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Pharmacology - Basic > Anti-arrhythmic Drugs > Flashcards

Anti-arrhythmic Drugs Flashcards

1
Q

what are the classes of anti-arrhythmic drugs?

A

1, 2, 3 and 4

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2
Q

name a class 1a anti-arrhythmic

A

procainamide

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3
Q

name a class 1b anti-arrhythmic

A

lidocaine

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4
Q

name a class 1c anti-arrhythmic

A

flecainide

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5
Q

name a class 2 anti-arrhythmic

A

bisoprolol

propranolol

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6
Q

name a class 3 anti-arrhythmic

A

amiodarone

sotalol

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7
Q

name a class 4 anti-arrhythmic

A

verapamil

diltiazem

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8
Q

what is the mechanism of action of class 1 anti-arrhythmics?

A

block Na channels in non-nodal cardiomyocytes

therefore slowing upstroke of action potential, slowing conduction of AP and increase refractory period

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9
Q

what is the difference between the sub-classes of type 1 anti-arrhythmics?

A

block K channels differently
1A>1C>1B
(KC blockade increases refractory period)

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10
Q

what are the side effects of Class 1 anti-arrhythmics?

A

pro-arrhythmic

dizziness

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11
Q

what is the mechanism of action of class 2 anti-arrhythmic drugs?

A

block beta 1 receptors in the AV node, slowing transmission of AP from atria to ventricles

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12
Q

what are the side effects of class 2 anti-arrhythmics?

A

bronchospasm (beta 2 adrenoceptors in lungs)

hypotension

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13
Q

name 2 class 3 anti-arrhythmic drugs

A

amiodarone

sotalol

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14
Q

what is the mechanism of action of class 3 anti-arhythmic drugs?

A

block K+ channels in all cardiac tissue, causing increased refractory period in nodal and non-nodal cardiomyocytes causing decreased speed of AP conduction

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15
Q

what are the side effects of class 3 anti-arrhythmics?

A

pro-arrhythmic

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16
Q

what are some serious side effects of amiodarone?

A

pulmonary fibres

bradycardia and AV block, so contra-indicated in patients with heart block os SAN dysfunction

17
Q

name 2 class 4 anti-arrhythmic drugs

A

verapamil

diltiazem

18
Q

what is the mechanism of action of class 4 anti-arryhythmic drugs?

A

calcium channel blockers in SAN and AVN - prevents upstroke of nodal action potential
slows heart rate

19
Q

what are the side effects of class 4 anti-arrhythmic drugs?

A

bradycardia

hypotension

20
Q

what drug group does digoxin belong to?

A

cardiac glycoside

21
Q

what is the mechanism of action of digoxin as an anti-arrhythmic?

A

inhibits NaK ATPasein all cardiac tissue

Na and Ca accumulate intracellularly causing slowed SAN and AVN conduction, slowing heart rate

22
Q

what are the side effects of digoxin?

A 
arrhythmias
blurred/yellow vision
dizziness
eosinophilia
rash
vomiting
23
Q

what is the mechanism of action of adenosine as an anti-arrhythmic drug?

A

activate A1 receptors in the heart which are GiPCRs

cause cell hyper polarisation in SAN and AVN, slowing AV conduction

24
Q

what are the side effects of adenosine?

A 
arrhythmia
AV block
dizziness
flushing
headache
nausea
25
Q

describe the NICE guidance for treatment of acute atrial fibrillation

A
  1. electrical cardioversion if life-threatening haemodynamic instability
  2. if pharmacological cardioversion is decided - use flecainide (1c) or amiodarone (3) when there is no evidence of IHD or structural disease (amiodarone if there is disease)
  3. anticoagulation
26
Q

describe the NICE guidance for long-term treatment of atrial fibrillation

A
  1. rate control - beta blocker (other than sotalol) or CCB
    as monotherapy (if doesn’t work, combine with diltiazem (4) or digoxin
  2. anticoagulation

Pharmacology - Basic (1 decks)

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