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Pharm Block 2 > Anti-arrythmics > Flashcards

Anti-arrythmics Flashcards

1
Q

Class 1’s

A

1A - Quinidine, procainemide
1B - Lidocaine
1C- Flecainide

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2
Q

Class 2’s

A

Propranolol, esmolol

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3
Q

Class 3’s

A

Amiodorone, Sotolol

Dofetalide, Ibutilide

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4
Q

Class 4’s

A

Verapamil, diltiazem

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5
Q

Local anesthetics - MoA

A

Binds to, inhibits, and releases from Na+ Channels a different rates

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6
Q

Class 1A (Procainamide, quinidine) - specific MoA

A

Intermediate binding
Drops conductivity, automaticity
Increases refractory, threshold

Increases QRS, QT
nothing to PR

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7
Q

Quinidine - adverse effects

A

anticholinergic, alpha receptor antagonist

Use with digitalis, beta block, or calcium channel block

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8
Q

Quinidine - spectrum

A

Atrial fibrillation and flutter

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9
Q

Procainamide - spectrum

A

supraventricular and ventricular arrhythmias

WPW with atrial fib

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10
Q

Class 1A- adverse effects

A

hypotension, torsades de pointes (incr. QT)

Lupus like syndrome with procainamide

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11
Q

Class 1B (lidocaine) - specific MoA

A

Fast binding,
No change in phase 0
incr. threshold
decr. phase 0 conduction in fast beating heart

incr. QRS in fast beating or ischemic heart

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12
Q

Lidocaine - spectrum

A

only ventricular tachycardia and fibrillation NOT atrial

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13
Q

Lidocaine - adverse effects

A

Dizziness, drowsiness

Less QT effect

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14
Q

Class 1C- Flecainide and propafenone - specific MoA

A

Very slow binding
Subs. decr. phase 0 and automaticity
incr. APD (K+) and refractory

Incr. PR, QRS, and QT

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15
Q

Flecainide - spectrum

A

supraventriculars, PVCs, ventricular tachy, and WPW

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16
Q

Flecainide - adverse effects

A

Proarrythmia and sudden death

heart failure

17
Q

Class 2 (propranolol, esmolol) - MoA

A

Beta-blockers

18
Q

Class 2 - specific MoA

A

incr action potential duration and refractory period in AV node
decr slope of phase 4 depolar

Incr. PR
Decr. HR

19
Q

Propranolol - spectrum

A

sinus and other tachys

convert reentry loops through AV node

20
Q

Propranolol - adverse effects

A

bronchospasm, hypotension

AV block or ventri. failure maybe produce detrimental results

21
Q

Class 3 (amiodorone, dronedarone, sotalol, ibutilide, dofetalide) - MoA

A

Potassium channel blockers

22
Q

Class 3 - specific MoA

A

incr refractory, APD, threshold
decr. phase 0, phase 4, speed of AV conduction

Incr. PR, QRS, QT,
Decr HR

23
Q

Amiodorone -oral/IV - spectrum

A

most arrythmias
Ventr. tachy and V fib
Heart failure arrythmias

24
Q

Amiodorone - adverse effects

A 
pulmonary fibrosis
hepatic injury
increase LDL cholesterol
Thyroid disease
photosensitivity
corneal lesions
25
Q

Dronedarone -oral

A

No iodine like amiodorone
No thyroid disease risk
Torsades risk
No for heart failure

26
Q

Sotolol -oral

A

Ventricular and atrial tachycardias

Incr QT
Decr HR

27
Q

Sotolol- adverse effects

A

Proarrhythmia
Fatigue
Insomnia

28
Q

Ibutilide -IV

A

Pure potassium current blocker
Atrial fib and flutter

Incr APD, QT (torsades risk)

29
Q

Dofetilide - oral

A

Pure potassium current blocker
Atrial fib and flutter

Incr APD, refractory, QT

30
Q

Class IV (Verapamil/Diltiazem)- MoA

A

Calcium channel blockers

31
Q

Class IV - specific MoA

A

decr. phase 0 slope (AV, calcium current)
decr. phase 4
incr. refractory period in AV node

Incr. PR

32
Q

Class IV - spectrum

A

control ventricles during atrial tachy.
convert supraventricular tachy
DAD derived ventricular tachycardia

33
Q

Calcium channel blockers

A

Partial AV block caution
Beta blocker on board can lead to asystole
Caution with hypotension

34
Q

Adenosine (IV) - MOA

A

binds alpha1 receptors and activates K+ currents in AV and SA node

decr. APD and hyperpolarization
decr HR

Blocks/slows AV conduction

35
Q

Adenosine - spectrum

A

convert re-entrant supraventricular arrhythmias

36
Q

Digioxin

A

enhances vagal activity (incr. K currents, decr. Ca, incr. refractory)
Slows AV conduction and slows HR

Atrial fib and flutter

37
Q

Atropine

A

muscarinic antagonist

blocks vagal activity to speed av conduction and incr HR

38
Q

Magnesium

A

Treats torsades (long QT)

Pharm Block 2 (13 decks)

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