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Pharm > Antidysrhythmics > Flashcards

Antidysrhythmics Flashcards

1
Q

Dysrhythmia

A

abnormal rate or rhythm of heart

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2
Q

The electrical conduction of the heart

A

SA node –> AV node —> Bundle of HIS —> Purkinje Fibers

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3
Q

SA Node

A

Gate keeper of heart

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4
Q

AV node

A

gateway for impulse to reach the ventricles; delays impulse travel

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5
Q

Automaticity

A

heart’s ability to generate an electrical impulse

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6
Q

Conductivity

A

ability of heart to transmit electrical impulses

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7
Q

How are action potentials generated?

A

by movement of ions into and out of the cell

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8
Q

Slow action potentials

A

SA and AV nodes

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9
Q

Fast Action Potentials

A

Myocardium and His-Purkinje system

Conducts electricity quickly through the heart

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10
Q

depolorization

A

contraction

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11
Q

P wave

A

depolarization of the atria

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12
Q

QRS complex

A

depolarization of the ventricles

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13
Q

T wave

A

repolarization of the ventricles

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14
Q

PR interval

A

time between onset of P and onset of QRS complex

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15
Q

QT interval

A

time between onset of QRS complex and end of T wave

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16
Q

ST segment

A

between end of QRS complex and start of t wave

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17
Q

ectopic

A

impulses starting in cells other than SA node

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18
Q

Causes of dysrhythmia

A

Disturbances of automaticity

Disturbances of conduction

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19
Q

Supraventricular Tachy

A

Intervention: vasalva maneuvers/Cardioversion

Drug Therapy: Adenosine/Class II or IV Drugs

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20
Q

Atrial Fibrillation

A

Interventions: Cardioversion

Drug Therapy: Class II or IV drugs/ Anticoagulation

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21
Q

Atrial Flutter

A

Intervention: Cardioversion

Drug Therapy: Class II or IV drugs/ Anticoagulation

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22
Q

Sustained Ventricular Tachycardia

A

Intervention: Cardioversion

Drug Therapy: Procainamide, Lidocaine, Amiodarone

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23
Q

Ventricular Filbrillation

A

Life threatening
Intervention: Cardioversion/CPR
Drug Therapy: Amiodarone/Lidocaine

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24
Q

Torsades de Pointes

A

Life threatening
Intervention: Cardioversion/ Stop QTc prolonging drugs
Drug Therapy: Magnesium

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25
Q

Class I

A

Sodium Channel Blockers

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26
Q

Class II

A

Beta-Blockers

27
Q

Class III

A

Potassium Channel Blockers

28
Q

Class IV

A

Calcium Channel Blockers

29
Q

Sodium Channel Blockers

A

Double Quarter Pounder Lettuce Mayo Fries Please

30
Q

Sodium Channel Blockers

Class 1A

A

Disopyramide
Quinidine
Procainamide

31
Q

Sodium Channel Blockers

Class 1B

A

Lidocaine

Mexiletine

32
Q

Sodium Channel Blockers

Class 1C

A

Flecainide

Propafenone

33
Q

Adverse Effects Quinidine

A

Diarrhea 1/3 patients (33%)

Cinchonism

34
Q

Cinchonism

A

hearing loss, tinnitus, dizziness, flushing, and blurry vision

35
Q

Adverse Effects for Procainamide

A

SLE (Lupus) reaction : rash
Blood dycrasias : blood abnormalities
Arterial embolism : clot traveling in artery

36
Q

Adverse Effects for Lidocaine

A

CNS effects

Toxic Doses: seizure, respiratory arrest

37
Q

Monitoring Considerations for Lidocaine

A

Narrow therapeutic index

Monitor: drug levels

38
Q

Monitoring Considerations for Flecainide

A

Increase mortality in post MI patients with asymptomatic Vtach

39
Q

4 Approved drugs for Class II: Beta-blockers

A

Propranolol
Acebutolol
Esmolol
Sotolol

40
Q

Adverse Effects of Propranolol

A

Av Block
Sinus Arrest
Hypotension
Bradycardia

41
Q

Monitoring of Propranolol

A

Give IV SLOWLY to avoid hypotension

Monitor: HR, BP, ECG

42
Q

Monitoring of Esmolol

A

Very fast acting
Short half-life
Monitor: HR, BP, ECG

43
Q

Monitoring of Sotalol

A

also causes blockage of K channels; can be considered Class II
Monitor: HR, BP, ECG

44
Q

Adverse Effects of Amiodarone

A

Toxicity: lungs, liver, eyes, thyroid

Photosensitivity

45
Q

Monitoring of Amiodarone

A

Hypotension

give through 0.22 micron filter

46
Q

Adverse Effects of Dronedarone

A

Photosensitivity

Hepatotoxicity

47
Q

Monitoring of Dronedaron

A

Contraindicated in pregnancy

48
Q

Monitoring of Dofetilide

A

initiated therapy in the hospital

49
Q

Monitoring of Sotalol

A

Class II and III agent - do NOT use like a typical beta-blocker

50
Q

Adenosine Mechanism of Action

A

Decreased automaticity of SA node
Decreased Conduction through the AV node
Prolonged PR interval

51
Q

Adenosine Indications

A

Termination of SVT ONLY

NOT for treatment of afib or aflutter

52
Q

Adenosine Pharmokinetics

A

EXTREMELY short half-life (2-10 seconds)

Must be given IV push

53
Q

Adenosine Adverse Effects

A

momentary asystole
Chest discomfort
Flushing (at least 20mL)

54
Q

Adenosine Drug Interactions

A

Methylxanthines (ex. theophylline) block adenosine receptors, do not give drug if patient is on this

55
Q

Digoxin Physiologic effects

A

decreased conduction through AV node
increases vagal tone
high drug level usually needed

56
Q

Digoxin Indications

A

atrial fibrillation

atrial flutter

57
Q

What do Sodium Channel Blockers do?

A

Decrease conduction velocity in the atria, ventricles and His-Purkinje system

58
Q

What do Beta-Blockers do?

A

Decrease automaticity in SA node
Decrease conduction velocity through AV node
Decrease myocardial contractility

59
Q

Class III: Potassium Channel Blocker Drugs

A 
Amiodaron
Ibutilide
Dofetilide
Dronedarone
Sotalol
60
Q

What do Potassium Channel Blockers do?

A

delay repolarization of fast action potentials

Prolong the QT interval

61
Q

What is a common Adverse Drug Effect (ADE) with IV administration

A

Hypotension

62
Q

What is something to consider relating to Class III drugs?

A

All of the medications here can cause QT elongations leading to Torsades de Pointes

63
Q

What do Calcium Channel Blockers Do?

A

Decrease SA node automaticity
Decrease AV node conduction velocity
Decrease myocardial contraction

64
Q

Calcium Channel Blocker Drugs

A

Diltiazem

Verapamil

Pharm (5 decks)

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