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T&D III exam 1 > Antiarrhythmic > Flashcards

Antiarrhythmic Flashcards

1
Q

Class I

A

Na Channel block (phase 0)

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2
Q

Class II

A

BB (sympathetic input/SA node)

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3
Q

Class III

A

prolong APD (inc ERP/block potassium)

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4
Q

Class IV

A

CCB

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5
Q

Class Ia

A

Moderate dissoc rate

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6
Q

Class Ib

A

Rapid dissoc

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7
Q

Class Ic

A

Slow dissoc

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8
Q

Class I is classified on

A

rate of dissociation from closed channels

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9
Q

state-dependent block means

A

binding to open or inactivated channels

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10
Q

association occurs in

A

systole

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11
Q

dissociation occurs in

A

diastole

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12
Q

Block related to depolarization

A

HR
ischemia
APD

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13
Q

what maintains block in normal

A

slowly dissociating (not rapid)

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14
Q

what maintains block in high HR, ischemia, prolonged APD

A

slow and rapid dissociation

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15
Q

Procainamide

A

Class Ia

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16
Q

Avoid in prolonged QT syndrome

A

Class Ia

torsades de pointes

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17
Q

Anticholinergic effect

A

Class Ia

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18
Q

Effect on AV node conduction with Class Ia

A

unpredictable

direct - decreases, antichol - increases

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19
Q

active metabolite of Procainamide

A

NAPA

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20
Q

ADR Procainamide

A

+ANA
Lupus like syndrome
Agranulocytosis/leukopenia
Proarrhythmic effect

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21
Q

CI for Procainamide

A

Prolonged QT
hypokalemia
SLE

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22
Q

Class Ib

A

Lidocaine

Mexiletine

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23
Q

Indications for Lidocaine

A

Life threatening V arrhythmias

Digoxin-induced arrhythmias

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24
Q

ADR - lidocaine

A

CNS (disorientation – seizures)
Hypotension
decrease cardiac contractility

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25
Q

CI - Lidocaine

A

hypersensitivy - amides
severe hepatic dysfunction

history of lidocaine-induced seizures

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26
Q

Class Ib

IV vs Oral

A

IV- lidocaine

Oral - Mexiletine

27
Q

Mexiletine ADR

A

thrombocytopenia
tremors
CNS
GI

28
Q

Main concern with lidocaine

29
Q

Class Ic

A

Flecainide

Propafenone

30
Q

Markedly slow conduction

31
Q

Tx of life threatening v. arrhythmias/Supraventricular arrhythmias in ABSENCE of organic heart disease

A

Flecainide

32
Q

Effect of FLecainide on mortality post MI

A

HUGE, don’t use if they have pre-existing heart disease

33
Q

Indicated for A flutter, fib and Post MI

A

BB - Class II

34
Q

Increased insulin induced hypoglycemia

A

beta blockers

35
Q

Non specific beta blocker

A

Propranolol

36
Q

Cardioselective beta blocker

A

Metoprolol

Esmolol

37
Q

Control sinus tachy , short half life

38
Q

Homogenous prolongation of APD

A

Proarrhythmic

Class III

39
Q

Tx of refractory life threatening V arrhythmias

40
Q

Class III

A

Amiodarone
Dronedarone
Ibutilide, Dofetilide
Sotolol

41
Q

DOC for acute suppression of V arrhythmias

A

Amiodarone

42
Q

Kinetics of Amiodarone

A

highly lipophilic

Very long half life - months

43
Q

ADR - Amiodarone

A 
Pulm fibrosis
Hyper-/Hypothyroidism
Hepatotox
AV block, bradycardia
Proarrhythmic

Corneal microdeposits
Photosensitive
Blue/gray nose and cheeks
drug-durg intrxn

44
Q

Why monitor ptns on amiodarone ?

A

Pulm fibrosis

45
Q

Class III and non selective BB

46
Q

Prevent recurrence of sx A flutter, A fib

47
Q

Class IV

48
Q

supraventricular arrhythmias and PSVT with AV nodal reentry as indication

49
Q

Tx of acute termination of PSVT BUT Avoid in Asthma and COPD

A

Adenosine

causes bronchoconstriction

50
Q

Terminate PSVT - valsalva, carotid sinus massage

A

Vagomimetics

51
Q

Tx of bradyarrhthmias (prior to pacemaker transplant)

A

atropine
Isoproterenol

Inc AV/SA

52
Q

Phase 0 on EKG

53
Q

Phase 2 and 3 - repolarization on EKG

A

ST segment and T wave

54
Q

Increased QT interval

A

Procainamide and Amiodarone

55
Q

increased QRS interval (slowing conduction/slowing depolarization)

A

Flecainide

also Procainamide and amiodarone

56
Q

No effect on EKG intervals

57
Q

Increased PR interval

A

Flecainide
Propranolol
Amiodarone
Verapamil

58
Q

class Ic drug with weak beta-blocking activity

A

propafenone

59
Q

refractory, life threatening V tach

A

Amiodarone

60
Q

backup drug for amiodarone

61
Q

Verapamil has DI with

A

Digoxin,

concurrent use of BB

62
Q

How is Adenosine administered

63
Q

Increased PR int, QRS int, and QT interval

A

Amiadarone

T&D III exam 1 (11 decks)

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