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cardio > Antiarrhythmics > Flashcards

Antiarrhythmics Flashcards

1
Q

what is the resting membrane potential of the heart determined by?

A

high Na concentration outside the cell, maintained by Na-k ATPase pump

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2
Q

how is quinidine metabolized?

A

hepatic metabolism

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3
Q

vomiting, tinnitus, HA, blurred vision

A

cinchonism

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4
Q

which class Ia drug would be good to monitor serum levels of to monitor toxicity and efficacy?

A

procainamide

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5
Q

SE:significant anticholinergic effects in addition to being a Na channel blocker

A

disopyramide

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6
Q

which antiarrhytmic is cleared renally (+hepatic)?

A

disopyramide

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7
Q

lidocaine is effective only in _______arryhtmias

A

ventricular

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8
Q

how is lidocaine administered?

A

IV

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9
Q

SE: CNS side effects mostly incl dizziness, paresthesias, confusion, coma, lethargy, tremor, seizures

A

lidocaine

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10
Q

flecainide and propafenone are used for only ______arrhytmias, recommended specifically for patients with _________

A

atrial

recommended for patients with lone A fib (nothing else)

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11
Q

how is flecainide metabolized?

A

hepatically + renally

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12
Q

which 2 class 1 drugs are fairly well tolerated with few side effects?

A

propafenone and flecainide

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13
Q

what have studies shown about ALL class I drugs in patients with CHF?

A

INCREASED MORTALITY

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14
Q

which class of antiarrhytmics have been shown to reduce mortality?

A

ONLY the beta blockers

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15
Q

sotolol is class III drug, as well as a ?

A

beta blocker (class II)

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16
Q

main issue with sotolol?

A

profound INCREASE IN QT INTERVAL (high risk of Torsades)

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17
Q

which class III drug? high bioavailability, hydrophilic, MUST doses down in renal failure

A

sotolol

18
Q

amiodarone has a low or high Vd?

A

very high Vd, and LOONNNG half life

19
Q

cardiac abnormalities assc’d with amiodarone

A

minimal risk of torsades

20
Q

is amiodarone safe or unsafe for heart failure patients

A

safe for CHF

21
Q

pulmonary abnormalities assc’d with amiodarone

A

3% get pulmonary fibrosis, delayed hypersensitivity pneumonitis

22
Q

ways to monitor pulmonary risks?

A

have patient report unexplained dyspnea, cough and fever

23
Q

thyroid abnormalities assc’d with amiodarone

A

can cause hypo or hyperthyroidism

24
Q

______% of amiodarone is _____

A

44% of amiodarone is iodine

25
Q

ocular abnormalities assc’d with amiodarone

A
  1. corneal deposits in almost ALL patients

2. halos, photophobia, overt retinopathy

26
Q

neuro abnormalities assc’d with amiodarone

A

20-40% patients have tremor, ataxia, peripheral neuropathy

27
Q

derm abnormalities assc’d with amiodarone

A

photosensitivity,blue green discoloration in sun exposed areas

28
Q

hepatic abnormalities assc’d with amiodarone

A

4-35% have asympatomatic elevations in transaminases & bilirubin
some get hepatitis

29
Q

GI abnormalities assc’d with amiodarone

A

N/V common

loss of taste, constipation

30
Q

amiodarone decreases effectiveness of what drugs (2)?

A
  1. digoxin

2. warfarin

31
Q

amiodarone increases effectiveness of what drugs (3)?

A
  1. beta blockers
  2. phenytoin
  3. theophylline
32
Q

what is amiodarone primarily used for?

A
  1. SVT (esp AF)
  2. VT
  3. VF
33
Q

contrast dronaderone to amioradone

A

Iodine–>CH3 = lower Vd, safer

BUT less effective for A fib

34
Q

cardiac abnormalities for dronaderone

A

CONTRAINDICATED in patients with health failure

35
Q

AE: rash, nausea, diarrhea, mild QT prolongation, contraindicated in severe CHF

A

dronaderone

36
Q

what is a new agent used for acute conversion of AF to NSR, and for maintenance of NSR?

A

dofetilide

37
Q

which drug? HIGHER incidence of torsades than sortolol, HA, chest pain, dizziness. requires 3 day inpatient initiation.

A

dofetilide

38
Q

C/I: verpamil, cimetidine, trimethoprim, ketoconazole, prochlorperzine, megasterol

A

dofetilide

39
Q

how to tx pt with A fib with no other heart disease?

A

flecainide or propafenone

40
Q

how to tx pt with A fib with h/o CAD but normal EF?

A

sotolol

41
Q

how to tx pt with A fib with CHF?

A

amiodarone or dofetilide

cardio (25 decks)

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