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Pharm test 3 > Anti-arrhythmics > Flashcards

Anti-arrhythmics Flashcards

1
Q

General rule about anti-arrhythmics?

A

They all cause arrhythmias.

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2
Q

Most AAs are negative/positive inotropes

A

negative

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3
Q

Pacemaker cells have what that allows them to beat on their own?

A

automaticity

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4
Q

What are most arrhythmias caused by? (2)

A
  1. slowed conduction in the pacemaker system leading to re-entry circuits
  2. altered rate of spontaneous discharge (ectopic pacemakers)
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5
Q

How many classes of AAs are there?

A

1 -A, B, C
2
3
4

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6
Q

Class 1 are…and how do they work?

A

sodium channel blockers that slow depolarization and have membrane stabilizing affect (MSA)

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7
Q

Class 1A are _________ na channel blockers. Name 3.

A

Intermediate
Quinidine
Disopyramidine
Procainamide

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8
Q

Class 1B are ______ na channel blockers. Name 3.

A

Fast
Lidocaine
Mexiletine
Tocainamide, Phenytoin

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9
Q

Class 1C are ________ na channel blockers. Name 2..

A

slow
Flecanide
Propafenone

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10
Q

Which class of AAs have a black cloud CAST upon them? Why?

A

Class 1C
Cardiac Arrhythmia Suppression Trial – found increased mortality in post-MI patients with non-life threatening vent. arr. SO, they are rarely used.

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11
Q

What are the Class 2 AAs? How do they work? Name 3.

A

Beta blockers
They reduce sympathetic tone…
Propanolol, Sotalol, Esmolol, Metroprolol, Atenolol

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12
Q

What are the Class 3 AAs? Name 3.

A

Potassium Channel Blockers
Amiodarone
Dofetilide
Sotalol

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13
Q

What are the Class 4 AAs? Name 2.

A

Calcium Channel Blockers

Diltiazem, Verapamil

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14
Q

Class 1A AAs are highly _________.

A

Anti-cholinergic.

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15
Q

Which class of AAs are highly anti-cholinergic?

A

Class 1A

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16
Q

What are some anti-cholinergic S/S? Which class of AA’s are prone to these effects?

A 
Class 1A
Anti-cholinergic = sympathetic...
increased HR
constipation, GI upset
dry mouth
urinary retention
17
Q

Which AA causes a Lupus-like syndrome? Which class is it?

A

Procainamide – Class 1a

18
Q

Lidocaine and Mexiletine are what class of AA?

A

Class 1B, Fast Na channel blockers

19
Q

What is lidocaine most commonly used for? How is it administered?

A

ventricular arrhythmias and local anesthesia

IV

20
Q

Why is Mexiletine used?

A

Oral maintenance for lidocaine.

21
Q

Which drugs were involved in the CAST?

A

Class 1C – Flecainide and Propafenone

22
Q

What is important about esmolol?

A

Short half life!

23
Q

How is amiodarone administered?

A

IV and PO

24
Q

Why is Amio used a lot?

A

Used for both ventricular and atrial arrhythmias.

25
Q

Amio has a ___Vd and _____half life.

A

large vd

long half life

26
Q

Amio accumulates at a ____rate and requires a _______dose

A

Slow

loading dose

27
Q

Name 4 AEs for amiodarone?

A

N/V
dysphagia
visual disturbances
blue-ish discolorization to skin

28
Q

What can amiodarone muck with? Why?

A

thyroid because it has “iodine” in it

29
Q

What should you monitor while prescribing amio? (before and after)

A

LFTs
eyes
neurologic exams
CXR for lungs

30
Q

what are rare dx associated with amio? what should you do before prescribing it?

A

pneumonitis, pulmonary fibrosis

CXR for lungs

31
Q

Can amio be used for CHF?

A

yes

32
Q

Dronedarone is a _______ of amio. What is it used for?

A

Pro-drug of amio

atrial arr.

33
Q

Why is dronedarone less toxic?

A

it lacks iodine moity that contributes to eyes, thyroid, liver and lung toxicity

34
Q

Can dronedarone be used in heart failure or hepatotoxicity?

A

no

35
Q

Sotalol blocks what two things?

A

Beta receptors and potassium channels

36
Q

What CCB drug of choice for A Fib/Flutter?

A

Diltiazem because it is easy to dose.

37
Q

What is the DOC for torsades?

A

magnesium sulfate

Pharm test 3 (9 decks)

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