Anti-Arrhythmic Drugs & Heart Failure Drugs

Question 1

Which drugs are used in rate control in atrial fibrillation?

Answer 1

• Beta blockers, digoxin or rate limiting calcium channel blockers
• Or chemically cardiovert with Amiodarone

Question 2

What classes of drugs are used in heart failure?

Answer 2

• ACE inhibitors
• ARBs
• Beta blockers
• Mineralocorticoid antagonists
• Neprilysin inhibitors
• SGLT2 inhibitors
• Diuretics

Question 3

What condition is digoxin effective in and what is the mechanism of action?

Answer 3

• Effective in atrial fibrillation
• Blocks atrial-ventricular (AV) conduction
• Digoxin produces a degree of AV conduction delay

Question 4

What are the harmful physiological effects of digoxin?

Answer 4

• Heart rate falling too much resulting in bradycardia and heart block
• An increase in ventricular irritability which produces ventricular arrhythmias

Question 5

Digoxin has a ______ therapeutic index

Answer 5

narrow

Question 6

What are some side effects of digoxin?

Answer 6

• Nausea
• Vomiting
• Yellow vision
• Bradycardia
• Heart block
• Ventricular arrhythmias

Question 7

What type of drug is Salcubitril / Valsartan?

Answer 7

Neprilysin inhibitor

Question 8

What is the mechanism of action of Salcubitril / Valsartan?

Answer 8

• Combination drug
• Contains ARB and endopeptidase inhibitor
• Neprilysin is an enzyme (the endopeptidase) which breaks down natriuretic peptide - this is bad
• Therefore by inhibiting neprilysin, the drug increases levels of natriuretic peptide in the body

Question 9

What are side effects of salcubitril / valsartan?

Answer 9

• Hypotension
• Renal impairment
• Hyperkalaemia
• Angioneurotic oedema

Question 10

What are examples of SGLT2 inhibitors?

Answer 10

• Dapagliflozin
• Empagliflozin