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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
CI - Lidocaine
hypersensitivy - amides severe hepatic dysfunction history of lidocaine-induced seizures
26
Class Ib IV vs Oral
IV- lidocaine | Oral - Mexiletine
27
Mexiletine ADR
thrombocytopenia tremors CNS GI
28
Main concern with lidocaine
seizure
29
Class Ic
Flecainide | Propafenone
30
Markedly slow conduction
Class Ic
31
Tx of life threatening v. arrhythmias/Supraventricular arrhythmias in ABSENCE of organic heart disease
Flecainide
32
Effect of FLecainide on mortality post MI
HUGE, don't use if they have pre-existing heart disease
33
Indicated for A flutter, fib and Post MI
BB - Class II
34
Increased insulin induced hypoglycemia
beta blockers
35
Non specific beta blocker
Propranolol
36
Cardioselective beta blocker
Metoprolol | Esmolol
37
Control sinus tachy , short half life
Esmolol
38
Homogenous prolongation of APD
Proarrhythmic | Class III
39
Tx of refractory life threatening V arrhythmias
Class III
40
Class III
Amiodarone Dronedarone Ibutilide, Dofetilide Sotolol
41
DOC for acute suppression of V arrhythmias
Amiodarone
42
Kinetics of Amiodarone
highly lipophilic | Very long half life - months
43
ADR - Amiodarone
``` Pulm fibrosis Hyper-/Hypothyroidism Hepatotox AV block, bradycardia Proarrhythmic ``` Corneal microdeposits Photosensitive Blue/gray nose and cheeks drug-durg intrxn
44
Why monitor ptns on amiodarone ?
Pulm fibrosis
45
Class III and non selective BB
Sotolol
46
Prevent recurrence of sx A flutter, A fib
Sotolol
47
Class IV
Verapamil
48
supraventricular arrhythmias and PSVT with AV nodal reentry as indication
Class IV
49
Tx of acute termination of PSVT BUT Avoid in Asthma and COPD
Adenosine causes bronchoconstriction
50
Terminate PSVT - valsalva, carotid sinus massage
Vagomimetics
51
Tx of bradyarrhthmias (prior to pacemaker transplant)
atropine Isoproterenol Inc AV/SA
52
Phase 0 on EKG
QRS
53
Phase 2 and 3 - repolarization on EKG
ST segment and T wave
54
Increased QT interval
Procainamide and Amiodarone
55
increased QRS interval (slowing conduction/slowing depolarization)
Flecainide | also Procainamide and amiodarone
56
No effect on EKG intervals
Lidocaine
57
Increased PR interval
Flecainide Propranolol Amiodarone Verapamil
58
class Ic drug with weak beta-blocking activity
propafenone
59
refractory, life threatening V tach
Amiodarone
60
backup drug for amiodarone
Sotolol
61
Verapamil has DI with
Digoxin, | concurrent use of BB
62
How is Adenosine administered
IV
63
Increased PR int, QRS int, and QT interval
Amiadarone

T&D III exam 1 (11 decks)

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