Antiarrhythmics

Question 1

Lidocaine

Answer 1

Class IB antiarrhythmic that produces Class IA action in diseased myocardium; used for life-threatening v-arrhythmia and digoxin induced arrhythmia

ADRs: Lidocaine-induced seizures; hypotension; decreased contractility

CIs: Epileptics, hepatic dysnfnxn

Question 2

Propafenone/ Fleicanide

Answer 2

Class IC antiarrhythmic that produces MARKEDLY slow signal conduction (decreased automaticity); used for life-threatening ventricular and supraventricular arrhythmias IN THE ABSENCE OF MYOCARDIAL DISEASE

*Increased mortality if used in post-MI pt.

⭐️Propafenone has some BB activity so AVOID IN COPD PTS

Question 3

Only drugs that can increase EF in CHF pts.

Answer 3

BBs

Question 4

Esmolol

Answer 4

Cardioselective BB w/ very short t^1/2 that can be used to control a-fib/flutter and sinus tachycardia

Question 5

Amiodarone

Answer 5

Class C antiarrhythmic that is used for life-threatening ventricular arrhythmias (acute suppression and refractory of these arrhythmias alongside sustained v-tach); drug is highly lipophilic and has a VERY LONG t^1/2

ADRs: Pulmonary fibrosis, hyper/hypothyroidism, hepatotoxicity (must monitor the function of all these); proarrhythmic; corneal deposits; blue extremities

Question 6

Dronedarone

Answer 6

Class III antiarrhythmic w/ some Class I fnxn that has increased mortality in CHF pts.; also can produce liver failure so watch that shit

Question 7

Sotolol

Answer 7

Class III antiarrhythmic that also produces a small B-blockade; will prolong QT (possible TdP)

Question 8

Adenosine

Answer 8

Sometimes used to tx arrhythmias and works via decreased AV conduction and termination of PSVT

-Avoid in asthma and COPD pts.

Question 9

Antiarrhythmics that most prolong the QT interval

Answer 9

Procainamide and Amiodarone

Question 10

Antiarrhythmic that most prolongs the QRS complex

Answer 10

Fleicanide

Question 11

Antiarrhythmic that acts on SA/AV nodes

Answer 11

Class IV (verapamil); make sure to look for this on depolarization chart

Question 12

Procainamide

Answer 12

Class IA antiarrhythmic that decreases automaticity, decreases conduction velocity, and increases ADP and ERP; used for life-threatening ventricular arrhythmia

Active metabolite= NAPA

ADRs: ANA (+), produces lupus-like syndrome; agranulocytosis; proarrhythmic

CIs: Prolonged QT (can induce Torsades de pointes); hypokalemia; SLE