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Pharmacology HOSA > Antiarrhythmics > Flashcards

Antiarrhythmics Flashcards

1
Q

Class 1 MOA

A

Membrane stabilizing or anesthetic effect on the cells of the myocardium

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2
Q

Class 1 indications

A

Arrhythmia, local anesthesia

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3
Q

Class 1 restrictions

A

Not for people with hyperkalemia

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4
Q

Class 1A indication and considerations

A

Arrhythmia, increase AP, QT, and ERP interval

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5
Q

Class 1A ex

A

Disopyramide, procainamide (SE: lupus), quinidine (SE: cinchonism)

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6
Q

Class 1A general side effects

A

Thrombocytopenia

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7
Q

Class 1B indications

A

Arrhythmia, post myocardial infections

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8
Q

Class 1B considerations

A

Decrease AP duration, effect ischemic tissue

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9
Q

Class 1B ex

A

Mexiletine (SE: GI upset), lidocaine (SE: CNS depression), phenytoin (SE: hirsutism)

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10
Q

Class 1C considerations

A

Used as last resort, no effect on AP duration

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11
Q

Class 1C ex

A

Propafenone, flecainide

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12
Q

Class 1C restrictions

A

Not for post myocardial infarction

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13
Q

Class 3 indications

A

Arrhythmia

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14
Q

Class 3 considerations

A

Increase AP duration, ERP, and QT interval

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15
Q

Class 3 ex

A

Amiodarone (LFT, dirty drug), ibutilide, dofetilide, sotalol (beta blocker), dronedarone

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16
Q

Class 4 indications

A

SVT, subarachnoid hemorrhage

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17
Q

Class 4 considerations

A

Decrease conduction velocity, increase PR interval, and ERP

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18
Q

Class 4 ex

A

Verapmil, dilitazem, nimodipine

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19
Q

Class 4 side effects

A

Cardiovascular, constipation, swelling in lower limbs

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20
Q

Adenosine MOA

A

Slows AV conduction

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21
Q

Adenosine indications

A

Bradycardia, flushing, dyspnea

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22
Q

Adenosine interactions

A

Caffeine and theophylline decrease effects, dipyridamole increases effects

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23
Q

Lidocaine indications

A

Ventricular arrhythmia, anesthetic

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24
Q

Lidocaine side effects

A

Paresthesias, seizures, respiratory depression, drowsy

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25
Q

Lidocaine interactions

A

Anesthetic effect increase with epinephrine

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26
Q

Magnesium sulfate MOA

A

Muscle relaxant

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27
Q

Magnesium sulfate indications

A

Preterm labor contractions, preeclampsia

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28
Q

Magnesium sulfate side effects

A

Warm feeling, low blood pressure, less deep tendon reflexes, decreased respiratory rate, decreased urine output, paralytic ileus

29
Q

Magnesium sulfate antidote

A

Calcium gluconate

30
Q

Atrial flutter

A

Type of arrhythmia, rapid contraction of the atria at a rate too fast for the ventricles to pump efficiently

30
Q

Atrial fibrillation

A

Type of arrhythmia, irregular and rapid atrial contraction, resulting in a quivering of the atria and causing an irregular and inefficient ventricular contraction

30
Q

PVCs

A

Type of arrhythmia, beats originating in the ventricles instead of the SA node in the atria, causing the the ventricles to contract before the atria, and resulting in a decrease in the amount of blood pumped to the body

30
Q

Ventricular tachycardia

A

Thyme of arrhythmia, a rapid heartbeat of usually more than 100 bpm, usually originating in the ventricles

31
Q

Ventricular fibrillation

A

Type of arrhythmia, rapid, disorganized contractions of the ventricles, resulting in the inability of the heart to pump any blood to the body, which will result in death unless treated immediately

32
Q

Class 1A MOA

A

Prolong action potential, produce moderate slowing of cardiac conduction

33
Q

Disopyramide MOA

A

Decreases depolarization of myocardial fibers, prolongs the refractory period, and increased the action potential duration of cardiac cells

34
Q

Qunidine MOA

A

Depresses myocardial excitability, decreasing the pulse rate and correcting the heartbeat

35
Q

Class 1B MOA

A

Shorten the action potential duration, and selectively depress cardiac conduction

36
Q

Lidocaine antiarrhythmic MOA

A

Decreases diastolic depolarization, decreases automaticity of ventricular cells and raises the threshold of the ventricular myocardium

37
Q

Class 1C MOA

A

Slight effect on repolarization, and profound slowing of conduction

38
Q

Flecainide MOA

A

Depresses fast sodium channels, decreases the height and rate of rise of action potentials and slows conduction of all areas of the heart

39
Q

Propafenone MOA

A

Direct membrane stabilizing effect on the myocardial membrane, prolongs the refractory period

40
Q

Class 2 MOA

A

Beta blockers, indirectly block calcium channels and block catecholamine caused arrhythmias, and also have membrane stabilizing effects

41
Q

Class 3 MOA

A

Prolongation of repolarization

42
Q

Amiodarone MOA

A

Acts directly of the cardiac cell membrane, prolonging the refractory period and repololarization and increasing the ventricular fibrillation threshold

43
Q

Inutilice MOA

A

Prolonging the action potential, producing a mild slowing of the sinus rate and AV conduction

44
Q

Class 4 MOA

A

Depressing depolarization, lengthening phase 1 and 2 of repolarization

45
Q

Verapmil MOA

A

Inhibit the movement of calcium through channels across the myocardial cell membranes and vascular smooth muscle, and slows conduction through the SA and AV nodes

46
Q

Antiarrhythmics use

A

Premature ventricular contractions (PVCs), ventricular tachycardia, premature atrial contractions, paroxysmal atrial tachycardia, other atrial arrhythmias (atrial fibrillation or flutter), tachycardia when rapid, but short term control of ventricular rate is desirable

47
Q

Propanolol use

A

Myocardial infarction

48
Q

Antiarrhythmics general side effects

A

Lightheadedness, weakness, somnolence, hypotension, arrhythmias, bradycardia, urinary retention, local inflammation

49
Q

Who is at the highest risk for proarrhythmic effect

A

People that are given excessive dosages, when pre-existing arrhythmia is life threatening or when the drug is given IV

50
Q

Antiarrhythmics contraindications

A 
Pregnancy and lactation, 2nd or 3rd degree 
AV block (if there is no pacemaker), severe heart failure, aortic stenosis, hypotension and cardiogenic shock
51
Q

Quinidine contraindications

A

Myasthenia gravis, systemic lupus erythematosus

52
Q

Amiodarone pregnancy cat

A

D

53
Q

Antiarrhythmics precautions

A

Hepatic disease, electrolyte disturbances, renal impairment, pregnancy (cat B or C), lactation, children

54
Q

Disopyraminde precautions

A

Heart failure, myasthenia gravis, urinary retention, glaucoma, men with prostate enlargement

55
Q

Quinidine precautions

A

Heart failure

56
Q

Flecainide precautions

A

Heart failure

57
Q

Disopyramide interactions

A

Clarithromycin and erythromycin and quinidine increase serum disopyramide levels, flouroquinolones and thioridazine and ziprasidone increase risk of life threatening arrhythmias, rifampin decreases disopyramide serum levels,

58
Q

Quinidine interactions

A

Cholinergic cause failure to terminate paroxysmal supraventricular tachycardia, cimetidine increases serum quinidine levels, hydantoins decrease therapeutic effect of quinidine, nifedipine decreases quinidine action and serum level, and cholinergic blocking drugs have an additive vagolytic effect

59
Q

Lidocaine interactions

A

Beta blockers increase lidocaine levels, and cimetidine decreases lidocaine clearance with possible toxicity

60
Q

Flecainide interactions

A

Amiodarone and cimetidine increase serum flecainide levels, disopyramide and verapmil May increase negative inotropic properties, increased serum level of beta blockers, which also results in increased serum levels of flecainide, and additive negative inotropic effects, local anesthetics increase risk of CNS reactions, anticoagulants increase prothrombin time and increase plasma anticoagulant levels, increased serum digoxin level, and increased serum theophylline level

61
Q

Propafenone interactions

A

Quinidine and SSRIs increase serum propafenone levels,

62
Q

When to withhold oral antiarrhythmics

A

When pulse rate is above 120 or below 60

63
Q

Antiarrhythmics elderly considerations

A

Greater risk for side effects, such as, additional arrhythmias, aggravation of existing arrhythmias, hypotension and heart failure

64
Q

Signs of cinchonism

A

Tinnitus, hearing loss, headache, nausea, dizziness, vertigo, and lightheadedness

65
Q

Class 2 ex

A

Beta blockers (acebutolol, propanolol)

Pharmacology HOSA (37 decks)

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