarrhythmics

A

Verapamil
Diltiazem

24
Q

Used for paroxysmal supraventricular arrhythmia, but not effective in ventricular arrhythmia

A

Class IV Drugs

25
Q

1st line treatment in acute Supraventtricular Tachycardia and PSVT

26
Q

Antiarrhythmic with very short half life (<10s)

A

Adenosine

A/Es: Bronchospasm

27
Q

1st line in the mx of Torsades de Pointes

A

Magnesium sulfate

28
Q

Increases vagal tone and slows AV node conduction velocity

29
Q

Used in Atrial fibrillation

(not preferred)

30
Q

Preferred drugs for Atrial Flutter & Atrial Fibrillation

A

Metoprolol
Amiodarone
Verapamil

31
Q

Preferred drugs for Acute SVT

A

Adenosine
Veraapamil

32
Q

Preferred drugs for Chronic SVT

A

B-blockers (Metoprolol)
CCBs

33
Q

Preferred drugs for Acute VT

A

Amiodarone
Lidocaine (IV)

34
Q

Preferred drugs for Chronic VT

A

Amiodarone
Beta blockers

35
Q

Preferred drugs for Ventricular fibrillation

Most dangerous

A

Amiodarone
Epinephrine

36
Q

Amiodarone is preferred drug for

A

Atrial Flutter
Atrial Fibrillation
Acute VT
Chronic VT
Ventricular fibrillation

37
Q

Verapamil is preferred drug for

A

Atrial Flutter
Atrial Fibrillation
Acute SVT

Pharmacology (26 decks)

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