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Year 2 Cardiovascular > Antiarrhythmic pharmacotherapy > Flashcards

Antiarrhythmic pharmacotherapy Flashcards

1
Q

class I antiarrhythmics block what channel?

A

sodium

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2
Q

class II antiarrhythmics block what channel?

A

beta

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3
Q

class III antiarrhythmics block what channel?

A

potassium

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4
Q

class IV antiarrhythmics block what channel?

A

calcium

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5
Q

class Ia antiarrhythmics have what effect on sodium levels

A

moderate sodium blockage

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6
Q

class Ib antiarrhythmics have what effect on sodium levels

A

mild sodium blockage

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7
Q

class Ic antiarrhythmics have what effect on sodium levels

A

marked sodium blockage

dcreasing conduction velocity, no effect on repol

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8
Q

what must be used first before quinidine in aF?

A

digoxin

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9
Q

where is quinidine metabolized?

A

liver

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10
Q

what is the main cardiac adverse effect of quinidine?

A

prolonged QT interval (torsade de pointes)

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11
Q

what is the main metabolite of procainamide?

A

NAPA

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12
Q

what are the main adverse effects of procainamide?

A

QT prolongation

drug induced lupus

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13
Q

where is disopyramide cleared?

A

kidney

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14
Q

what are the adverse effects of disopyramide?

A

potent anticholinergic (dryness)

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15
Q

what type of local anesthetic is lidocaine?

A

amide

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16
Q

what is a benefit of lidocaine?

A

minimal effect of QT or QRS

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17
Q

lidocaine is only effective for what type of arrhythmia?

A

ventricular

18
Q

flecainide is only effective for what type of arrhythmia? what is their first line use?

A

atrial (SVTs with normal heart function)

atrial fibrillation only

19
Q

class Ic antiarrhythmics are contraindicated in what population?

A

anyone with structural heart disease (CHF)

20
Q

what is the indication for propafenone?

A

without sig CHF that have aF or sustained VT/VF

torsades, AV block, CHF

21
Q

MOA of beta blockers

A

prolongs AP and slows HR

22
Q

what is the only class of antiarrhythmics found to reduce mortality in arrhythmia patients?

A

beta blockers

23
Q

what kind of drug is sotolol

A

beta blocking agent with class III properties

also blocks potassium channels

24
Q

what are the indications for sotolol?

A

AF and sustained VT/VF

25
Q

what is the main side effect of sotolol?

A

torsades de pointes

potent QT prolongation

26
Q

what class of drug is amiodarone? what are its effects on channels?

A

class III

has effects in all four Vaughn-WIlliams classes (all channels)

27
Q

what is the principal MOA of amiodarone?

A

delayed repolarization by prolonging APD and ERP

28
Q

what are the indications for amiodarone?

A

all types of arrhythmias, increasingly for VF

29
Q

why does amiodarone have such potent side effects?

A

huge volume of distribution
long tissue half life
short peripheral half life

30
Q

what are the cardiac and pulmonary side effects of amiodarone?

A

cardiac - torsades

pulmonary - fibrosis

31
Q

amiodarone is only one of two antiarrhythmics safe to use in what condition?

A

CHF

32
Q

what are the thyroid and ocular side effects of amiodarone?

A

thyroid - hypo or hyperthyroidism

ocular - corneal deposits, halos, photophobia, retinopathy

33
Q

what are the neuro and derm side effects of amiodarone?

A

neuro - tremor, ataxia, peripheral neuropathy, seizure

derm - photosensitivity, blue-gray discoloration

34
Q

what are the hepatic and GI side effects of amiodarone?

A

hepatic - elevated transaminases

GI - loss of taste

35
Q

what kind of drug is dronaderone? what is its clinical use?

A

derivative of amiodarone

AF

36
Q

dronaderone is contraindicated in what population?

A

CHF

37
Q

what are the indications for dofetilide?

A

acute conversion of AF to NSR and for maintenance of NSR

38
Q

what is the main adverse effect of dofetilide?

A

HIGH incidence of torsades de pointes

39
Q

treatment for AF with no other heart disease?

A

flecainide or propafenone

40
Q

treatment for AF with history of CAD, but normal EF?

A

sotolol

41
Q

treatment for AF with CHF?

A

amiodarone, dofetilide

42
Q

what are the rate control drugs for atrial arrhythmias?

A

beta blockers
diltiazem
digoxin

Year 2 Cardiovascular (43 decks)

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