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Pharmacology > Antiarrhythmics > Flashcards

Antiarrhythmics Flashcards

1
Q

Class 1A examples

A

Quinidine

Procainamide

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2
Q

Class 1A mechanism of action

A

Block fast Na Channels
Prolong depolarisation, action potential and refractory period
moderately depress phase 0

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3
Q

Class 1A uses

A

Quinidine- maintains sinus rhythm in atrial fibrillation

Procainamide- acute IV treatment of supra ventricular and ventricular arrhythmias

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4
Q

Class 1A side effects

A

Hypotension
Generates new arrhythmias
Dizziness, seizures, lupus like syndrome

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5
Q

Class 1B example

A

Lidocaine

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6
Q

Class 1B mechanism of action

A

Block Na channels in late phase 2 of action potential
Shortened duration of action potential and refractory period
No change in 0 due to minimal blockage of fast sodium channels

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7
Q

Class 1B uses

A

Acute ventricular tachycardia

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8
Q

Class 1B side effects

A

GI upset
Dizziness
Drowsiness
Less pro-arrhythmic than class 1A

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9
Q

Class 1C examples

A

Flecainide

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10
Q

Class 1C mechanism of action

A

powerful fast Na channel blocker
marked phase 0 depolarisation depression
Inhibits purkinje conduction system
limited shortened decrease in action potential and refractory period

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11
Q

Class IC uses

A

super ventricular arrhythmias, premature ventricular contractions, Wolff-prkinson-white syndrome
Increase PR, QRS and QT

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12
Q

Class 1C side effects

A

Proarrhythmic
sudden death
CNS and gastro effects

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13
Q

Class 2 examples

A

Bisoprolol

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14
Q

Class 2 mechanism of action

A

Beta-adrenergic blocker
prevent action of catechalomine on the heart
Depress SANode automaticity and slow conduction, HR and contractility

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15
Q

Class 2 uses

A

Sinus and catechalomine dependant tachycardias
Convert reentrant arrhythmias at the AV node
Protect the ventricles from high atrial rates
decrease heart rate

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16
Q

Class 2 side effects

A

Bronchospasm

Hypotension

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17
Q

Class III examples

A

Amiodarone

Sotalol

18
Q

Amiodarone mechanism of action

A

Blocks K+ channels for phase 3
also Na and Ca channels
increase action potentials and refractory period
Prolong depolarisation

19
Q

Amiodarone uses

A

effective for most arrhythmias

20
Q

Amiodarone side effects

A 
pulmonary fibrosis 
hepatic injury 
Increase LDL
Thyroid disease
photosensitivity
optic neuritis
21
Q

Sotalol mechanism of action

A

Blocks K+ channels for phase 3
increase action potential and refractory period
prolong repolarisation
blocks beta receptors as well

22
Q

Sotalol uses

A

Supraventicular and ventricular tachycardias

23
Q

Sotalol side effects

A

pro arrhythmic
fatigue
insomnia

24
Q

Class IV examples

A

Verapamil

Diltiazem

25
Q

Class IV mechanism of action

A

Ca channel blockers during depolarisation in SAN and AVN

Slow conduction and contractility

26
Q

Class IV uses

A

Supraventricular tachycardias

27
Q

Class IV side effects

A

systole if with partial AV block
Hypotension as decrease CO or sick sinus
GI upset

28
Q

Adenosine mechanism of action

A

natural nucleoside that finds A1 receptors and activated K+ turrets in AV and SANode
potassium current activation in SAN and AVN

29
Q

Adenosine Uses

A

Used for supraventricular tachycardias, hypotension, slows AV conduction

30
Q

Vernakalant mechanism of action

A 
Blocks atrial specific K+ channels
outward channel class 3
31
Q

Vernakalant uses

A

atrial fibrillation

32
Q

Vernakalant side effects

A

Hypotension
AV block
Sneezing and taste disturbances

33
Q

Ivabradine mechanism of action

A

Block if iron current highly expressed in Sinus node

34
Q

Ivabradine uses

A

sinus tachycardia
decrease heart rate in heart failure and angina
slows sinus node but does not affect blood pressure

35
Q

Ivabradine side effects

A

flashing lights

teratogenicity

36
Q

Atropine mechanism of action

A

selective muscarinic antagonist

37
Q

Atropine uses

A

vagal bradycardia

blocks vagal activity to speed AV conduction and heart rate

38
Q

Cardiac glycoside examples

A

Digoxin

39
Q

Cardiac glycoside mechanism of action

A

Inhibits Na/k/atpase
slows heart AV node activity
Stimulates vagus

40
Q

Cardiac glycoside uses

A

Atrial fibrillation

improve contractility

41
Q

Cardiac glycoside side effects

A

digoxin toxicity

dizziness, mood changes, anxiety, GI symptoms

Pharmacology (13 decks)

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