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Pharm Test 4 > Antidysrhythmic Drugs > Flashcards

Antidysrhythmic Drugs Flashcards

1
Q

class I:

A

sodium channel blockers

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2
Q

class II:

A

beta blockers

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3
Q

class III:

A

potassium channel blockers

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4
Q

class IV:

A

calcium channel blockers (some are better for high bp, some are better for dysrhythmia

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5
Q

dysrhythmia definition

A

an abnormality in the rhythm of the heart

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6
Q

two basic types of dysrhythmias

A

tachydysrhythmia and bradydysrhythmia

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7
Q

tachydysrhythmia

A

heart rate is increased

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8
Q

bradydysrhythmia

A

heart rate is slowed

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9
Q

dysrhythmia are also known as

A

arrhythmias

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10
Q

what is the pacemaker of the heart

A

sinoatrial node - fires 60-100 per min

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11
Q

impulse conduction

A

pathways and timing

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12
Q

AV node

A

fires 40-60 times/min; has pacemaker abilities if SA node fails

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13
Q

His- purkinje system

A

fires less 4o times/min; so used if SA and AV node both shut down

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14
Q

cardiac action potentials

A

occur in fibers of the His-Purkinje system and in atrial and ventricular muscle

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15
Q

phases of cardiac action potentials

A

0 - depolarization; 1 - (partial repolarization; 2 - plateau; 3 - repolarization; 4 - stable potential

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16
Q

always have electrical event followed by a **

A

mechanical effect

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17
Q

fundamental causes of dysrhythmias

A

disturbances of automaticity; disturbances of conduction

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18
Q

disturbances of automaticity

A

SA or AV node will not fire

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19
Q

disturbances of conduction

A

atriventricular block, reentry (recirculating activation) (not conducting through normal pathway of the heart)

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20
Q

supravantricular dysrhythmias

A

impulse arises above the ventricle, atrial flutter, atrial fibrillation, sustain supraventricular tachycardia (SVT)

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21
Q

atrial fibrillation

A

Firing of electrical current in several different places in the atria; clotting prblem with a fib so put pt on anticoagulent; amiodanone diltiazem (cardezan); decreased cardiac output and potential for clots**

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22
Q

supraventricular **

A

any impulse that arrives above ventazole

23
Q

supraventricular tachycardia (SVT)

A

atria doesn’t dump blood down into ventricles (not as much)

24
Q

ventricular dysrhythmias

A

sustained ventricular tachycardia; ventricular fibrillation; digoxin-induced ventricular dysrhythmias

25
Q

ventricular dysrhythmias are

A

life threatening, won’t have cardiac output so no pulse ready for death, rapid firing in the ventricles

26
Q

ventricular premature beats

A

every now and then, too much caffeine or too much stress

27
Q

no pulse and no blood pressure

A

call 911 and start CPR 1. defiberate; DOC after 2. CPR 3. epinephrine 4. amiodarone 5. potassium or magnesium

28
Q

sodium channel blockers treat

A

atrial and ventricular dysrhythmias; DOC lidocaine

29
Q

lidociane (xylocaine) effects on the heart and ECG **

A

blocks cardiac sodium channels - slows conduction in the atria, ventricles and his purkinje system; reduces automaticity in the ventricles and his-purkinje fibers

30
Q

class II:beta blockers - **

A

propranolol (Inderal), carvedilol (Coreg)

31
Q

carvedilol (Coreg)

A

specifically for rapid heartbeats

32
Q

class II:beta blockers effects on the heart and ECG **

A

decreased automaticity of the SA node; decreased velocity of conduction through the AV node; decreased myocardial contractility - negative inotropic effect

33
Q

class II:beta blockers therapeutic effects

A

dysrhythmias caused by excessive sympathetic stimulation; SA tachydysrhythmias

34
Q

SA tachydysrhythmia

A

suppression of excessive discharge; slowing of the heart rate

35
Q

class II:beta blockers adverse effects

A

heart block, heart failure, AV block, sinus arrest, hypotension, bronchospasm (in asthma pts)

36
Q

other class II:beta blockers

A

acebutolol (sectral), exmolol (brevibloc)

37
Q

class III: potassium channel blockers have both **

A

atrial and ventricular fibrillation

38
Q

class III: potassium channel blockers

A

amiodarone

39
Q

class III: potassium channel blockers therapeutic uses

A

long term therapy for life threatening ventricular dysrhythmias and converting a fib to normal sinus rhythm; recurrent ventricular fibrillation; recurrent hemodynamically unstable ventricular tachycardia

40
Q

amiodarone effects on heart

A

reduces automaticity in the SA node, reduced contractility, reduced conduction velocity, QRS widening, prolongation of the PR and QT intervals

41
Q

amiodarone adverse effects

A
  1. pulmoary toxicity; cardiotoxicty; toxicity in pregnancy and breast feeding; corneal microdeposits; optic neuropathy (last two high doses)
42
Q

pulmoary toxicity

A

damage to lung tissue

43
Q

cardiotoxicity

A

toxic to heart muscle

44
Q

potassium channel blockers have lots of

A

drug interactions: quidine, diogoxin, procainamide, diliazem, phenytoin, warfarin

45
Q

class IV: calcium channel blockers

A

verapamil and diltiazem

46
Q

verapamil and diltiazem

A

reduces SA nodal automaticity; delays AV nodal conduction; reduces myocardial contractility

47
Q

class IV: calcium channel blockers therapeutic uses

A

slows hr (a fib or atrial flutter); terminate SVT cause by an AV nodal reentrant circuit (slowing of HR and decrease in BP)

48
Q

verapamil and diltiazem adverse effects

A

bradycardia; hypotension; AV block; heart failure; peripheral edema; constipation

49
Q

adenosine

A

decreases automaticity in the SA node; slows conduction through the AV node; prolongation of PR interval

50
Q

therapeutic uses of adenosine

A

termination of paroxysmal SVT

51
Q

paroxysmal

A

sudden rapid HR

52
Q

adenosine adverse effects

A

sinus bradycardia, possible assystole; dyspnea; hypotension; facial flushing

53
Q

adenosine drug interactions

A

methylzanthines, dipyridamole

Pharm Test 4 (8 decks)

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