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Anti-Arrhythmics Flashcards

1
Q

What is the MOA of Class IA Anti-Arrythmic Agents?

A
  • Block the flow of Na+ ions into cells
    • slowed rate of conduction/ contraction
  • Blocks K+ flow
    • Increase refractory period
    • (prolonged phase 3 = prolonged Q-T)
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2
Q

Quinidine*

  • MOA
  • IND
  • SE
A
  • Moa:
    • Class IA Anti-Arrhythmic
    • Muscarinic receptor antagonist
    • Alpha adrenergic blocker
  • IND
    • Re-entrant arrhythmias
    • Rarely used
  • SE
    • Cardiotoxicity
      • AV block
      • cause arrhythmias from slow conduction (SA node)
    • Hypotension (alpha blocker)
    • Cinchonism (loss of hearing, tinnitis, blurred vision)
    • Anti-muscarinic effects

Weak base = increased excretion with acidic urine

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3
Q

Procainamide

  • MOA
  • IND
  • SE
A
  • MOA
    • Class IA anti- arrhythmic
  • IND
    • Life threatening ventricular arrhythmias
  • SE
    • Heart block (long QT)
    • Lupus syndrome
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4
Q

Disopyramine

  • MOA
  • IND
  • SE
A
  • MOA
    • Class IA anti arrhythmic
  • IND
    • only for life threatening ventricular arrhythmias
  • SE
    • Cardiac depression
    • Ventricular tachycardia
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5
Q

What increases excretion of Quinidine?

A

Acidic urine

(Quinidine is a weak base)

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6
Q

What is the MOA of Class IB Anti- Arrhythmics?

A
  • Block flow of sodium ions into cells
    • bind both activated and inactivated channels
    • Decreased AP duration and ERP
    • Increased threashold
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7
Q

Lidocaine

  • MOA
  • IND
  • SE
A
  • MOA
    • Class IB Anti- Arrhythmic
  • IND
    • Ventricular fibrillation
    • Ventricular tachycardia
  • SE
    • CNS effects
    • Hypotension
    • DO NOT use in 2nd or 3rd degree heart block

Do not use orally: Extensive first- pass effect

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8
Q

Why is Lidocaine not given orally?

A

It has an extensive first pass effect by the liver

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9
Q

What is the MOA of Class IC Anti- Arrhythmic Agents?

A
  • Strong block of Na+ channels
    • slow conduction
    • increased refractory period in AV node
    • Inhibits Premature Ventricular Contractions
    • < P-R and QRS intervals
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10
Q

Flecainide

  • MOA
  • IND
  • SE
A
  • MOA
    • Class IC Anti- Arrhythmic
  • IND
    • Life- threatening ventricular arrhythmia
  • SE
    • Increased mortality rate
    • Arrhythmias
    • (Visual disturbance)
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11
Q

Propaferone

  • MOA
  • IND
  • SE
A
  • MOA
    • Class IC Anti- Arrhythmic
  • IND
    • Atrial fibrillation
    • Atrial flutter
    • Supraventricular tachycardia
  • SE
    • Arrhythmias
    • Aggravates Heart failure and sinus node dysfunction
    • (Metallic taste)
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12
Q

What is the MOA of Class II Anti- Arrhythmics?

A

Beta adrenergic blockers

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13
Q

Propanolol

  • MOA
  • IND
  • SE
A
  • MOA
    • beta blocker
    • Class II Anti- Arrhythmic
  • IND
    • Supraventricular Arrhythmias
    • Digitalis Toxicity
  • SE
    • A-V block
    • Angina after sudden withdrawal
    • CON: Heart failure
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14
Q

Amiodarone

  • MOA
  • IND
  • SE
A
  • MOA
    • Class III Anti- Arrhythmic
  • IND
    • Life- threatening, recurrent, or malignant arrhythmias
  • SE
    • Hepatitis
    • Pneumonitis
    • Heart Block
    • CHF
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15
Q

Sotalol

  • MOA
  • IND
  • SE
A
  • MOA
    • Class III Anti- Arrhythmic
    • Also beta- blocker
  • IND
    • Life- threatening, recurrent, or malignant arrhythmias
  • SE
    • negative chronotrope and ionotrope
    • Arrhythmia
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16
Q

What is the MOA of Class III Anti- Arrhythmic Agents?

A
  • Block the flow of potassium
    • increased refractory period
    • decreased contractile frequency
17
Q

What is the MOA of Class IV Anti- Arrhythmic Agents?

A
  • Ca 2+ channel blockers in SA and AV nodes
    • slow phase 4 spontaneous depolarization
    • delayed repolarization
18
Q

Verapamil

  • MOA
  • IND
  • SE
A
  • MOA
    • Class IV Anti- Arrhythmic
  • IND
    • Supraventricular tachycardia
    • Re-entry tachycardia involving A-V node
  • SE
    • Hypotension
    • Heart Block
19
Q

Diltiazem

  • MOA
  • IND
  • SE
A
  • MOA
    • Class IV Anti- Arrhythmic
  • IND
    • Supraventricular tachycardia
    • Re-entry tachycardia involving A-V node
  • SE
    • Hypotension
    • Heart Block

Pharmacology (12 decks)

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