Anti-Arrhythmics

Question 0

Adenosine

Answer 0

-SVT - supraventricular tachycardia
-SA & AV nodes
-short 1/2 life=10 sec
MOA
-DEC HR (- chronotropy)
-DEC AV nodal conduction (- dromotropy)
-brief asystole can occur
-vacular: vasodilates

Question 1

Atropine

Answer 1

-bradycardia
-anticholinergic - inhibit parasympathetic NT Ach
-muscarinic receptors (M2)
MOA
-INC HR (+ chronotropy)
-INC AV nodal conduction (+ dromotropy)

Question 2

Amiodarone

Answer 2

-Refractory V-tach/V-fib & A-tach
-K-channel blocker
-very long 1/2 life
MOA (primary)
-blocks rapid component of the delayed rectifier K-current
-prolongs AP & QT interval
-slows HR via slows AV node condution
MOA (secondary)
-inhibits p-glycoprotein & CYP40 enzymes
-INC plasma levels of drugs
ADE
-DEC AV or SA nodal fx
-DEC cardiac contractility
-hypotension
-low incidence of TdP
-bradycardia

Question 3

Sotalol

Answer 3

-V-tach/ V-fib
-K-channel blocker
-B-blocker
MOA
-blocks rapid component of the delayed rectifier K-current

Question 4

Mg Sulfate

Answer 4

-V-Tach/V-fib, TdP
MOA
-DEC influx of Ca
-DEC amplitude of early afterdepolarizations (EAD)–>terminates arrhythmia

Question 5

Procainamide

Answer 5

-V-tach/V-fib
-Na-channel blocker
-class 1A
MOA
-blocks Na channels

Question 6

Lidocaine

Answer 6

-V-tach/v-fib
-Na-channel blocker
-Class 1B
MOA
-blocks Na channels

Question 7

Dihydropyridines

Nicardipine, Nifedipine, Isradipine, Amiodipine, Felodipine, Nimodipine

Answer 7

-Angina & HTN
-“-dipines”
-Ca-channel blockers
MOA
-blocks Ca channels
-arterial vasodilators
-INC/DEC contractility

Question 8

Verapamil

Diltiazem

Answer 8

-SVT, angina, HTN, a-fib (dilt)
-Phenylalkyamine, benzothiazepine
-Ca channel blocker
MOA
-controls ventricular rate (alt to Adenosine in treating SVT)
-DEC HR (-chronotropy)
-DEC conduction velocity (- dromotropy)
-DEC contractility (- ionotropy)
-smooth muscle relaxation (vasodilation)
ADE
-hypotension (if too much)