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A1 > Antiarrhythmics > Flashcards

Antiarrhythmics Flashcards

1
Q

MV of phase 2

A

+10-+20

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2
Q

AP of conducting system (is not nodal)

A

0 na in
1cl in, k out
2 ca in, k out
3 k out
4 restoration of ions, k seeps out

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3
Q

RMP THP of conducting (ventricle) AP

A

RMP- -90
THP- -70

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4
Q

RMP THP nodal cell

A

RMP- -60
THP- -40

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5
Q

Impluse generation of arrhythmias

A

(Ectopic pace makers)
Sympathomimetic influences
Hypoxia/ hypercarbia
Dig toxicity

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6
Q

What causes re-entry

A

Unidirectional block of impulse
Slow conduction via alternate pathway
Impulse fund unidirectional block conducts impulse retrograde

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7
Q

Where can re rentry occur?

A

SA node (sa nodal re entry)
Atrium (a tachy or a flutter)
AV node (av node re entry and accessory pathways)
Ventricle (VT)

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8
Q

Na channel blockers are blocked for ___

A

Atria and ventricles

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9
Q

CA channels blockers are blocked for ___

A

SA/AV nodes

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10
Q

Classes of antiarrhythmics, phase they effect

A

1a- Na blockers (slow 0, prolongs 3)
1b- Na (slow 0, shortens 3)
1c- Na (very slow 0, no change to 3)
2- BB (reduces slope of 4)
3- K blockers (prolongs 3)
4- CA channel blockers (reduces slope of 4)
5 (unclassified)

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11
Q

Class 1 antiarrhythmic drugs

A

1a- disopyramide quinidine procainamide
1b- lidocaine
1c- flecainide propafenone

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12
Q

Class 3 antiarrhythmic drugs

A

AmioDARONE
DroneDARONE
sotalol

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13
Q

Class 4 antiarrhythmic drugs

A

Verapamil
Dilt

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14
Q

Unclassified class drugs

A

Digoxing
Adenoside

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15
Q

Procainamide toxicity presentation

A

myocardial depression
Hypotension
QRS/ QT prolongation
Heart block
Ventricular ectopy
SLE like syndrome

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16
Q

Quinidine toxicity presentation

A

QT prolongation
VTach
Thrombocytopenia
Cinchonism (headache/ tinnitus)

17
Q

BB toxicity

A

Bronchospasm
Brady or asystole
LV failure

18
Q

What will amio potentiate?

A

BB and CACB

19
Q

Amio interactions

A

With alot
Anticoagulants (more bleeding)
Digoxin (toxicity)
Lido
Versed (sedation, respiratory depression)
Suggamadex (brady)

20
Q

Dig MOA/ SE

A

Inhibits Na K ATPase
Keeps k out and na in
Inhibits Na CA pump
Keeps Na out and CA in
Can increase conduction thru accessory pathways (can increase WPW rate)

21
Q

Dig toxicity risk and presentation

A

Risk factors : hypercalcemia, hypokalemia
Presentation: PVC, VT, VF, 2nd degree HB,

22
Q

Adenosine MOA/ receptors

A

Hyperpolarize SA/AV via k channels
Inhibits cAMP
A1-dromotrope,beta sympatholytics

A3 -inotrope -dromotope

23
Q

Adenosine toxicity

A

Facial flushing
Dyspnea
Chest pressure
Bronchoconstriction in asthmatics

24
Q

What class of antiarrhythmics can trigger torsades?

A

K blockers
1a and 3

25
Q

QT prolonging drugs (not antiarrhythmics)

A

ANTI Arrhythmics- 1a/3
ANTI Biotics- macrolides
ANTI Cychotics- haldol, risperidol
ANTI Depressants- celexa, lexapro
ANTI Emetics- zofran

26
Q

Wide complex tachycardia drug risks

A

1C

27
Q

Ventricle arrhythmia risk factors

A

Diseases: acidosis, hypothermia, hypoxia, hypokalemia, tamponade
Drugs: anabolics, cocaine, amphetamines
Non modifiable: male, ef <35, stemi (brugada)

28
Q

Indications for class 2 antiarrhythmics

A

SVT, a tach, a fib, a flutter

29
Q

Indications for class 3 antiarrhythmics

A

Amio: V fib, V tach, A fib, WPW
Dronedarone: A fib

30
Q

Indications for class 4 antiarrhythmics

A

Dilt: Ventricular rate control, A fib, A flutter
Verapamil: SVT, A fib, A flutter

31
Q
A
32
Q

Dilt SE/ toxicity

A

CYP inhibitor
Toxicity -
Brady/ hypo
Edema
Constipation

33
Q

Indications for class 5 antiarrhythmics

A

Dig: A fib RVR HF, A flutter, SVT
Adenosine: PSVT, NO A FIB NO A FLUTTER

34
Q

Indications for class 1 antiarrhythmics

A

Disopyramide- Atrial / Ventricular tachyarrhythmias
Quinidine- A fib, A flutter, V tach V fib
Procainamide- Vtach, A tach, SVT, PVC,
-
Lidocaine- Ventricular arrhythmias, NOT SVT
Phenytoin- Ventricular arrhythmias, dig toxicity, vtach, torsades
-
Flecainide- PVCs, a tach, WPW

35
Q

QT prolongaiton risk factors

A

> 65 yo
Bradycardia
HYPO kalemia, magnesemia, calcemia
Female
Heart disease
QTC >500
Recent cardioversion
DM hypothyroid hypothermia

A1 (122 decks)

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