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Pharmacology 2: Section 1 > Anti-Arryhtmics > Flashcards

Anti-Arryhtmics Flashcards

1
Q

Phase of the Cardiac Action Potential where Na+ and Ca2+ are rushing in.

A

Phase 0 (Depolarization)

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2
Q

Phase of the Cardiac Action Potential where Na+ channels close.

A

Phase 1

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3
Q

Phase of the Cardiac Action Potential where Ca2+ continues to go into the cell and K+ is leaving the cell.

A

Phase 2

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4
Q

Phase of the Cardiac Action Potential where K+ leaves the cell and Ca2+ channels close.

A

Phase 3 (Rapid Repolarization)

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5
Q

Phase of the Cardiac Action Potential with leaky K+ channels.

A

Phase 4 (Resting Potential)

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6
Q

What Class of medications works on Phase 0 of the Cardiac Cycle?

A

Class 1 = Na⁺ Channel Blocker

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7
Q

What Class of medications works on Phase 4 of the Cardiac Cycle?

A

Class 2 = Beta Blocker

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8
Q

What Class of medications works on Phase 3 of the Cardiac Cycle?

A

Class 3 = K+ Channel Blocker

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9
Q

What Class of medications works on Phase 2 of the Cardiac Cycle?

A

Class 4 = Ca²⁺ Channel Blocker

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10
Q

What does the Relative Refractory period coincide with on an EKG?

A

T Wave Apex

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11
Q

Ia Na⁺ Channel Blockers

A

Disopyramide
Quinidine
Procainamide

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12
Q

Ib Na⁺ Channel Blockers

A

Lidocaine
Mexiletine

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13
Q

Ic Na⁺ Channel Blockers

A

Flecainide
Propafenone

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14
Q

Beta Blockers

A

Metoprolol
Atenolol

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15
Q

K⁺ Channel Blockers

A

Amiodarone
Fofetilide
Ibutilide
Sotalol

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16
Q

Non-Dihydropyridine Ca²⁺ Channel Blockers

A

Diltiazem
Verapamil

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17
Q

Class V Medications

A

Adenosine
Digoxin

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18
Q

Medications that slow the rate of rise of phase 0 by prolonging the duration of action potential and increases the effective refractory period of the ventricle.

A

Class Ia Na⁺ Channel Blockers
(↑ ERP + ↑ AP Duration)

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19
Q

What do Class Ia Na⁺ Channel Blockers treat?

A

Ventricular + Atrial Arrhythmias in patients without a history of ischemic heart disease

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20
Q

What is an adverse drug reaction caused by Class Ia Na⁺ Channel Blockers?

A

Lupus-Like Syndrome
Increase Arrhythmias

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21
Q

Medications that shorten the action potential duration and refractory period of the Purkinje Fibers and ventricular muscles.

A

Class Ib Na⁺ Channel Blockers
(↓ ERP + ↓AP Duration)

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22
Q

When do you give Class Ib Na⁺ Channel Blockers?

A

Ventricular Arryhtmias

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23
Q

What is a Class Ib Na+ Channel Blocker that is 2nd line in treating V-Tach and V-Fib?

A

Lidocaine

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24
Q

Is Lidocaine effective against Atrial Arrhythmias?

A

No

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25
Q

Medication that has the greatest effect on early depolarization. Can cause a markedly prolonged QRS during normal sinus rhythm.

A

Class Ic Na⁺ Channel Blockers.

26
Q

What is the indication for a Class Ic Na⁺ Channel Blocker?

A

Supra-ventricular Arrhythmias in patients without structural heart disease.

27
Q

Medications that block cardiac Beta-1 receptor and reduces cAMP

A

Beta Blockers
- Metoprolol
- Propranolol
- Atenolol
- Esmolol

28
Q

What do Beta Blockers ultimately result in?

A

Cardiac Membrane Stabilization
Slowed SA + AV Node Conduction
↑ Refractory Period

29
Q

What are Beta-Blockers used to treat?

A

Re-infarction & sudden death in patients with HF or MI.

30
Q

What are some adverse drug reactions caused by Beta-Blockers?

A

AV BLOCK
Bronchospasm
Cardiac Depression
Hypotension

31
Q

Medications that prolong or delay repolarization.

A

K⁺ Channel Blockers

32
Q

What do all K⁺ Channel Blockers do?

A

Prolong QT
(Amiodarone does it the least)

33
Q

What is the drug of choice for the acute treatment of V-Tach and V-Fib?

A

Amiodarone

34
Q

What medications are safe to treat heart failure with A-Fib?

A

Amiodarone
Dofetilide

35
Q

What are two adverse drug reactions of K⁺ channel blockers?

A

QT Prolongation
Torsades de Pointes

36
Q

What are some signs of Amiodarone toxicity?

A

GI = Nausea + Vomiting
Pulmonary = Pulmonary Fibrosis
Endocrine = Hyper or Hypo Thyroid
Eyes = Corneal Microdepsoits (100%)
Liver = Heptatotoxicity

37
Q

What is the half-life of Amiodarone?

A

52 days
(Reactions can take Months or Years)

38
Q

How does Amiodarone interact with Warfarin?

A

Inhibits Warfarin Metabolism
↑ INR
Tx: ↓ Warfarin by 50%

39
Q

How does Amiodarone interact with Digoxin?

A

↑ Digoxin Effect
↑ Risk of AV Block
↑ Risk of GI + Neuro Toxicity
Tx: ↓ Digoxin by 50%

40
Q

How does Amiodarone interact with Statins (HMG Co-A Reductase Inhibitors)

A

Inhibits Statin Metabolism
↑ Risk of Myopathy + Myalgia
Tx: Avoid high doses of:
Lovastatin
Atorvastatin
Simvastatin

41
Q

Medications that slow conduction through the AV node and increase the effective refractory period in the AV node.

A

Ca²⁺ Channel Blockers

42
Q

Ca²⁺ channel blockers prolong what?

A

PR Interval

43
Q

What is an indication for a Ca²⁺ channel blocker?

A

A-Fib rate control

44
Q

What are some adverse drug reactions of Ca²⁺ channel blockers?

A

Cardiac:
- Negative Inotrope
- AV Node Block
- Sinus Arrest

Non-Cardiac:
- Peripheral Vasodilation
- Constipation

45
Q

Class of medications used for Ventricular Arrhythmias and A-Fib.

A

Ia + Ic Na⁺ Channel Blockers

46
Q

Class of medications used for A-Fib, Ventricular Arrhythmias, and Post-Myocardial Infarction.

A

Beta Blockers

47
Q

Class of medications used for Atrial and Ventricular Arrhythmias, especially when other drugs fail.

A

K⁺ Channel Blockers

48
Q

Class of medications effective for A-Fib and A-Flutter.

A

Ca²⁺ Channel Blockers

49
Q

Medication that can cause tinnitus, headache, vision changes, thrombocytopenia, and lupus-like syndrome.

A

Quinidine

50
Q

Medication that can cause CNS effects, confusion, and seizures.

A

Lidocaine

51
Q

Medication that is pro-arrhythmic, especially in structural heart disease.

A

Flecainide

52
Q

Medications that can cause Bradycardia, Hypotension, and Bronchospasm.

A

Beta-Blockers

53
Q

Medications that can cause QT Prolongation.

A

K⁺ Channel Blockers

54
Q

Medication that can cause pulmonary fibrosis, thyroid abnormalities, and hepatotoxicity.

A

Amiodarone

55
Q

Medication that can cause AV Blocks, bradycardia, and hypotension.

A

Ca²⁺ Channel Blockers

56
Q

Medication used to treat paroxysmal SVT.

A

Adenosine

57
Q

What are some adverse drug reactions of Adenosine?

A

Flushing
Dyspnea
AV Block
Arrhythmia

58
Q

Medication that partially inhibits Na⁺/K⁺ ATPase Pump and increases contraction without effecting heart rate.

A

Digoxin

59
Q

When is Digoxin used?

A

2nd or 3rd Line for: A-Fib or Heart Failure

60
Q

What are some adverse drug reactions caused by Digoxin?

A

Nausea + Vomiting
Blurred Vision + Halos
AV Block
MUST MONITOR DRUG LEVEL

61
Q

What medications can cause QT Prolongation?

A

Class 1A and III
Tricyclic Antidepressants
Quinolones
Phenothiazines
Haloperidol
Zofran

Pharmacology 2: Section 1 (4 decks)

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