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Cardio > Arrhythmia Drugs > Flashcards

Arrhythmia Drugs Flashcards

1
Q

Anti-Arrhythmic Drug Classes

A

Class I: Na+ channel blockade
Class II: B-adrenergic receptor blocker
Class III: K+ DRK channel blockers
Class IV: Ca+2 channel blockers

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2
Q

Class I Subgroups

A

Class IA: moderate Na+ block (Increase in AP duration)
Class IB: mild Na+ block (Decrease in AP duration)
Class IC: marked Na+ block (No affect on AP)

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3
Q

Class IA Effects

A
  • Increase AP duration (for reentrant Arrhythmias)
  • Decrease slope of phase 4 (for automaticity arrhythmias)
  • Increase threshold potentials (for automaticity arrhythmias)
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4
Q

Class IA Drugs

A

Quinidine
Procainamide
Disopyramide

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5
Q

Quinidine

A
  • Class IA moderate Na+ block
  • Flagship
  • RISK OF TORSADES
  • some GI distress
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6
Q

Torsades

A

Blockade of HERG K+ channels results in prolonged QT syndrome leading to Torsades and death

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7
Q

Procainamide

A
  • Class IA moderate Na+ block
  • LESS PRONOUNCED QT EXTENSION
  • Fever/rash
  • Mild ganglionic blocker
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8
Q

Disopyamide

A
  • Class IA moderate Na+ block
  • DECREASED CARDIAC INOTROPY
  • can accumulate in renal dysfuncation leading to Torsades
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9
Q

Class IB Effects

A
  • Decrease AP duration (for reentrant arrhythmias)
  • Decrease slope of phase 4 (for automaticity arrhythmias)
  • Increase threshold potentials (for automaticity arrhythmias)
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10
Q

Class IB Drugs

A

Lidocaine

Mexiletine

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11
Q

Lidocaine

A
  • Class IB mild Na+ block
  • ONLY IV INFUSION
  • CNS side effects
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12
Q

Mexiletine

A
  • Class IB mild Na+ block
  • CAN BE ORAL
  • CNS side effects
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13
Q

Class IC Effects

A
  • NO effect on AP duration (for reentrant arrhythmias)
  • Decrease slope of phase 4 (for automaticity arrhythmias)
  • Increase threshold potentials (for automaticity arrhythmias)
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14
Q

Class IC Drugs

A

Flecainide

Propafenone

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15
Q

Flecainide

A
  • Class IC marked Na+ block
  • INCREASED RISK OF VENTRICULAR ARRHYTHMIAS
  • CNS side effects
  • Oral
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16
Q

Propafenone

A
  • Class IC marked Na+ block
  • WEAK B-BLOCKER
  • CNS side effects
17
Q

Class II Effects

A
  • Decrease slope of Phase 4 depolarization (decrease automaticity)
  • Block reentry by increasing effective refractory peroid (prolonged repolarization in AV node)
  • Used for management of Supraventricular Arrhythmias
  • Block catecholamine induces arrhythmias
18
Q

Class II Drugs

A

-Propranolol
-Esmolol
-Metoprolol
-Timolol
-Acebatalol
(B-Blockers)

19
Q

Class III Effects

A
  • K+ DRK channel blocker
  • Prolonged repolarization increases AP duration
  • Effects reentrant arrhythmias
20
Q

Class III Drugs

A
  • Amiodarone
  • Dronedarone
  • Sotalol
  • Dofetilide
  • Ibutilide
21
Q

Amiodarone

A
  • Class I,II,III,IV effects
  • Decreases sinus node firing, automaticity, reentrant circuits
  • Vasodilation
  • Negative Inotropy
  • EFFECTIVE FOR VENTRICULAR AND SUPERVENTRICULAR TACHYARRHYTHMIAS
22
Q

Amiodarone Side Effects

A
  • 6hr absorption and 30-60day half-life
  • Pulmonary and Cardiac toxicity
  • Changes in thyroid function
  • GI effects
  • CNS Effects
  • Torsades
23
Q

Dronedarone

A
  • Class III K+ blocker
  • GI side effects
  • NO TORSADES
  • NO IODINE
24
Q

Dofetilide

A
  • Class III K+ blocker
  • DANGEROUS TORSADES
  • NO IODINE
25
Q

Sotalol

A
  • Class III K+ blocker
  • B-BLOCKER
  • TORSADES
26
Q

Ibutilide

A

Boring, nothing here

27
Q

Blaise Pascal on the Heart

A

“The heart has reasons that reason cannot know.”

Doesn’t that sum up Cardiology?

28
Q

Class IV Effects

A
  • Ca+2 channel blockers
  • Decrease slope of phase 4 (for automaticity arrhythmias)
  • Increase threshold potentials (for automaticity arrhythmias)
  • Most active in nodes
  • Increase refractory period
  • Decrease conduction velocity
  • Decrease heart rate
  • Primary TX for AV nodal reentrant tachy
29
Q

Class IV Drugs

A
  • Diltizam

- Verapamil

30
Q

Class IV Side Effects

A
  • hypotension

- HF in patients with B-Blockers

31
Q

Digoxin

A
  • Decreases Na+-K+ ATP ase
  • Used in HF to increase quality of life
  • Enhances Vagal tone
  • Used in Atrial ailments
  • Termination at reentrant loops
32
Q

Adenosine

A
  • Rapid hyperpolarization
  • VERY short half life (10 sec)
  • Used to stop events and reset
  • Acts on AV node
33
Q

Let’s do this

A

http://m.youtube.com/watch?v=GPc7G0Cp91k

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