Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > Antiarrhythmics > Flashcards

Antiarrhythmics Flashcards

1
Q

How do you identify A fib?

A

irregularly irregular rhythm, NO P WAVES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Rate of A fib vs A flutter

A

A fib: usually 100-140 bpm

A flutter: >140 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are class I antiarrhythmics

A

Na channel blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Na channel blocker examples most often used (according to Kim’s notes)

A

Flecanide (tambacor)

Rythmol (propafenone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are class II antiarrhythmics

A

beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

beta blocker examples

A

lopressor/Metoprolol - go to agent
Carvedilol/Coreg
atenolol (Tenormin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are class III antiarrhythmics

A

potassium channel blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

potassium channel blocker examples

A

dofetilide (Tikosyn)
sotalol (beta pace)
amiodarone
dronedarone (Multaq)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

special considerations with potassium channel blockers

A

pt must be admitted to hospital for observation when initiating medication b/c can cause QT prolongation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

potassium channel blocker CI

A
  1. renal dysfunction

2. many drug interactions (other drugs that cause QT prolongation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Special considerations for amiodarone

A

very effective but lots of bad side effects

only use short-term or in elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do you have to test when giving amiodarone

A
  1. thyroid
  2. PFTs
  3. Liver function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are class IV antiarrhythmics

A

non-dihydropyridine calcium channel blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

non-dihydropyridine calcium channel blocker examples

A

verapamil (calan)

diltiazem (cardizem)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of arrhythmia

A
  1. Coronary artery disease/MI
  2. altered impulse formation (ectopic foci, changes in automaticity)
  3. altered impulse conduction (block of conduction)
  4. heart failure
  5. drug/medication induced
  6. electrolyte disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Three R’s of arrhythmia management

A
  1. rate control
  2. rhythm control
  3. risk of stroke/need for anticoagulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Sodium Channel Blockers MOA

A

block Na channels –> slower conduction of AP
1A - moderate slowing
1B - minimal slowing
1C - maximal slowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Subclass 1A of Sodium Channel Blockers indications

A

atrial and ventricular arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Subclass 1A of Sodium Channel Blockers examples

A

procainamide

quinidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Risk factors for A fib

A

HTN, DM, obesity, sleep apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

paroxysmal A fib

A

goes about 48 hours then stops by itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Sodium channel blockers classes

A

1A, 1B, 1C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Sodium channel blockers MOA

A

slow conduction –> influence QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where is quinidine initiated

A

hospital setting b/c can prolong QT interval, risk for ventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Quinidine S/E
severe GI upset, diarrhea
26
Quinidine drug interactions
digoxin | warfarin
27
1B Sodium channel blockers indications
ventricular arrhythmias
28
1B Sodium channel blockers examples and route of administration
Lidocaine (Xylocaine) - IV | Mexiletine - oral
29
Mexiletine initiation setting
often in hospital but can be outpatient
30
Mexiletine S/E
Tremor, seizure, N/V
31
1C Sodium channel blockers MOA
prolongs the AV node refractory period
32
1C Sodium channel blockers indications
a fib
33
1C Sodium channel blockers CIs
CAD, MI, LV dysfunction, ischemic arrhythmia, decreased EF
34
1C Sodium channel blockers examples
propafenone (rhythmol) | flecainide (tambocor) - will see a lot!
35
Flecainide initiation setting
outpatient
36
monitoring when giving flecainide
exercise stress test w/o imaging 1-2 weeks after initiation to evaluate possible QRS widening
37
what must you always prescribe with flecainide
a rate controlling agent
38
Flecainide S/E
dizziness, headache, blurred vision
39
Beta Blockers MOA
decrease automaticity, slow conduction velocity, prolongs refractory period (depresses AV node)
40
metoprolol forms and differences
Metoprolol tartrate: short acting, dosed BID (don't use if LV dysfunction) Metoprolol succinate: long acting, dosed QD
41
Beta Blocker side effects
1. fatigue 2. GI disturbances 3. insomnia, nightmares 4. lethargy 5. erectile dysfunction 6. bradycardia
42
Potassium Channel Blockers MOA
blocks potassium channels in phase 3 of AP --> slows efflux of K back out of myocyte --> lengthens plateau phase
43
Dofetilide (Tikosyn) initiation setting
hospital 72 hour admission (continuous telemetry, regular ECG, daily BMP)
44
Dofetilide (Tikosyn) indications
a fib
45
Dofetilide (Tikosyn) S/E
QT prolongation | Torsades
46
Dofetilide (Tikosyn) drug interactions
thiazide diuretics
47
downside to Dofetilide (Tikosyn)
have to monitor ECG and BMP every 6 months
48
sotalol initiation setting
hospital 72 hour admission - daily ECG, BMP, continuous telemetry
49
sotalol indications
atrial and ventricular arrhythmias
50
amiodarone indications
most effective of antiarrhythmic drugs
51
amiodarone s/e
liver, thyroid, GI, skin, CNS (tremor), visual (corneal deposits, optic neuropathy), photosensitivity, pulmonary fibrosis
52
What do you have to get before starting amiodarone
baseline thyroid labs, LFTs, PFTs w/ DLCO
53
what do you have to monitor when taking amiodarone
LFTs, TSH, CXR, PFTs every 6 months
54
how long does it take amiodarone to leave the body
6 weeks
55
amiodarone cardiac SE
bradycardia heart block Hypotension
56
amiodarone noncardiac SE
``` pulmonary fibrosis thyroid dysfunction (MC) blue skin nausea constipation anorexia liver damage ```
57
what is dronedarone / multaq and where is it initiated
modified amiodarone molecule (deionization) - can be started outpatient
58
dronedarone / multaq CIs
hx of heart failure!!!! or permanent AF
59
calcium channel blockers MOA
blocks calcium channels in phase 0 of AP --> slower pacemaker in SA node, longer refractory period in AV node
60
diltiazem/cardizem is often given for
rapid A fib in ER
61
diltiazem/cardizem SE
headache, dizziness, bradycardia
62
important things to remember when giving diltiazem/cardizem
take thorough history monitor labs q6 months - serum electrolytes, renal function routine monitoring of renal and hepatic function ECG every 6-12 mo
63
which version of metoprolol do you give for heart failure
long acting version - succinate
64
what is MC beta blocker used for CHF and A fib
carvedilol
65
carvedilol vs. metoprolol
carvedilol often well tolerated but not as strong for limiting rate as metoprolol
66
CI for atenolol
poor kidney function
67
What do you need to watch for with tikosyn/dofetilide
hypokalemia, magnesium labs
68
CI for tikosyn/dofetilide
kidney dysfunction - could build up and cause QT prolongation
69
drug interactions with tikosyn
A LOT | zofran, tagamet, etc.
70
CI for sotalol
kidney impairment - will build up and cause QT prolongation, bradycardia
71
dosing for amiodarone
have to take higher dose initially to build it up in the system then gradually drop down to lower dose over 1 month to reach maintenance dose
72
amiodarone uses by age
give to old people | young: used peri-procedurally for ablation, ideally <12 month, bridge therapy
73
sign of amiodarone toxicity
SOB + regular rhythm
74
warfarin indications
prophylaxis for DVT, PE, post-MI, mechanical valves!
75
warfarin dosing
must be adjusted to each pt's metabolism, INR response
76
what does CHADS2-VASc stand for
``` CHF HTN Age 75+ (2) DM Prior stroke or TIA (2) vascular disease Age 65-74 Sex category - female ```
77
scoring for CHADS2-VASc
2+ for men | 3+ for women
78
what does HAS-BLED stand for
``` HTN Abnormal renal and liver function (1 each) Stoke Bleeding Labile INR Elderly (>65) Drugs or alcohol (1 each) ```
79
HAS-BLED score
3+ = high risk
80
oral anticoagulants
1. vitamin K antagonist 2. direct thrombin inhibitors 3. factor Xa inhibitors
81
vitamin K antagonist example
warfarin
82
direct thrombin inhibitors example
dabigatran / pradaxa
83
factor Xa inhibitor examples
rivaroxiban / xarelto apixaban / eliquis endoxaban / savaysa
84
how long does it take warfarin to become effective
48-72 hours
85
DOAC indications
prevention of thromboembolism in non-valvular A fib treatment of DVT/PE a fib
86
DOAC examples
pradaxa xarelto eliquis savaysa
87
DOAC with most indications and most dosages available
xarelto
88
DOAC CIs
``` active pathological bleeding known hypersensitivity mechanical prosthetic heart valves severe renal dysfunction severe hepatic impairment P-gp and strong CYP34A inhibitors or inducers ```
89
reversal agent for warfarin and how fast does it work
phytonadione (vitamin k), 12-24 hours fresh frozen plasma prothrombin complex concentrate
90
reversal agent for pradaxa
idarucizumab
91
what is triple therapy for a fib
warfarin, aspirin, clopidogrel | goes INR is 2-2.5
92
antiplatelets vs. anticoagulants (the ones we talked about)
antiplatelets for artery things | anticoagulants for venous things
93
who is eliquis really good for?
patients >80, also renal dysfunction
94
special consideration for xarelto
requires protein for absorption (Take with biggest meal of day at consistent time)
95
when do DOACs become effective after given
2 hours after dosing
96
reversal agent for Xarelto and eliquis
andexxa

Pharmacology (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions