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Clinical Pharmacology > Arrhythmia > Flashcards

Arrhythmia Flashcards

1
Q

Class IB

A

Na channel blockers e.g. Lidocaine

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2
Q

Lidocaine MoA

A

Block fast Na channels resposible for phase 0 (decrease slope)
Ventricular myocytes
No effect on SAN/AVN
rapidly depolarizing tissue- particularly post MI damage

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3
Q

Lidocaine use

A

Ventricular tachycardia (ventricular myocyte selective)

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4
Q

Class IC

A

Flecanide

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5
Q

Flecainide MoA

A

Stronger decrease phase 0 than Lidocaine
decreases automaticity
increases action potential duration

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6
Q

Flecainide use

A

Wide spectrum

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7
Q

Flecainide ADR

A

Pro-arrythmic - give B blocker to prevent ventricular tachycardia

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8
Q

Class II

A

B blockers e.g. bisoprolol

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9
Q

B blocker MoA

A

B1 receptor- SAN/AVN
decrease sinus rate, conduction velocity
decrease phase 4 (upstroke of pacemaker)

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10
Q

B blocker ECG effect

A

Increase PR

decrease HR

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11
Q

B blocker uses

A

Catecholamine dependent tachycardia (SNS)
AVN re-entry arrhtyhmias
Afib

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12
Q

B blocker ADR

A

Bronchospasm

Hypotension

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13
Q

B blocker warnings

A

AV block

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14
Q

Class III

A

K channel blockers

E.g. Amiodarone

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15
Q

Amiodarone MoA

A

Increase refractory period and AP duration
decrease phase 0
decrease phase 4 (B block and Ca block)
decrease AV conduction

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16
Q

Amiodarone ECG effects

A

Increase PR, QRS, QT

decrease HR

17
Q

Amiodarone ADR

A

Pulmonary fibrosis
increase LDL
optic neuritis

18
Q

Amiodarone DDI CYPs

A

Inhibits CYP2C9, CYP34A (warfarin)

19
Q

Amiodarone warnings

A

Thyroid disease- contains iodine.

20
Q

Sotalol MoA

A

Class II and III effects
Increase APD and refractory period
Slows phase 4
Slows AV conduction

21
Q

Class IV

A

Ca channel blockers e.g. Verapamil

22
Q

Verapamil MoA

A

Ca channel underlies upstroke in pacemaker cells.
slows AV conduction
increases refractory period in AVN
Increase phase 4 slope SAN

23
Q

Verapamil uses

A

Surpaventricular tachycardia

Re-entry around AV

24
Q

Verapamil DDI

A

B blocker- asystole

25
Q

Adenosine MoA

A

Binds to A1 receptor
decrease CAMP –> increase K channels –> hyperpolarisation –> decrease HR
slows AVN conduction

26
Q

Adenosine uses

A

supraventricular arrhythmia - EMERGENCY

diagnosis of coronary artery disease

27
Q

Ivabradine MoA

A

Blocks funny current in SAN- decreases HR

28
Q

Ivabradine uses

A

Heart failure

Sinus tachycardia

29
Q

Digoxin MoA

A

Inhibits Na/K ATPase
Decrease HR
Increase contractility

30
Q

Digoxin uses

A

Atrial fibrillation and flutter

31
Q

Atropine MoA

A

Selective mAChR antagonist (M2 in the heart)
blocks vagal activity
Increases HR and AV conduction

32
Q

Atropine uses

A

Bradycardia

Clinical Pharmacology (18 decks)

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