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Pharm U4 > Anti-arrhythmics > Flashcards

Anti-arrhythmics Flashcards

1
Q

What are the class IA anti-arrhythmias?

A

Quinidine
Procainamide
Disopyramide

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2
Q

What is the mechanism of action of the class IA anti-arrhythmias?

A

Block inward K+ rectifying channel at normal concentrations

Blocks Na+ channels at high concentrations

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3
Q

What are the uses of the class IA anti-arrhythmics?

A

Atrial fibrillation/flutter
Paroxysmal supraventricular tachycardia
Ventricular tachycardia

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4
Q

What are the side effects of the class IA anti-arrhythmics?

A 
QT prolongation
TdP arrhythmias
Heart block
Hypotension
Lupus-like syndrome

Thrombocytopenia with quinidine
Anticholinergic effects with disopyramise

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5
Q

What are the class IB anti-arrhythmics?

A

Lidocaine

Mexiletine

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6
Q

What is the mechanism of action of the class IB anti-arrhythmics?

A

Block Na+ channels in inactivated state

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7
Q

What is the use for the class IB anti-arrhythmics?

A

Digitalis toxicity

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8
Q

What are the side effects of the class IB anti-arrhythmics?

A

Tremor
Nausea
Seizures
Local anesthetic action

GI toxicity with mexiletine

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9
Q

What are the class IC anti-arrhythmics?

A

Flecainide
Propafenone
Moricizine

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10
Q

What is the mechanism of action of the class IC anti-arrhythmics?

A

Sodium channel blockers acting as negative inotrope

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11
Q

What are the uses of class IC anti-arrhythmics?

A

Atrial fibrillation/flutter
Paroxysmal supraventricular tachycardia
Ventricular tachycardia

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12
Q

What are the side effects of the class IC anti-arrhythmics?

A

Worsened heart failure
Proarrhythmia in ischemic tissue
Increased mortality

Blurred vision with flecainide

Sinus bradycardia and bronchospasm with propafenone

Contraindicated in HF and post-MI–increased mortality

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13
Q

Class II anti-arrhythmics?

A

Beta-blockers–non-selective

Propanolol
Carvedilol

Beta-blockers–selective

Metoprolol
Acebutolol
Esmolol

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14
Q

What is the mechanism of action the class II anti-arrhythmics?

A

Blocks beta-adrenergic receptors

Decrease SA, AV node activity –phase 4 depolarization

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15
Q

What are the uses for the class II anti-arrhythmics?

A

Control of ventricular rate in atrial fibrillation/flutter

Long term suppression of SVTs and PVCs

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16
Q

What are the side effects of the class II anti-arrhythmics?

A

Heart block
Hypotension
Bronchospasm
Bradycardia

17
Q

What are the class III anti-arrhythmics?

A 
Sotalol
Amiodarone
Dofetilide
Ibutelide
Dronedarone
18
Q

What is the mechanism of action of the class III anti-arrhythmics?

A

K channel blockade–prolongs refractoriness

19
Q

What are the uses of the class III anti-arrhythmics?

A

Atrial fibrillation/flutter
Paroxysmal supraventricular tachycardia
Ventricular tachycardia

20
Q

What are the side effects of the class III anti-arrhythmics?

A 
Torsades de Pointes
QT prolongation
Bradycardia
Pulmonary fibrosis
Peripheral neuropathy
Hepatic dysfunction
Hypotension
Bronchospasm

Photosensitivity–blue-gray skin

21
Q

What are the class IV anti-arrhythmics?

A

Nifedipine
Amlodopine
Verapamil
Diltiazem

22
Q

What is the mechanism of action of the class IV anti-arrhythmics?

A

Blockade of L-type Ca++ channels
Slows SA and AV nodal activity
Prolong AV refractoriness

23
Q

What are the uses of the class IV anti-arrhythmics?

A

Prevent or terminate reentrant SVTs

24
Q

What are the side effects of the class IV anti-arrhythmics?

A 
Hypotension
Bradycardia
Constipation
Dizziness
Increased serum digoxin levels***
25
Q

What anti-arrhythmics are contraindicated when pt has Wolff-Parkinson-White (WPW) syndrome?

A

Class II anti-arrhythmics (B-blockers) and Class IV anti-arrhythmics (Ca++ channel blockers)

26
Q

What is the mechanism of adenosine?

A

Adenosine receptors in atrium, sinus node and AV node–activated K current–shortening AP, hyper polarizing tissue, and slowing down automaticity and AV conduction

27
Q

What are the uses of adenosine?

A

AFib

Paroxysmal supraventricular tachycardia

28
Q

What are the side effects of adenosine?

A

Sedation
Dyspnea
Hypotension

29
Q

What is the mechanism of action of digoxin?

A

Na/K pump inhibitor–slow AVN activity and conduction

30
Q

What are the uses of digoxin?

A

AFib/flutter
Chronic SVT
HF

31
Q

What are the side effects of digoxin?

A

Nausea
Cognitive dysfunction
Blurred or yellow vision

May cause DAD arrhythmias

32
Q

What is the down side of digoxin?

A

Narrow therapeutic window and excreted by the kidney so dosing dependent on kidney function

33
Q

Used to prevent recurrent TdP and some digitalis-induced arrhythmias?

A

Magnesium sulfate

Also an alternative to amiodarone for shock-refractory cardiac arrest

Pharm U4 (8 decks)

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