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cb > antidysrhythmic drugs > Flashcards

antidysrhythmic drugs Flashcards

1
Q

what are antidysrhythmic drugs

A

medications used to treat abnormal heart rhythms (dysrhythmias or arrhythmias). they modify electrical impulses in the heart aiming to restore normal rhythm or control the heart rate

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2
Q

what are class 1 antidysrhythmic drugs

A

sodium channel blockers
block sodium channels slowing depolarisation in cardiac myocytes

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3
Q

what are the sub types of class 1 antidysrhythmics

A

class 1a
class 1b
class 1c

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4
Q

what do class 1a drugs do

A

moderate sodium channel blockade prolongs action potential duration
examples quinidine, procainamide, disopyramide

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5
Q

example of class 1a drugs

A

quinidine
procainamide
disopyramide

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6
Q

what indications are class 1a drugs used to treat

A

atrial fibrilation
ventricular tachychardia

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7
Q

what are class 1b drugs used for

A

mild sodium channel blockade, shortens action potential duration

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8
Q

what are examples of class 1b drugs

A

lidocaine
mexiletine

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9
Q

what indications are class 1b drugs used for

A

ventricular arrythmias, post myocardial infarction

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10
Q

what are class 1c drugs used for

A

strong sodium channel blockade little affect on action potential duration

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11
Q

examples of class 1 drugs

A

flecainide,propafenone

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12
Q

what indications are class 1 drugs used for

A

life threatening ventricular arrythmias, atrial fibrilation

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13
Q

what are class ii antidysrhythmic drugs

A

beta blockers

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14
Q

what are the mechanisms of beta blockers

A

increase perfusion time and so diastolic time (which means coronary blood flow is increased)
block beta adrenergic receptors, reducing heart rate and contractility decreasing sympathetic stimulation

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15
Q

what are examples of beta blockers

A

propranolol, metorprolol,esmolol

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16
Q

what indications can beta blockers such as esmolol, proranolol and metorprolol be used to treat

A

atrial fibrilation, atrial flutter, ventricular arrythmias, arrythmias triggered by stress or exercise

17
Q

what mechanism do class iii potassium channel blockers workby

A

prolong repolarisation by inhibiting potassium efflux during phase 3 of the action potential

18
Q

what are examples of class iii anti dysarrythmic drugs (potassium channel blockers)

A

amiodarone,sotalol,dofetilide,ibutilide

19
Q

what are indications of class iii potassium ion channel blockers

A

atrial fibrilation, atrial flutter, ventricular tachychardia

20
Q

what is special about amiodarone

A

has effects across multiple classes and requires monitoring for long term toxicities

21
Q

how do class 4 calcium ion channel blockers work

A

block l type calcium channels, slowing conduction through av node

22
Q

what are examples of calcium ion channel blockers

A

verapamil,dilitiazem

23
Q

what indications are calcium ion channel blockers used to treat

A

supraventricular tachychardia, atrial fibrilation,atrial flutter

24
Q

what kind of patients are class 4 channel drugs avoided in

A

patients with heart failure and reduced ejection fraction

25
Q

what are class five drugs, miscellaneous

A

includes drugs that do not fit into any category but has antidysrhythmic effects

26
Q

what are examples of class five drugs

A

adenosine-short acting, slows conduction through the av node
digoxin- increases vagal tone slowing av conduction

27
Q

explain mechanism of miscallaenous drug digoxin

A

increases vagal tone slowing av conduction
indications-atrial fibrilation atrial flutter

28
Q

explain mechanism of miscallaenous drug adenosine

A

short acting slows conduction through av node indications acute termination of superaventricular tachychardia

29
Q

how does magnesium sulfate cause anti dysrhythmic effects

A

stabilises myocardial cells

30
Q

what considerations are taken into account for antidysrythmic therapy

A

patient specific factors
adverse effects
drug interactions
monitoring

31
Q

what patient specific factors are considered in antidysrythmic therapy

A

type of arrythmia (atrial vs ventricular)
underlying conditions (heart failure, ischeamic heart disease)
renal and hepatic functionfor drug metabolism and clearance

32
Q

what adverse effects can occur

A

proarrythmia- can induce arrythmias some drugs
non cardiac toxcities
amiodarone, thyroid dysfunction, pulmonary fibrosis,liver toxicity
beta blockers- fatigue, bronchospasm, bradychardia
calcium channel blockers-peripheral edema, constipation

33
Q

what kind of monitoring is needed

A

regular ecgs to access effectiveness and watch for adverse effects
lab tests for drug levels and side effects (thyroid, liver function with amiodarone)

cb (24 decks)

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