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peripheral vasodilators2 > antidysrhythmias2 > Flashcards

antidysrhythmias2 Flashcards

1
Q

2 major mechanisms antidysrhythmics

A

reentry, enhanced automaticity

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2
Q

factors assoc with dysrhythmias

A

arterial hypoxia, electrolyte and acid/base balance abnormalities, myocardial ischemia, altered sympathetic activity, bradycardia, dilated cardiomyopathy, prolonged qt (acquired), r on t phenomenon

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3
Q

class 1 antidysrhythmics

A

all sodium channel blockers and decrease rate phase 0 depolarization
-all depress automaticity and decrease rate of conduction

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4
Q

class IA drugs

A

quinidine, procainamide, disopyramide

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5
Q

class IA speed of action

A

intermediated

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6
Q

class IA actions

A

depress phase 0 depolarization
prolong action potential duration
slow conduction velocity

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7
Q

class IB action speed

A

most rapid binding and dissociation

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8
Q

class IB drugs

A

lidocaine, mexiletine, phenytoin

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9
Q

class I B action

A

shorten action potential duration,
little effect phase 0 depolarization
bind in inactive state
most effective on tacy arrhythmias

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10
Q

class I C speed-

A

slowest of class I

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11
Q

class I C drugs

A

flecainide

propafenone

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12
Q

class I C actions

A

markedly decreased phase 0 depolarization
minimal effect on phase 0 depolarization
profoundly decreased conduction velocity
best on tachy arrhythmias

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13
Q

class II drugs

A

beta blockers- propanolol, esmolol

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14
Q

class II mech action

A

inhibit sympathetic activity
beta block
-decrease rate of discharge sinus and ectopic pacers and increase effective refractory period of AV node

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15
Q

carvedilol

A

class II, alpha and beta block, can also block K, CA, NA current and prolong action potential duration

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16
Q

class III drugs

A

amiodarone, ibutiide, sotalol (II and III)

17
Q

Class III action

A

block K channels and prolong depolarization, prolong action potential duration and prolong refractory period, prolong QT.

18
Q

Class IV drugs

A

calcium channel blockers- verapamil, diltiazem

19
Q

action class IV drugs

A

decreased conduction through SA and AV node. (negative chronotropy and dromotropy)

20
Q

procainamine treats

A

IA- treats reentry and automaticity (a tach, V tach, prolong QT, QRS and cause ST-T changes

21
Q

excretion procainamide

A

renal excretion. active metabolite- NAPA contributes to effects

22
Q

dosage procainamide

A

100mg every 5 minutes up to 15mg/kg

23
Q

lidocain treats

A

(IB) reentry- vent. dysrythmias, pvcs, v tach

24
Q

metabolism lidocaine

A

hepatic metabolism with active metabolities

25
Q

side effects lidocaine

A

seizures with plasma conc>5mcg/ml, cns depression, apnea, arrest >10mcg/ml

26
Q

dose of lidocaine

A

1-2mg/kg

infuse at 1-4mg/mmin

27
Q

phenytoin treats

A

(IB) reentry and automaticity, ventricular dysrhythmias

28
Q

metabolism phenytoin

A

hepatic metabolism 1/2 time 24 hours

29
Q

side effects phenytoin

A

ataxia, nystagmus, vertigo, slurred speech, sedation, confusion, hyperglycemia, leukopenia, thrombocytopenia

30
Q

beta blockers causes

A

(II) decreased conduction velocity, increased refractory period, increased PR duration, decreased QT duration

31
Q

Class III antidysrhythmics treats

A

reentry and automaticity SVT, a fib, VT

32
Q

amiodarone action

A

block alpha and beta, calcium and potassium blocking effects. dilates coronary arteries.

33
Q

metabolism amiodarone

A

hepatic, 1/2 time 29 days

34
Q

s/e amiodarone

A

pulmonary alveolitis, prolonged QT, bradycardia, block, decreased cardiac output, decreased vitamin K
rash, cyanosis, peripheral neuropathy, weakness, increased dig level

35
Q

sotalol at high dose

A

prolongs action potential all tissues

36
Q

sotalol at low doses

A

nonselective beta antagonist

37
Q

dig what treats

A

a tach, heart failure

38
Q

digoxin mech action

A

+ inotrope- inhibits sodium potassium atpase ion transport system. slow conduction through AV node, increase stroke volume, decrease LV end diastolic pressure, positive lusitrope, negative chronotrope, enhance conduction

39
Q

s/s hypokalemia induced dig toxicity

A

anorexia, nausea, vomiting, pain, prolonged PR, degrading block, a tach, v fib

peripheral vasodilators2 (10 decks)

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