Antiarrythmics Flashcards
Even though it’s Class 3, ____ is also a non-selective Betablocker that can block K+.
Sotalol
______ is the most effect Anti-AR drug likely because it can block Na, Ca, K, and Beta-Adrenoceptors
Amiodarone
Calcium channel blockers greatly decrease phase ____ slope
4
Mnemonic for Class 3 Antiarrhythmics?
“Is Bad”
Adenosine does what 3 things to cause Negative Hyperpolarization and suppression of calcium-dependent APs?
- Activate Inward rectifier K+ current to boot out potassium
- Inhibit Calcium Channel
- Inhibit Funny Current
Beta blockers are contraindicated in patients with ________
Wolf-Parkinson-White Syndrome
Anything that blocks Potassium (such as Type 1) can cause which key adverse effect?
Torsade De Pointes
Conduction gets slowed too much
How is Esmolol different than propranolo.?
- Selective B1 antagonist
- Ultra Rapid half-life of 9 minutes!
Class 1C Anti-AR drugs 2 facts about mech of action?
- Minimal APD effect
2. Slows upstroke conduction
2 main Toxicities of Class 1B Anti-ARs, also what is NOT a risk?
- Mainly Paresthesia and tremors
- NOT Torsades!
Beta Blockers dual mech of action?
Lower cAMP to reduce both Na and Ca currents.
Main usage of Class 1C Anti-AR drugs?
Supraventricular Arrhythmias (1B can't do these)
Class 1B Anti-AR drugs Mechanism of action?
Shorten APD by targeting either activated or inactivated sodium channels
Magnesium as an Anti-AR drug is most effective against _______
Torsades
Class 2 Anti-AR drugs are mainly ____ _____ Blocking Drugs
Beta Adrenoreceptor
In patients who have late-stage heart failure, they were given IVABRADINE, because unlike the Beta-blockers, it blocks the ____ current while preserving the heart’s contractility.
Funny
2 Indications for Class 3 Anti-ARs
- Most Vent. Arrhythmias
2. Maintain Sinus in A-fib
Donedarone is similar to ______ but WITHOUT iodine to avoid thryoid problems. Vernakalant and Ranolzine are also similar to this drug.
Amiodarone
Digoxin is used as an adjunctive agent to help Ventricular response during which two heart probs by slowing AV conduction?
- Atrial Fib/Flutter
2. Supravent. Arrhytmia
4 Main uses of Beta blockers?
- A-fib/Flutter
- PVCs
- Prevent night SupraVent Tachy
- Treat Catecholamine excess
Class 4 Anti-AR drug Mechanism (3 facts)
- Block both activated and Inactivated L-type calcium channel
- INCREASE refractory period
- DECREASE Conduction Velocity
Aside from never mixing with Beta Blockers, Main toxic event of Class 4 Anti-ARs?
AV block!
_____ is the Drug of choice for the prompt conversion of paroxysmal supraventricular tachycardia to Sinus.
Adenosine
Adenosine primarily inhibits ____ nodal conduction
AV
Ibutilide, Sotalol, Bretylium, Amiodarone, Dofetilide are all Class ______ Anti-AR drugs that mainly block ______ channels.
3, K+
Out of the Class 3 Anti-ARs ____ and ____ are experts at treating Atrial Flutter and Atrial Fibrillation
- Ibultilide
- Dofetilide
Aside from AV block, 3 common side effects of Class 4 Anti-ARs?
- Hypotension
- Constipation
- Edema
Beta blockers decrease phase ____ slopes
4
3 Contraindications of Type 1B Anti-ARs
- A-fib
- A-Flutter
- Supraventricular Tachy
What is the double Mechanism of Action of Class 1A Anti-AR drugs?
Moderate Na+ AND K+ block to PROLONG APD and slow upstroke
Misleading bc they’re considered mainly Na blockers
Flecainide, propafenone, moricizine are all _____ _____ _____ drugs
Class 1C Anti-AR
3 Main uses of Type 1B Anti-ARs
- MI Arrhythmias
- V-tach
- Cure Digitalis Arrhythmia
Most class 3 drugs, except ______ are reverse use-dependent; whereby unfortunately AP prolongation happens the least in areas with super fast-rates (where it is desirable).
Amiodarone
3 Adverse effects of Class 3 Anti-ARs
- Long QT
- Torsades
- Bradycardia
Which Type 1 Anti-AR drug causes a Lupus-like syndrome as a side-effect?
Procainamide
5 Class 3 Anti-AR drugs
- Ibultilide
- Sotalol
- Bretylium
- Amiodarone
- Dofetiliide
Class 3 Anti-AR mechanism
Block phase 2 K+ to prolong APD.
Flecainide is the prototypical drug for Class _____ Anti-AR drugs and mainly blocks ____ channels
1C, Sodium
Procainamide, Quinidine, and Disopyramide are all ______ _____ ______ drugs
Class 1A Antiarrhythmic
Main toxicity of Class 1C Anti-AR drugs?
Lethal Arrhythmias.
Although Amiodarone is super effective it has 4 Terrible Side-effects
- Pulmonary Fibrosis
- Microcrystalline deposits in eye/skin
- Thyroid Probs
- Warfarin/Digoxin Itneractions
Class ____ Anti-AR drugs are the only ones that do not help during Ventricular Arrhytmias out of classes 1-4.
4
Class ____ Anti-AR drugs are key for WPW-related arrhtymias
1C
Procainamide is a prototypical class ______ antiarrhytmic drug blocking mainly _____ channels
1A, Sodium
Lidocaine and Mexiletine are both _____ _____ ______ Drugs
Class 1B Anti-AR
Verapamil and Diltiazem are both Class _____ Anti-AR drugs that block ____ channels
4, Calcium
Name the 2 Class 4 Anti-AR drugs (Calcium Blockers)
- Verapamil
2. Diltiazem
Mg is thought to treat arrhythmias by antagonizing ____ channels
Calcium
Lidocaine is the prototypical drug of Class ______ Anti-AR drugs blocking mainly _____ channels
1B, Sodium
