Arrhythmias & EKG (Giudici) Flashcards
Class 1a antiarrhythmic drug that blocks the fast inward sodium channel, prolonging the action potential duration and QT interval
quinidine; used primarily for atrial fibrilation and ventricular tachycardia, causes diarrhea, metabolized in the liver by cyt p450
drug with similar uses as quinidine, that is primarily a sodium channel blocker but may also block outward potassium channels
procainamide; used for acute atrial fibrilation (especially WPW syndrome) and “VT storm” but may cause rashes, myalgias, lupus
class 1a drug that is a sodium channel blocker, and shows vagolytic activity (ie, can increase SA and AV nodes)
disopyramide; used for atrial fibrilation (especially hypertrophic cardiomyopathy) and has anticholinergic side effects (e.g., dry mouth, blurred vision, constipation, urinary retention)
drug used to treat brugada syndrome and early repolarization syndrome
quinidine
drug formerly used to treat VT, still an option for bedside conversion of AFib or VT storm when other options fail
procainamide
good drug in women over 40 with atrial tachyarrhythmias, esp if bradycardic
disopyramide
class 1b drug used acutely for arrhythmias associated with acute MI and is given only intravenously
lidocaine; very narrow therapeutic window and shortens QT interval
drug used in adjunct with amiodarone or sotalol, and works to shorten the QT interval
lidocaine
considered the oral form of lidocaine - used with amiodarone or sotalol and in automatic arrhythmias and it works to shorten the QT interval
mexilitine; liver metabilized, take with meals
sodium channel blocker that has use-dependence, is good for women, and is metabolized in the liver
propafenone
Which two heart rhythm drugs can raise your INR, making warfarin more effective?
amiodarone and propafenone
used in healthy people for premature atrial/ventricular contractions, AFib and outflow tract arrhythmias (NOT FLUTTER); has both renal and hepatic metabolism
flecainide
drug that has sodium, potassium and calcium channel blocking properties which was developed as an antianginal
ranolazine
class of drugs that is lipophilic and hydrophilic, and has a variety of uses including hypertension and cardiac arrythmias
beta blockers
what are the benefits of the beta blocker nadolol?
long half life and low lipophilicity (no CNS side effects)
drug with intrinsic sypathomimetic activity, used for its beta nonselectivity to treat conditions in young healthy people (ie neurogenic syncope)
pindolol
first beta blocker, heavy hitter psych drug and also used for tremors
propranolol
alpha and beta blocker used for the treatment of HTN for its vasodilation and sympathomimetic activity; safe for use during pregnancy
labetolol
one drawback of many beta blockers is that they have ____ effects, including weight gain, inhibition of lypolysis, and insulin resistance
metabolic
major advantage of this alpha/beta blocker is that it improves insulin sensitivity compared with metoprolol and atenolol
carvedilol
major advantage of this beta blocker is that it improves cardiac output, ejection fraction and stroke volume when compared to atenolol
nebivolol
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
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.
Which of the following drugs does NOT have intrinsic sympathomimetic activity?
A. Pindolol
B. Acebutolol
C. Nadolol
D. Alprenolol
E. Carteolol
C
alpha/beta blocker with ISA used to treat HTN, malignant HTN and pheochromocytoma
labetalol
pulmonary-friendly calcium channel blocker metabolized in the liver that blocks AV node and is used for multifocal atrial tachycardia (MAT)
verapamil
renal metabolized calcium channel blocker that is readily available in IV and PO and is very synergistic with beta blockers
diltiazem
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)
automatic atrial tachycardia
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
junctional tachycardia
type of tachycardia that is usually present in young women that is usually treated successfully with ISA beta blockers and ivabradine
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
drug best used to treat multifocal atrial tachycardia (various p wave morphologies)
verapamil
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.)
atrial
