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CVS Pharmaco > Antiarrythmic Drugs > Flashcards

Antiarrythmic Drugs Flashcards

1
Q

Name the 5 phases of an action potential

A

Phase 0: Upstroke
Phase 1: Early-fast repolarisation
Phase 2: Plateau
Phase 3: Repolarisation
Phase 4: Diastole

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2
Q

Define excitability

A

Cell can change its internal electrical balance to reach threshold

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3
Q

Define automaticity

A

Cell can generate an electrical impulse without itself being stimulated

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4
Q

Define conductivity

A

Cell can transfer an electrical impulse to the next cell

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5
Q

Name the 6 classes of antiarrythmic drugs

A

Class 1A
Class 1B
Class 1C
Class II
Class III
Class IV

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6
Q

Class I antiarrythmics are ____ blockers

A

Sodium channel

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7
Q

Class II antiarrythmics are ____ blockers

A

Beta

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8
Q

Class III antiarrythmics are ____ blockers

A

Potassium channel

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9
Q

Class IV antiarrythmics are ____ blockers

A

Calcium channel (Non-DHP)

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10
Q

State the duration of actions of class 1A, 1B and 1C antiarrhythmics

A

1A: Intermediate acting
1B: Fast acting
1C: Slow acting

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11
Q

Name a class 1A antiarrhythmic

A

Procainamide

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12
Q

Effect of procainamide on phases

A

Reduces rate of phase 0 rise

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13
Q

Effect of procainamide on conductivity

A

Reduces

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14
Q

Effect of procainamide on automaticity

A

Reduces

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15
Q

Effect of procainamide on ERP

A

Increases

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16
Q

Effect of procainamide on APD

A

Increases

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17
Q

Name a class 1B antiarrhythmic

A

Lidocaine

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18
Q

Effect of lidocaine on phases

A
  1. Reduces rate of phase 0 rise
  2. Shortens phase 3 repolarisation
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19
Q

Effect of lidocaine on conductivity

A

Little effect

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20
Q

Effect of lidocaine on automaticity

A

Reduces

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21
Q

Effect of lidocaine on ERP

A

No change

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22
Q

Effect of lidocaine on APD

A

Reduces

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23
Q

Name a class 1C antiarrhythmic

A

Flecainide

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24
Q

Effect of flecainide on phases

A
  1. Reduces rate of phase 0 rise
  2. Shortens phase 3 repolarisation
25
Effect of flecainide on conductivity
Reduces
26
Effect of flecainide on automaticity
Reduces
27
Effect of flecainide on ERP
No / little effect
28
Effect of flecainide on APD
No / little effect
29
State a specific clinical use of a class 1C antiarrhythmic like flecainide
Refractory ventricular tachycardias that tend to progress to ventricular fibrillation
30
Name 2 examples of class 2 antiarrhythmics
Beta blockers: 1. Metoprolol 2. Propanolol
31
Effect of beta blockers on phases
Reduces phase 4 depolarisation
32
Effect of beta blockers on conductivity
Prolongs AV conduction
33
Effect of beta blockers on automaticity
Reduces
34
Effect of beta blockers on ERP
No change
35
Effect of beta blockers on APD
No change
36
General sympatholytic effect of beta blockers on the heart
Reduce heart rate and contractility of the heart
37
4 specific clinical uses of beta blockers as an antiarrhythmic
1. Atrial fibrillation 2. AV nodal reentrant tachycardia 3. Tachycardia caused by sympathetic activation 4. Reduces sudden arrhythmic death post myocardial infarction
38
Name a class 3 antiarrhythmic
Amiodarone
39
Effect of amiodarone on phases
Prolongs phase 3 repolarisation without effect on phase 0
40
Effect of amiodarone on ERP
Increase
41
Effect of amiodarone on APD
Increase
42
Besides blocking potassium channels, state 3 other MOA of amiodarone
1. Block sodium channels 2. Blocks adrenergic receptors 3. Block calcium channels
43
Amiodarone is metabolised in the ___ to the active metabolite ___
Liver, Desethylamiodarone
44
State 2 clinical uses of amiodarone
1. Effective in maintaining normal sinus rhythm in patients with atrial fibrillation 2. Effective in prevention of reentrant ventricular tachycardia
45
State 2 ADRs of amiodarone use
1. Symptomatic bradycardia 2. Heart block
46
State 2 examples of a class IV antiarrhythmic
Non-DHP Calcium channel blockers: 1. Verapamil 2. Diltiazem
47
Effects of non-DHP CCBs on phases
Prolongs phase 4 depolarisation
48
Effect of non-DHP CCB on AV node conduction
Reduces conductivity on AV node
49
Effect of non-DHP CCB on ERP
Increase
50
Effect of non-DHP CCB on APD
Increase
51
State 3 clinical uses of verapamil
1. Supraventricular tachycardia 2. Hypertension (use DHP CCB as a first line instead) 3. Angina
52
Verapamil is contraindicated in patients with ___
Preexisting depressed cardiac function
53
State an adverse effect of verapamil use
Hypotension
54
State 2 effects on calcium and potassium that adenosine has in the heart
1. Stimulates cardiac K+ channels 2. Inhibits calcium current
55
State 2 cardiac effects of adenosine
1. Suppression of atrioventricular nodal conduction 2. Increase AV nodal refractory period
56
Half life of adenosine in blood
Less than 10 seconds
57
State a clinical use of adenosine
Supraventricular tachycardia
58
State 5 adverse effects of adenosine use
1. Flushing 2. Shortness of breath / Chest burning 3. Induction of AV block or AF 4. Headaches 5. Hypotension

CVS Pharmaco (6 decks)

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