Arrhythmias & EKG (Giudici)

Question 1

Class 1a antiarrhythmic drug that blocks the fast inward sodium channel, prolonging the action potential duration and QT interval

Answer 1

quinidine; used primarily for atrial fibrilation and ventricular tachycardia, causes diarrhea, metabolized in the liver by cyt p450

Question 2

drug with similar uses as quinidine, that is primarily a sodium channel blocker but may also block outward potassium channels

Answer 2

procainamide; used for acute atrial fibrilation (especially WPW syndrome) and “VT storm” but may cause rashes, myalgias, lupus

Question 3

class 1a drug that is a sodium channel blocker, and shows vagolytic activity (ie, can increase SA and AV nodes)

Answer 3

disopyramide; used for atrial fibrilation (especially hypertrophic cardiomyopathy) and has anticholinergic side effects (e.g., dry mouth, blurred vision, constipation, urinary retention)

Question 4

drug used to treat brugada syndrome and early repolarization syndrome

Answer 4

quinidine

Question 5

drug formerly used to treat VT, still an option for bedside conversion of AFib or VT storm when other options fail

Answer 5

procainamide

Question 6

good drug in women over 40 with atrial tachyarrhythmias, esp if bradycardic

Answer 6

disopyramide

Question 7

class 1b drug used acutely for arrhythmias associated with acute MI and is given only intravenously

Answer 7

lidocaine; very narrow therapeutic window and shortens QT interval

Question 8

drug used in adjunct with amiodarone or sotalol, and works to shorten the QT interval

Answer 8

lidocaine

Question 9

considered the oral form of lidocaine - used with amiodarone or sotalol and in automatic arrhythmias and it works to shorten the QT interval

Answer 9

mexilitine; liver metabilized, take with meals

Question 10

sodium channel blocker that has use-dependence, is good for women, and is metabolized in the liver

Answer 10

propafenone

Question 11

Which two heart rhythm drugs can raise your INR, making warfarin more effective?

Answer 11

amiodarone and propafenone

Question 12

used in healthy people for premature atrial/ventricular contractions, AFib and outflow tract arrhythmias (NOT FLUTTER); has both renal and hepatic metabolism

Answer 12

flecainide

Question 13

drug that has sodium, potassium and calcium channel blocking properties which was developed as an antianginal

Answer 13

ranolazine

Question 14

class of drugs that is lipophilic and hydrophilic, and has a variety of uses including hypertension and cardiac arrythmias

Answer 14

beta blockers

Question 15

what are the benefits of the beta blocker nadolol?

Answer 15

long half life and low lipophilicity (no CNS side effects)

Question 16

drug with intrinsic sypathomimetic activity, used for its beta nonselectivity to treat conditions in young healthy people (ie neurogenic syncope)

Answer 16

pindolol

Question 17

first beta blocker, heavy hitter psych drug and also used for tremors

Answer 17

propranolol

Question 18

alpha and beta blocker used for the treatment of HTN for its vasodilation and sympathomimetic activity; safe for use during pregnancy

Answer 18

labetolol

Question 19

one drawback of many beta blockers is that they have ____ effects, including weight gain, inhibition of lypolysis, and insulin resistance

Answer 19

metabolic

Question 20

major advantage of this alpha/beta blocker is that it improves insulin sensitivity compared with metoprolol and atenolol

Answer 20

carvedilol

Question 21

major advantage of this beta blocker is that it improves cardiac output, ejection fraction and stroke volume when compared to atenolol

Answer 21

nebivolol

Question 22

Which of the following beta blockers is INCORRECTLY matched with its FDA approved use?

A. Propranolol: urgent treatment of tachycardia

B. Acebutalol: pre-ventricular contraction control

C. Esmolol: Perioperative supraventricular tachys

D. Sotalol: Recurrent AF

E. Atenolol: hypertension

Answer 22

A. Propanolol is used for general tachycardia, ventricular rate control in AF, PVC control and drug-induced tachycardia

Esmolol, in addition to perioperative SVTs, is indicated for urgent treatment of tachycardia.

Question 23

Which of the following drugs does NOT have intrinsic sympathomimetic activity?

A. Pindolol

B. Acebutolol

C. Nadolol

D. Alprenolol

E. Carteolol

Answer 23

C

Question 24

alpha/beta blocker with ISA used to treat HTN, malignant HTN and pheochromocytoma

Answer 24

labetalol

Question 25

pulmonary-friendly calcium channel blocker metabolized in the liver that blocks AV node and is used for multifocal atrial tachycardia (MAT)

Answer 25

verapamil

Question 26

renal metabolized calcium channel blocker that is readily available in IV and PO and is very synergistic with beta blockers

Answer 26

diltiazem

Question 27

type of tachycardia that is most common in children and women and can be treated with beta blockers or antiarrhythmics (e.g., flecainide, propafenone, disopyaramide, verapamil)

Answer 27

automatic atrial tachycardia

Question 28

type of tachycardia most often seen in kids that is difficult to treat, may be able to treat successfully with verapamil, flecainide or carefully performed ablation therapy

Answer 28

junctional tachycardia

Question 29

type of tachycardia that is usually present in young women that is usually treated successfully with ISA beta blockers and ivabradine

Answer 29

sinus tachycardia. can treat with adenosine, verapamil, and dilitiazem (also ibutilide used for conversion of actue atrial flutter). nonpharmacological interventions - ice water, valsalva, carotid sinus massage

Question 30

drug best used to treat multifocal atrial tachycardia (various p wave morphologies)

Answer 30

verapamil

Question 31

At this point i’m checking out. But Giudici just said if it’s more than 150 bpm, it’s _____ flutter. And you should always look for P waves. (Uh, ok, great.)

Answer 31

atrial