Antiarrhythmics

Question 1

Generic names
Antiarrhythmics

Answer 1

Adenosine
Amiodarone
Atropine
Digoxin
Disopyramide
Esmolol
Flecainide
Isoprenaline
Lidocaine (cardiovascular)
Sotalol
Verapamil

Question 2

Drug class and indication

Adenosine

Answer 2

Antiarrhythmic
* Acute treatment of SVT
* Diagnostic aid for broad or narrow complex tachycardia
* For use with radionuclide myocardial perfusion imaging in patients unable to exercise adequately (seek specialist advice)

Tachyarrhythmias

Question 3

MOA + Drug class
Adenosine

Answer 3

Antiarrhythmic
* Depresses sinus node activity and slows conduction through the atrioventricular node; also produces peripheral and coronary vasodilation.
* Adenosine has a rapid onset and short duration of action.

Tachyarrhythmias

Question 4

Indication and drug class
Amiodarone

Answer 4

Antiarrhythmic
Treatment and prophylaxis of serious tachyarrhythmias refractory to other treatment, including ventricular tachycardia, AF and SVT

Tachyarrhythmias

Question 5

MOA and drug class
Amiodarone

Answer 5

Antiarrhythmic
Decreases sinus node and junctional automaticity, slows atrioventricular (AV) and bypass tract conduction and prolongs refractory period of myocardial tissues (atria, ventricles, AV node and bypass tract); also has weak beta-blocker activity.

Tachyarrhythmias

Question 6

Indication and Drug class
Digoxin

Answer 6

Antiarrhythmic
AF and atrial flutter
Heart failure

Heart failure, Tachyarrhythmias

Question 7

MOA and drug class
Digoxin

Answer 7

Antiarrhythmic
Slows heart rate and reduces atrioventricular (AV) nodal conduction by an increase in vagal tone and a reduction in sympathetic activity. Increases the force of myocardial contraction by increasing the release and availability of stored intracellular calcium.

Heart failure, Tachyarrhythmias

Question 8

Indication and Drug class
Disopyramide

Answer 8

Antiarrhythmic
Life-threatening ventricular tachyarrhythmias refractory to other treatment

Tachyarrhythmias

Question 9

MOA and drug class
Disopyramide

Answer 9

Antiarrhythmic
Prolongs refractory period of myocardial tissue (atria, ventricles, ventricular conduction system, bypass tracts) and reduces automaticity in Purkinje fibres. It has significant anticholinergic activity, which may increase atrioventricular nodal conduction, and it also has a negative inotropic effect.

Tachyarrhythmias

Question 10

Drug class and indication
Flecainide

Answer 10

Antiarrhythmic
* SVT
* Paroxysmal AF or atrial flutter associated with disabling symptoms
* Maintenance of sinus rhythm following cardioversion
* Serious ventricular arrhythmias refractory to other treatment (including DC cardioversion)

Tachyarrhythmia

Question 11

Drug class and MOA
Flecainide

Answer 11

Antiarrhythmic
Slows cardiac conduction and to a lesser extent, increases refractory period in all myocardial tissues (including bypass tracts) but particularly in the His-Purkinje (ventricular conduction) system. Also has negative inotropic activity.

Tachyarrhythmia

Question 12

Drug class and indication
Isoprenaline

Answer 12

Antiarrhythmic
* Heart block
* Bradycardia with haemodynamic compromise
* Adjunct in cardiogenic, septic or hypovolaemic shock

Bradyarrhythmia

Question 13

Drug class and MOA
Isoprenaline

Answer 13

Antiarrhythmic
Beta agonist; increases cardiac output for bradyarrhythmia

Bradyarrhythmia

Question 14

Drug class and indication
Lidocaine (cardiovascular)

Answer 14

Antiarrhythmic
Treatment of serious ventricular arrhythmias

Tachyarrhythmia

Question 15

Drug class and MOA
Lidocaine (cardiovascular)

Answer 15

Antiarrhythmic
Reduces automaticity of myocardial tissue with little effect on cardiac conduction. It has a mild negative inotropic effect and weak neuromuscular blocking activity.

Tachyarrhythmia