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608 Pharmacology > Antiarrhythmics > Flashcards

Antiarrhythmics Flashcards

1
Q

5 Main Commonly Used Drug Classes in Cardiology

A
  1. Diuretics (preload reducers)
  2. Inotropes
  3. Afterload Reducers
  4. Neurohormonal modulators (RAAS/SNS)
  5. Antiarrhythmics (chronotropes)
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2
Q

Cardiomyocyte Action Potentials

A
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3
Q

P wave?

A

atrial depolarization

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4
Q

PR super wide on the ECG means?

A

1st degree AV block

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5
Q

PR Interval/segment

A

AV nodal conduction

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6
Q

QRS complex

A

representation of His-Purkinje fibers

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7
Q

Where do you see the sinoatrial node on an ECG?

A

you don’t, it’s silent

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8
Q

5 Causes of Arrhythmias in Dogs

A
  1. Primary cardiac disease
  2. Metabolic disorders
  3. Drugs/Toxins
  4. Autonomic Imbalance
  5. The whole shebang (GDV/pain/trauma/hypoxia/sepsis/splenic problems, etc)
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9
Q

consequences of arrhythmias

A

decreased cardiac fxn, dec. BP, limited tissue perfusion, limited exercise capacity, syncope, electrical instability, asystole, sudden cardiac death

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10
Q

Supraventricular

A

obviously means ABOVE the ventricle, so sinus, atrial, or the AV jxn

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11
Q

NO BODY KILLS CATS

A

Here’s your four classes of Antiarrhythmic Drugs!
-Sodium channel blockers
-Beta blockers
-Potassium channel blockers
-Calcium channel blocker

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12
Q

Class 1 Antiarrhythmic Drugs

A

sodium channel blockers
quinidine, procainamide, lidocaine, mexiletine, propafenone

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13
Q

Class 2 Antiarrhythmic Drugs

A

beta blockers
propranolol, atenolol

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14
Q

Class 3 Antiarrhythmic Drugs

A

potassium channel blockers
amiodarone, sotalol***

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15
Q

Class 4 Antiarrhythmic Drugs

A

calcium channel blockers
Diltiazem, amlodipine

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16
Q

Can you give lidocaine to cats?

A

you really shouldn’t but technically can tolerate at hella low dose

17
Q

Can you give lidocaine orally?

A

sure but it ain’t gonna do anything (high first pass effect)

18
Q

What class 1 is used PO instead of lidocaine?

A

mexiletine

19
Q

Can you abruptly stop a betablocker?

A

NO OMG NO –> ventricular tachycardia and then sudden death

20
Q

Can you give beta blockers to a CHF patient?

A

probably not advised since they’ll just die faster

21
Q

3 Mechanisms of Arrhythmogenesis

A
  1. Enhanced/abnormal automaticity
  2. Reentry
  3. Triggered activity
22
Q

Automaticity

A

accelerated generation of action potential (enhanced occurs in nodal tissue, abnormal is non-nodal tissues)

23
Q

Re-entry

A

impulse recirculates within the tissue causing repetitive reactivation without need for a new impulse

24
Q

Triggered activity

A

secondary scatter currents (afterdepolarizations) following initial impulse leading in oscillations in the membrane potential (DADs and EADs)

25
Q

Beta blocker MOA

A

decrease sympathetic nervous system (SNS) via beta receptor 1 (b1) and slows conduction through the AV node

26
Q

Are there beta blockers that are specific?

A

yes, and will only block b1, limiting side effects to other organs seen in non-specific/selective drugs

27
Q

MOA of Potassium Channel Blockers

A

prolongs repolarization

28
Q

Do class 3 drugs just block potassium channels?

A

nah, they have mixed properties usually (ex: sotalol and amiodarone)

29
Q

Adverse Effects of Amiodarone

A

hepatotoxicity, GI upset, neutropenia, hypothyroidism (so not a great first line drug)

30
Q

Diltiazem

A

class 4 antiarrhythmic for supraventricular arrhythmias

31
Q

Drug to treat ACUTE Ventricular Arrhythmias (VPCs/Vtach) (IV)

A

Lidocaine

32
Q

Drug to treat CHRONIC Ventricular Arrhythmias (VPCs/Vtach) (oral)

A

Sotalol

33
Q

Drug to treat ACUTE Supraventricular Arrhythmias (Atach/Afib) (IV)

A

Procainamide

34
Q

Drug to treat CHRONIC Supraventricular Arrhythmias (Atach/Afib) (oral)

A

Diltiazem

35
Q

Drug to treat ACUTE COMBINED Supraventricular and Ventricular Arrhythmias (IV)

A

Procainamide

36
Q

Drug to treat CHRONIC COMBINED Supraventricular and Ventricular Arrhythmias (oral)

A

amiodarone

608 Pharmacology (13 decks)

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