Arrhythmia

Question 1

Class 1 drugs?

Answer 1

Sodium channel blockers

Question 2

Class 1A drugs?

Answer 2

Procainamide

Question 3

Class 1B drugs?

Answer 3

Lidocaine

Question 4

Class 1C drugs?

Answer 4

Flecainide

Question 5

MOA of Procainide?

Answer 5

“1. Slows Phase 0 depolarization
2. Slows conductivity and automaticity
3. Increases ERP and APD

Question 6

MOA of Lidocaine?

Answer 6

1. Slow Phase 0 rise
2. Shorten Phase 3 repolarization
3. Lower Automaticity, little effect on conductivity
4. Lower APD
5. No change in ERP

Question 7

MOA of Flecainide

Answer 7

1. Lower rate of Phase 0 rise
2. Shorten phase 3 repolarization
3. Reduce conductivity + automaticity
4. No/little effect on APD + ERP

Question 8

Use of Flecainide?

Answer 8

Refractory Ventricular tachycardias that progress to VF

Question 9

Beta blockers names?

Answer 9

Metoprolol
Propranolol

Question 10

MOA of beta blockers?

Answer 10

“1. Block binding of Beta-1 ligand to Gs protein on myocyte surface

1. Reduce Phase 4 depolarization
2. Reduce Automaticity
3. Prolong AV conduction
4. Reduce HR + contractility
5. No change to APD + ERP”

Question 11

Uses of beta blockers?

Answer 11

1. Tachycardia caused by sympathetic activation
2. Atrial fibrillation
3. AV nodal re-entrant tachycardia
4. Reduce sudden arrhythmic death post-MI

Question 12

What class is beta blockers?

Answer 12

Class 2

Question 13

Class 3 drugs?

Answer 13

K channel blockers, Amiodarone

Question 14

MOA of amiodarone

Answer 14

1. Block I kr and I ks (III)
2. Block sodium channels (I)
3. Block adrenergic receptor (II)
4. Block Calcium channels (IV)
5. Prolong Phase 3 repolarization (no Phase 0 effect)
6. Increase ERP + APD

Question 15

ADR of amiodarone?

Answer 15

Symptomatic bradycardia
Heart block

Question 16

Use of amiodarone?

Answer 16

Maintain normal sinus rhythm in patients with atrial fibrillation

Prevent re-entrant ventricular tachycardia”

Question 17

Class 4 drugs?

Answer 17

Non-DHP calcium channel blockers

Question 18

Name of class 4 drugs?

Answer 18

Verapamil
Diltiazem

Question 19

MOA of Non-DHP calcium channel blockers?

Answer 19

“1. Prolong Phase 4 depolarization
2. Reduce conductivity on AV node
3. Raise ERP and APD”

Question 20

Use of Class 4 drugs?

Answer 20

Supraventricular Tachycardia
Hypertension
Angina

Question 21

ADR of Class 4 drugs?

Answer 21

Hypotension
Banned for patients with pre-existing depressed cardiac function

Question 22

MOA of adenosine?

Answer 22

1. Supress AV Nodal conduction
2. Increase AV nodal refractory period
3. Stimulate cardiac K channel
4. Inhibit Calcium current

Question 23

Use of Flecainide?

Answer 23

Refractory Ventricular tachycardias that tend to progress to VF

Question 24

Use of beta blockers in arrhythmia?

Answer 24

Tachycardia caused by sympathetic activation
Atrial fibrillation
AV nodal re-entrant tachycardia
Reduce sudden arrhythmic death post-MI

Question 25

Use of Amiodarone in arrhythmia?

Answer 25

Maintain normal sinus rhythm in patients with atrial fibrillation
Prevent re-entrant ventricular tachycardia

Question 26

Use of Non-DHP Calcium channel blockers in arrhythmia?

Answer 26

Supraventricular tachycardia
Hypertension
Angina