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PMP 201 Patient-Centred Learning > Antiarrhythmic drugs > Flashcards

Antiarrhythmic drugs Flashcards

1
Q

Verapamil hydrochloride

A
  • Treatment of superventricular arrhythmias
  • Calcium channel blocker
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2
Q

Amiodarone

A
  • Treatment of both superventricular arrhythmias and ventricular arrhythmias
  • Potassium channel blocker
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3
Q

Lidocane hydrochloride

A
  • Treatment of ventricular arrhythmias
  • Sodium channel blocker
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4
Q

Digoxin

A
  • Treatment of rapid arterial fribrillation
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5
Q

Cardiac pacemaker action potential in arrhythmias

A
  • If the impuse is brater at another node compared to SN
  • Heartbet driven by ventricles if initiated at purkinje fibres so larger QRS
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6
Q

Class 1 antiarrhythmatics

A
  • Na+ channel blockers
  • Decrease the influx of Na+ into cardiac myocytes during phase 0 causing slow depolarisation
  • Decrease conduction of AP thus wide QRS slow heart rate
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7
Q

Moderate 1a arrhythmatic drug

A
  • decrease influx of sodium into cardiac myocytes slow depolarisation
  • Longer refractory period decrease in conduction velocity
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8
Q

1c Antiarrhythmatic drug

A
  • Slower depolarisation as lower influx of Na+
  • No change in refactory
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9
Q

Fleccanide

A
  • Na+ channel blocker
  • Management of AF and Paroxysmal superventricular tachicardis inhibiting conduction causing arrhithmyas
  • Increase threashold for depolarisation
  • Slow unbinding during diastole
  • Prolong refractory peroid of heart
  • Block ryanodine receptor reduction of calcium release from sarcoplasmic reticulum
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10
Q

Class II antiarrhythmatic drugs: Propranolol

A
  • Propranolol non selective Beta adrenogetic antagonist used to treat superventricular tachychadias
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11
Q

Side effects of Propranolol

A
  • SA node depression sinus bradycardia and heart block
  • Fatigue, sedation, sleep disturbances and bronchospasm
  • Hypoglycemia
  • Ineracts with CCB
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12
Q

Selective beta adrenageric blockers

A
  • Atenolol
  • Esmolol
  • Mertropolol
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13
Q

How do beta blockers work

A
  • Beta bockers with noradrenaline and adrenaline bind to B1 adrenogic receptors
  • Beta blockers bind to cAMP it fails to activate PKA
  • PKA doesn’t activate T-type calcium channels allow influx of Ca2+ into cell
  • PKA doesn’t activate SR for the release of Ca2+ into cell
  • Doesn’t activate myosin phosphorylation which results in stronger contraction
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14
Q

Beta blocker effect on ECG

A
  • Reduce firing of pacemaker cells decrease heart rate and lengthen PR interval
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15
Q

How is the ventricular muscle effected by b1 adrenergic receptor

A
  • Decrease in Ca2+ influx into phase 2
  • Decrease Ca2+ in cell
  • Decrease force of contarction
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16
Q

Cautions with propranolol

A
  • Reduce effect of catecholamines
  • Decrease contractility and ionotropic effect
  • Decrease cellular excitability
  • Prolonged diastole
17
Q

Amiderone

A
  • Treatment of recurrent hemodynamically unstable VT and reoccouring VF
  • Slows rate of repolarisation
  • Prolonged action potentional and QRS
  • Block cacium channel longer to leave the cells
  • Deacrease function of Voltage gated Na+, K+ and Ca2+
18
Q

Structure of amiodarine

A
  • Contains iodine in its structure therefore is very lipophilic
  • Can cause toxicity half life of 100 days with high BD causing liver disfunction
19
Q

Class IV drugs: CCB

A
  • Target pacemaker and non pacemaker cells
  • Decrease myocardial contactility
  • Decrease myocardial contraction and conduction velocity
  • Selective vasular smooth muscle to vasodialate
20
Q

Non-dihydropyradine: verapamril

A
  • Decrease L type calcium channel
  • Decrease Ca2+ into cell
  • Decrease firing rate and heart rate with conduction velocity
  • Longer PR interval
  • Slight block in AV node
21
Q

Adverse effects of CCB

A
  • Heart block and SA node depression
22
Q

Drug interaction of CCB

A
  • Cannot be taken with Beta blockers decreases AV node
23
Q

Contraindication of CCB

A
  • Arterial flutter
  • Bradycardia
  • Cardiogenic shock
  • Heart failure
  • Hypotention
24
Q

Digoxin

A
  • Cardiac glycoside used to treat mild to moderate HF
  • Ventricular response to rate control
25
Q

Adenosine

A
  • Rapid reversion to sinus rhythm of paroxysmal superventricular tachycharia aids diagnosis

PMP 201 Patient-Centred Learning (51 decks)

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