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Semester 1 Quizzes > Antiarrhythmics Classes I-V - QUIZZES > Flashcards

Antiarrhythmics Classes I-V - QUIZZES Flashcards

1
Q

Procainamide does all of the following except:

a) Decreases myocardial tissue excitability
b) Increases action potential duration
c) Blocks potassium channels
d) Blocks fast sodium channels
e) Increases conduction velocity

A

e) Increases conduction velocity

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2
Q

Class 1a antiarrhythmics block both sodium and potassium channels leading to which of the following cardiotoxic effects:

Select all that apply.

a) QT shortening
b) QRS narrowing
c) QRS widening
d) QT prolongation

A

c) QRS widening

d) QT prolongation

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3
Q

Class 1b agents such as lidocaine also exert potassium channel effects. True or False?

A

False

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4
Q

Sodium channel blocking agents show “state dependent” affinity. Which of the following is true regarding their affinity?

a) Procainamide has low affinity for inactive channels
b) Lidocaine effects inactive and open channels
c) Class 1 agents like procainamide have high affinity for rested channels
d) Lidocaine has high affinity for strictly rested channels

A

b) Lidocaine effects inactive and open channels

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5
Q

Procainamide is useful in re-entry tachyarrhythmias through which of the following:

a) Through increasing effective refractory period
b) Through decreasing effective refractory period
c) Through increasing conduction velocity
d) Through decreasing action potential duration

A

a) Through increasing effective refractory period

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6
Q

Which of the following is the least cardiotoxic Class I antiarrhythmic?

a) Quinidine
b) Flecainide
c) Procainamide
d) Lidocaine

A

d) Lidocaine

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7
Q

Which of the following is true regarding precautions with Class 1 antiarrhythmic administration?

a) Procainamide has profound nervous system effects
b) Lidocaine should not be administered in conjunction with QT prolonging medications
c) Procainamide should not be given to those with hepatic failure
d) Hepatic failure increases the risk of Lidocaine toxicity

A

d) Hepatic failure increases the risk of Lidocaine toxicity

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8
Q

Beta blockers are a generic group of medications, which act exactly the same, throughout the class. True or False?

A

False

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9
Q

Beta-blockers are classified according to the adrenoreceptor binding affinities as well as: (select all that apply)

a) Ability to block sodium and potassium channels
b) Selectivity
c) Distribution
d) Elimination percentage

A

b) Selectivity

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10
Q

Beta-blockers exert their effects by:

a) Competitively binds to beta receptors – decreasing intracellular K
b) Non-Competitively binds to beta receptors – decreasing extracellular calcium
c) Competitively binds to beta receptors decreasing cAMP mediated calcium
d) Non-competitive agonism of catecholamines – slowing conduction through conduction tissues

A

c) Competitively binds to beta receptors decreasing cAMP mediated calcium

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11
Q

Please select the Beta 1 effects of Beta Blockers:

a) Bronchodilation
b) Decreased action potential duration
c) Decreased insulin resistance
d) Increased peripheral vascular resistance
e) Increased action potential duration
f) Decreased contractility
g) Decreased conduction velocity

A

e) Increased action potential duration
f) Decreased contractility
g) Decreased conduction velocity

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12
Q

Which of the following explains the mechanism behind Beta-blockers termination of tachyarrhythmias:

a) Increased pacemaker automaticity
b) Decreased contractility
c) Increased conduction velocity
d) Decreased pacemaker and myocyte automaticity

A

d) Decreased pacemaker and myocyte automaticity

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13
Q

Beta blockers such as Sotalol show effects from other classes of antiarrhythmics.

True or False?

A

True

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14
Q

Class III agents exert antiarrhythmic effects through which of the following mechanisms:

a) Blockade of Potassium channels in phase 2 increasing action potential duration
b) Blockade of Potassium channels in phase 0 increasing membrane voltage potential
c) Blockade of Potassium channels in Phase 1 decreasing action potation duration
d) Blockade of Potassium channels in Phase 3 prolonging action potential duration

A

d) Blockade of Potassium channels in Phase 3 prolonging action potential duration

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15
Q

Amiodarone is a class III antiarrhythmic that also exert which of the following effects from other antiarrhythmic classes:

(Select all that apply)

a) Alpha adrenergic blockade
b) Magnesium channel blockade
c) Calcium channel blockade
d) Beta adrenergic blockade
e) Acetylcholine blockade
f) Sodium channel blockade

A

a) Alpha adrenergic blockade
c) Calcium channel blockade
d) Beta adrenergic blockade
f) Sodium channel blockade

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16
Q

Sotalol is also a class III antiarrhythmic with which of the following effects:

a) Sodium Channel blockade
b) Alpha adrenergic antagonism
c) Beta adrenergic antagonism
d) Calcium Channel blockade

A

c) Beta adrenergic antagonism

17
Q

Amiodarone has highly variable and erratic parenteral absorption and distribution. True or False?

A

False

18
Q

Amiodarone has antiarrhythmic and proarrhythmic effects. It’s proarrhythmic effects are a result of:

a) Class II effects
b) Class IV effects
c) Class III effects
d) Class I effects

A

d) Class I effects

19
Q

Amiodarone has numerous drug interaction including which of the following:

(Select all that apply)

a) Potentiates effects of TXA
b) Increased concentrations of Digoxin
c) Increased pro-arrhythmic effects with QT prolonging medications
d) decreased concentrations of Digoxin
e) Potentiates effects of warfarin

A

b) Increased concentrations of Digoxin
c) Increased pro-arrhythmic effects with QT prolonging medications
e) Potentiates effects of warfarin

20
Q

The following are adverse outcomes associated with Amiodarone, except:

a) Torsade de Pointe
b) Pulmonary Fibrosis
c) Hypothyroidism
d) Hypertension

A

d) Hypertension

21
Q

All of the following are true regarding Calcium channel blockers except:

a) Act exclusively on L-Type Calcium Channels in smooth muscle
b) Decrease inotrope
c) Play an important role in phase 0 action potential
d) Further divided into Dihydropyridine and Non-Dihydropyridine

A

a) Act exclusively on L-Type Calcium Channels in smooth muscle

22
Q

Non-Dihydropyridine CCB have high selectivity for vascular smooth muscle.

True or False?

A

False

23
Q

Which of the following is considered a contraindication to Diltiazem?
Select all that apply.
a) Severe hypotension or cardiogenic shock
b) All of the options
c) Pregnancy
d) Second or Third degree AV block without pacemaker
e) Administration concomitantly or within a few hours of beta blocking agents

A

b) All of the options

24
Q

Diltiazem has which of the following effects:
Select all that apply.
a) Arterial dilation
b) Decreased inotrope
c) Increase effective refractory period in AV node and myocytes
d) Decrease effective refractory period in AV node
e) Increased chronotropy

A

a) Arterial dilation
b) Decreased inotrope
c) Increase effective refractory period in AV node and myocytes

25
Q

Nifedipine and other Dihydropyridine CCB exert which of the following:

a) Vascular smooth muscle contraction
b) Venodilator
c) Decrease cardiac conduction
d) Vascular smooth muscle relaxation

A

d) Vascular smooth muscle relaxation

26
Q

List the adverse outcomes from the following drug combinations:

a) Diltiazem + Beta Blockers w/in 2-3 hours
b) Diltiazem + Carbamazepine
c) Diltiazem + Dantrolene

A

a) Diltiazem + Beta Blockers w/in 2-3 hours: asystole
b) Diltiazem + Carbamazepine: decreased Diltiazem serum concentrations
c) Diltiazem + Dantrolene: hyperkalemia

27
Q

Cells in various parts of the heart show differing sensitivities to Digitalis through either direct or neural mediated effects. True or False?

A

True

28
Q

Which of the following mechanisms describes Digitalis’ antiarrhythmic properties?

a) Increased vagal efferent activity leading to decreased SA node firing and conduction velocity
b) Decreased vagal efferent activity leading to decreased SA node firing and conduction velocity
c) Increased intracellular calcium leading to prolonged action potential duration
d) Decreased intracellular calcium leading to prolonged action potential duration

A

a) Increased vagal efferent activity leading to decreased SA node firing and conduction velocity

29
Q

List the adverse interactions with the following medication interactions:

a) Digitalis + Quinidine
b) Digitalis + Amiodarone
c) Digitalis + Diuretics
d) Digitalis + Clarithromycin

A

a) Digitalis + Quinidine: dereased renal & non-renal excretion of digitalis
b) Digitalis + Amiodarone: increased steady state digitalis concentration
c) Digitalis + Diuretics: increased risk of toxicity through hypokalemia
d) Digitalis + Clarithromycin: increased digitalis levels d/t alterations in gut flora

30
Q 
Incidence of adverse reactions due to Digoxin are high owing to: 
Select all that apply.
a) Narrow therapeutic index 
b) Difficult to metabolize and clear 
c) Variable oral bioavailability and distribution 
d) Shortened action potential duration
e) Poor tissue absorption 
f) Wide ranging drug interactions
A

a) Narrow therapeutic index
c) Variable oral bioavailability and distribution
d) Shortened action potential duration
f) Wide ranging drug interactions

31
Q

Digoxin may cause virtually all known arrhythmias, however the following ECG changes should raise suspicion for Digitalis toxicity, except:

a) Diminished impulse conduction
b) Global swooping ST depression
c) Increased automaticity
d) Decreased automaticity

A

d) Decreased automaticity

32
Q

Digifab works to terminate Digitalis tox related arrhythmia through:

a) Antagonism of the vagus efferent channels
b) Antagonism of calcium receptors
c) Higher affinity for Digoxin than it for the receptor sites
d) Higher affinity for potassium binding sites

A

c) Higher affinity for Digoxin than it for the receptor sites

33
Q 
Digibiind or Digoxin-specific antibody fragments can be given in severe Digitalis toxicity. Which of the following are potential complications of the administration: 
Select all that apply.
a) Atrial fibrillation 
b) Hyperkalemia 
c) Heart failure 
d) Hypokalemia 
e) Anaphylaxis
A

a) Atrial fibrillation
c) Heart failure
d) Hypokalemia
e) Anaphylaxis

34
Q

Adenosine exerts its electrophysiological effects via:

a) B2
b) A1
c) A2
d) B1

A

b) A1

35
Q

Which of the following are effects of Adenosines action:
Select all that apply.
a) Membrane hyperpolarization in the SA node
b) Inhibits the release of Norepinephrine
c) Increased slope of phase 4 of action potential
d) Increase beta-adrenoreceptor response to catecholamines
e) Reduced action potential duration
f) Inhibits L type Calcium channels decreasing conduction velocity

A

a) Membrane hyperpolarization in the SA node
b) Inhibits the release of Norepinephrine
e) Reduced action potential duration
f) Inhibits L type Calcium channels decreasing conduction velocity

36
Q

Adenosine has an exceptionally long half-life. True or False?

A

False

37
Q

Due to its mechanism of action, Adenosine is useful in terminating all of the following arrhythmia, except:

a) PSVT
b) AVNRT
c) Atrial Fibrillation
d) AVRT

A

c) Atrial Fibrillation

38
Q

Magnesium Sulfate administration Is indicated in which of the following arrhythmias:
Select all that apply.
a) PSVT
b) Any serious Atrial or Ventricular tachycardia in the setting of hypomagnesemia
c) Monomorphic Ventricular Tachycardia
d) Polymorphic Ventricular Tachycardia
e) Prolonged QTc

A

b) Any serious Atrial or Ventricular tachycardia in the setting of hypomagnesemia
d) Polymorphic Ventricular Tachycardia
e) Prolonged QTc

39
Q

Which of the following are correct regarding precautions with Magnesium administration?

a) Use in extreme caution in patients with pulmonary hypertension
b) Use in extreme caution in patients with Hyperthyroidism
c) Use in extreme caution in patients with Hepatitis
d) Use in extreme caution in patients with neuromuscular disease

A

d) Use in extreme caution in patients with neuromuscular disease

Semester 1 Quizzes (42 decks)

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