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Step 1 cardiology > Antiarrythmics > Flashcards

Antiarrythmics Flashcards

1
Q

Sodium channel blockers (class I)

A

slow or block conduction(esp in depol cells).

dec slope of phase 0 depol.

State dependent (selectively depress tissue that is frequently depol)

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2
Q

Class 1a list

A

Quinidine, Procainamide, Disopyramide

“The Queen Proclaims Diso’s Pyramid.”

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3
Q

Class I MOA

A

increase: AP duration, effective refractory period in ventricular action potential, QT interval

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4
Q

Class I use

A

atrial and ventricular arrhythmias (esp. re-entrant and ectopic SVT and VT)

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5
Q

Class I ADR

A

thrombocytopenia, torsades de pointes due to inc QT interval

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6
Q

quinidine ADR

A

cinchonism (HA, tinnitus)

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7
Q

procainamide ADR

A

reversible SLE-like sx

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8
Q

disopyramide ADR

A

heart failure

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9
Q

Class 1b list

A

Lidocaine, Mexiletine

Phenytoin can be classified here

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10
Q

Class 1b MOA

A

dec AP duration.

preferentially affect ischemic or depol. Purkinje and ventricular tissue

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11
Q

Class 1b use

A

acute ventricular arrhythmias (esp post MI)

digitalis-induced arrhythmias

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12
Q

Class 1b ADR

A

CNS stimulation/depression, CV depression

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13
Q

Class 1C list

A

flecinide, propafenone

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14
Q

Class 1c MOA

A

significantly prolongs ERP in AV node and accessory bypass tracts.

no effect on ERP in Purkinje and ventricular tissue.

minimal effect on AP duration

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15
Q

Class 1C use

A

SVTs, including afib

only as last resortin refractory VT

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16
Q

Class 1C contraindications

A

proarrhythmic, esp post-MI (contraindictated)

structural and ischemic heart disease

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17
Q

Antiarrhythmics Class II (BB) list

A

metoprolol, propranolol, esmolol, atenolol, timolol, carvedilol

18
Q

BB MOA

A

dec. SA and AV nodal activity by dec cAMP, Ca currents.

Suppress abnormal pacemakers by dec slope of phase 4

AV node particularly sensitive, inc. PR interval.

19
Q

BB use

A

SVT, ventricular rate control for afib and atrial flutter

20
Q

BB ADR

A

impotenence; exacerbation of COPD and asthma; bradycardia/AV block/HF; sedation, sleep alterations; may mask sx of hypoglycemia

21
Q

Metoprolol ADR

A

dyslipidemia

22
Q

Propanolol ADR

A

exacerbate vasospasm in prinzmetal angina

23
Q

BB contraindications

A

pheochromocytoma, cocaine toxicity

cause unopposed a1-agonism if given alone

24
Q

BB OD tx

A

saline, atropine, and glucagon

25
Q

Antiarrhythmics Class III (KCl channel blockers) list

A

amiodarone, ibutilide, dofetilide, sotalol

“AIDS”

26
Q

KCl channel blockers MOA

A

increased: AP duration, ERP, QT interval

27
Q

KCl channel blockers use

A

afib, atrial flutter

28
Q

Amiodarone, sotalol use

A

ventricular tachycardia

29
Q

Sotalol ADR

A

torsades de pointes, excessive B blockade

30
Q

Ibutilide ADR

A

torsades de pointes

31
Q

Amiodarone ADR

A

check PFTS, LFTS, TFTS*
pulmonary fibrosis, hepatotox, thyroidism, corneal deposits, blue/gray skin deposits resulting in photodermatitis, neuro effects, constipation, bradycardia/heart block/HF

32
Q

Why is amiodarone special?

A

lipophilic, has class I-IV effects

33
Q

Antiarrhythmics Class IV (Ca channel blockers) list

A

verapamil, diltiazem

34
Q

Ca Channel blockers MOA

A

dec conduction velocity

inc ERP, PR interval

35
Q

Ca channel blockers use

A

prevention of nodal arrhythmias (eg SVT)

rate control in afib

36
Q

Ca channel blockers ADR

A

constipation, flushing, edema, HF/AV block/sinus node depression

37
Q

Other antiarrythmics

A

adenosine, MG

38
Q

adenosine MOA

A

inc K+ out of cells –> hyperpolarizing the cell and dec Ica

39
Q

Adenosine use

A

dx/terminating certain forms of SVT (very short acting)

40
Q

Adenosine antagonists

A

theophylline, caffeine

41
Q

Adenosine ADR

A

flushing, hypotension, chest pain, sense of impending doom, bronchospasm

42
Q

Mg2+ use

A

effective in torsade de pointes and digoxin toxicity

Step 1 cardiology (2 decks)

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