Anti-arrhythmics

Question 1

What is the class for Quinidine, procainamide, disopyramide

Answer 1

Class IA anti-arrhythmics

Question 2

What is the mechanism for Quinidine, procainamide, disopyramide

Answer 2

Block inward potassium rectifying channel (slow rate) at normal concentrations; blocks sodium channels (fast rate) at high concentrations

Question 3

What are the therapeutics for Quinidine, procainamide, disopyramide

Answer 3

Atrial fibrillation/flutter, paroxsymal supraventricular tachycardia, ventricular tachycardia

Question 4

What is the class for Lidocaine, mexiletine, tocainide

Answer 4

Class IB anti-arrhythmics

Question 5

What is the mechanism for Lidocaine, mexiletine, tocainide

Answer 5

Block sodium channels in inactivated state mostly; no action on atrial tissue

Question 6

What are the therapeutics for Lidocaine, mexiletine, tocainide

Answer 6

Digitalis toxicity

Question 7

What is the class for Flecainide, propafenone, moricizine

Answer 7

Class IC anti-arrhythmics

Question 8

What is the mechanism for Flecainide, propafenone, moricizine

Answer 8

Sodium channel blockers (most potent in class I), acting as negative ionotrope

Question 9

What are the therapeutics for Flecainide, propafenone, moricizine

Answer 9

Atrial fibrillation/flutter, paroxsymal supraventricular tachycardia, ventricular tachycardia

Question 10

What are the important side effects for Flecainide, propafenone, moricizine

Answer 10

Worsened heart failure, proarrhythmia in ischemic tissue, increased mortality

Question 11

What is the class for Propanolol, carvedilol.

Answer 11

Class II anti-arrhythmics - beta blockers

Question 12

What is the mechanism for Propanolol, carvedilol.

Answer 12

Blocks beta-adrenergic receptors; decrease SA, AV node activity (phase 4 depolarization)

Question 13

What are the therapeutics for Propanolol, carvedilol.

Answer 13

Control of ventricular rate in atrial fibrillation/flutter; prevent or terminate SVTs

Question 14

What are the important side effects for Propanolol, carvedilol.

Answer 14

Hypotension, brochospasm, bradycardia

Question 15

What are the miscellaneous for Propanolol, carvedilol.

Answer 15

Decreases mortality in CHF.

Question 16

What is the class for Sotalol, amiodarone, dofetilide, ibutelide, dronedarone

Answer 16

Class III anti-arrhythmics

Question 17

What is the mechanism for Sotalol, amiodarone, dofetilide, ibutelide, dronedarone

Answer 17

K channel blockade = prolongs refractoriness

Question 18

What are the therapeutics for Sotalol, amiodarone, dofetilide, ibutelide, dronedarone

Answer 18

Atrial fibrillation/flutter, paroxsymal supraventricular tachycardia, ventricular tachycardia

Question 19

What are the important side effects for Sotalol, amiodarone, dofetilide, ibutelide, dronedarone

Answer 19

Torsades de Pointes; QT prolongation, pulmonary fibrosis, peripheral neuropathy, hepatic dysfunction

Question 20

What are the other side effects for Sotalol, amiodarone, dofetilide, ibutelide, dronedarone

Answer 20

Photosensitivity (blue-gray skin; numerous drug interactions

Question 21

What is the class for Nifedipine, amlodipine, felopidine, isradipine, veapamil, diltiazam.

Answer 21

Class IV anti-arrhythmics - calcium chanel blockers

Question 22

What is the mechanism for Nifedipine, amlodipine, felopidine, isradipine, veapamil, diltiazam.

Answer 22

Blockade of L-type calcium channels: slow SA & AV node activity; prolong AV refractoriness

Question 23

What are the therapeutics for Nifedipine, amlodipine, felopidine, isradipine, veapamil, diltiazam.

Answer 23

Prevent or terminate reentrant SVTs

Question 24

What are the important side effects for Nifedipine, amlodipine, felopidine, isradipine, veapamil, diltiazam.

Answer 24

Hypotension, bradycardia, constipation, dizziness

Question 25

What are the other side effects for Nifedipine, amlodipine, felopidine, isradipine, veapamil, diltiazam.

Answer 25

Increased serum digoxin levels

Question 26

What are the miscellaneous for Nifedipine, amlodipine, felopidine, isradipine, veapamil, diltiazam.

Answer 26

Contraindicated in WPW

Question 27

What is the class for Adenosine

Answer 27

Anti-arrhythmic

Question 28

What is the mechanism for Adenosine

Answer 28

Adenosine receptors in atrium, sinus node, AV node; activates K current, shortening AP, hyperpolarizing tissue, and slowing down automaticity and AV conduction

Question 29

What are the therapeutics for Adenosine

Answer 29

AF, paroxsymal supraventricular tachycardia

Question 30

What are the important side effects for Adenosine

Answer 30

Sedation, dyspnea, hypotension

Question 31

What is the class for Digoxin

Answer 31

Anti-arrhythmic

Question 32

What is the mechanism for Digoxin

Answer 32

Na/K pump inhibitor; slows AVN activity and conduction

Question 33

What are the therapeutics for Digoxin

Answer 33

Atrial fibrillation/flutter; chronic SVT

Question 34

What are the important side effects for Digoxin

Answer 34

Nausea, cognitive dysfunction, blurred or yellow vision

Question 35

What are the other side effects for Digoxin

Answer 35

May cause DAD arrhythmias

Question 36

What are the miscellaneous for Digoxin

Answer 36

Low therapeutic index

Question 37

What is the class for Magnesium sulfate

Answer 37

Anti-arrhythmic

Question 38

What are the therapeutics for Magnesium sulfate

Answer 38

Prevents recurrent TdP and some digitalis-induced arrhythmias

Question 39

What are the miscellaneous for Magnesium sulfate

Answer 39

Alternative to amiodarone for shock-refractory cardiac arrest.