Anti-Arrhythmic Pharmacology

Question 1

What are the different classes of anti-arrhythmic drugs?

Answer 1

Class 1 – Na channel blockers
Class 2 – Beta Blockers
Class 3 – Repolarization delay
Class 4 – Calcium channel blockers
Other

Question 2

What are the Na channel blockers?

Answer 2

Procainamide, Lidocaine, and Flecainide

Question 3

What are the NA channel blockers used for?

Answer 3

Life threatening ventricular rhythms

Question 4

What nonselective beta blocker can be used for tachyarrhythmia’s?

Answer 4

Propranolol

Question 5

What are the other most common indications for propranolol?

Answer 5

Angina, essential tremors, migraine, and anxiety

Question 6

What selective beta blockers can be used for arrhythmias?

Answer 6

Metoprolol & Atenolol

Question 7

: What is our repolarization delay medication?

Answer 7

Amiodarone

Question 8

If a patient had a recent MI and new onset of afib, what medication would they likely be placed on?

Answer 8

Amiodarone

Question 9

So amiodarone can be used off label for afib, but what is it mainly used for?

Answer 9

Life-threatening/unresponsive Vfib & Vtach

Question 10

What calcium channel blockers can we use for arrhythmias? What’s their class?

Answer 10

Nondihydropyridines – Verapamil & Diltiazem

Question 11

Can you use a calcium channel blocker with a beta blocker?

Answer 11

NO

Question 12

Can you use a calcium channel blocker for HF?

Answer 12

NO – except for amlodipine

Question 13

What medication is our naturally occurring nucleoside?

Answer 13

Adenosine

Question 14

What medication can be used during PSVT to help slow it down to help with diagnosis?

Answer 14

Adenosine

Question 15

What is the other use of adenosine?

Answer 15

Stress testing

Question 16

What medication can you use to control the rate during Afib?

Answer 16

Digoxin

Question 17

What is the drug class of digoxin?

Answer 17

cardiac glycoside

Question 18

What is MOA of digoxin?

Answer 18

Promotes an influx in calcium, leading to an increase contractility

Question 19

What else can digoxin be used for?

Answer 19

HF

Question 20

What medication is our Electrolyte?

Answer 20

MgSO4

Question 21

When do you use Electrolyte?

Answer 21

Digitalis induced arrhythmia & off label for torsades de pointes

Question 22

What medications can cause QT prolongation, and should be avoided in those with CAD?

Answer 22

Macrolides = Erythromycin & Azithromycin

Question 23

How do you give MgSO4?

Answer 23

IV

Question 24

When someone is diagnosed with Afib, what are they at an increased risk for? How do you prevent this?

Answer 24

Stroke. Prevent with anticoag such as Dabigatran

Question 25

What should we remember about dosing dabigatran?

Answer 25

It cannot be stopped suddenly

Question 26

If a patient is on a statin, can they take dabigatran?

Answer 26

Nope, it will decrease the effects of the anticoag

Question 27

If someone has a valvular disease and Afib, can they be put on dabigatran?

Answer 27

Nope, contraindicated