Anti-dysrhythmic medications

Question 1

List the four classes of dysrhythmic medications

Answer 1

Class 1I- Sodium Channel blockers

Class II- Beta Blockers (Nodal)

Class III-Potassium Channel Blockers

Class IV-Calcium Channel Blocker (non-dihydropyridines, nodal)

Question 2

What are nodal blockers?

Answer 2

The medications known as AV nodal blocking drugs—beta blockers, calcium channel blockers, and digoxin—work by slowing the heart’s electrical signal as it passes through the AV node on its way from the atria to the ventricles.

Question 3

What are Class I examples?

Answer 3

IA: Quinidine, procainamide

IB: lidocaine, mexiletine

IC: flecainide, propafenone

Question 4

What are Class I medications used for?

Answer 4

Afib, aflutter, FATs, V Tach, V fib

Question 5

What are adverse effects for Class I medications?

Answer 5

Leukopenia, thrombocytopenia

Question 6

What are Class II medications?

Answer 6

Beta Blockers (Nodal)

Question 7

What are examples of beta blockers?

Answer 7

Propranolol, atenolol, metoprolol, esmolol

Question 8

What are beta blockers used for?

Answer 8

Afib, Aflutter, FATs, AVNRT, sinus tach

Question 9

What are the adverses effects of Class II (beta blockers)?

Answer 9

mask hypoglycemia**
bronchospasm
hypoglycemia

Question 10

What are Class III medications?

Answer 10

Potassium Channel Blockers

Question 11

What are examples of Class III (K+ channel Blockers)?

Answer 11

→ Amiodarone (contains iodine)

→ Dronedarone, dofetilide (no iodine)

Question 12

What are Class III (K+ channel blockers) adverse effects?

Answer 12

Cyanosis, visual disturbance, liver tox, thyroid dysfunction, visual disturbance

Question 13

What are Class III (potassium channel blockers) used for?

Answer 13

Afib, Aflutter, FATs, V Tach

Question 14

What are Class IV medications?

Answer 14

Calcium Channel blockers (non-dihydropyridines, nodal)

Question 15

What are examples of Calcium Channel blockers (non-dihydropyridines, nodal)?

Answer 15

Verapamil, diltiazem

Question 16

What are Calcium Channel Blockers (non-dihydropyridines, nodal) used for?

Answer 16

Afib, Aflutter, FAts, AVNRT

Question 17

What are adverse effects of Calcium Channel blockers (non-dihydropyridines, nodal)?

Answer 17

GI upset, edema, constipation

Question 18

Define dysrhythmias

Answer 18

Abnormal electrical activity in the heart

• ->Rate
• ->Rhythm
• ->Sequence
• ->Origin

Question 19

Describe the normal electrical activity in the heart

Answer 19

–>Rate: 60-100 bpm
–>Rhythm : normal velocity (note this changes in different parts of the heart)
–>Origin: beings at the sinoatrial (SA) node - your SA node is your natural pacemaker
Sequence: Normal conduction pathway
SA (sinoatrial) node → Atria → AV node (atrioventricular)–> Bundle of HIS→ Purkinje Fibers→ Ventricular myocardium

Question 20

What is the normal conduction pathway (sequence)

Answer 20

SA (sinoatrial) node → Atria → AV node (atrioventricular) →Bundle of HIS→ Purkinje Fibers→ Ventricular myocardium

Question 21

What are SA Node dysrhythmias caused by?

Answer 21

increased automaticity

Question 22

What are the most important ions involved in de/repolarization (action potential)?

Answer 22

sodium, calcium, and potassium

Question 23

Describe torsades de pointe?

Answer 23

V-tach with prolonged QT interval

Question 24

What type of medication is propranolol?

Answer 24

it is a beta blocker and NON-selective. It is a problem in pts with reactive airway problems.

Question 25

What are adverse effects of amiodarone?

Answer 25

• potassium channel blocker

* has a LOT of adverse effects including cyanosis and thyroid dysfunction (b it contains iodine)

Question 26

What are the adverse effects of adenosine?

Answer 26

Feeling of dread and death

Question 27

What are the adverse effects of digoxin?

Answer 27

Visual disturbance
Hypok/mg
hypera

Question 28

What is atropine used for? (anti muscarinic)

Answer 28

bradycardias