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Pharma > Cardiac Anti Arrhythmics > Flashcards

Cardiac Anti Arrhythmics Flashcards

1
Q

Group I AA

A

Sodium channel blockers

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2
Q

Group II

A

Beta blockers

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3
Q

Group 3

A

Potassium channel blockers

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4
Q

Group 4

A

Calcium channel blockers

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5
Q

Group 5 AA

A

Miscellaneous groups

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6
Q

Group I AA Drugs act on

A

Phase 0

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7
Q

Group 1A AA MOA

A

Prolong the AP duration by blocking INa and slowing conduction velocity in atria, purkinje and ventricular cells

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8
Q

Group 1A AA (4)

A

Procainamide
Quinidine
Disopyramide
Amiodarone

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9
Q

Prolongs AP duration

Intermediate dissociation

A

Group1A

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10
Q

Blocks Na ch leading to slow upstroke AP

Non specific blockade of K ch (Phase4)

A

Procainamide

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11
Q

Procainamide SE (4)

A

SLE-like symptoms
Arthralgia
Arthritis
Torsade

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12
Q

Blocks Na ch but more toxic

A

Quinidine

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13
Q

Quinidine SE (5)

A 
Cinchonism
Tinnitus
Cardiac depression
GI upset
Torsade
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14
Q

Na ch blocker with more antimuscarinic effect

A

Disopyramide

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15
Q

Disopyramide SE (2)

A

Heart failure

Atropine-like (mad as hatter etc)

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16
Q

Class1A drugs can (2)

A

Inc serum digoxin levels

Hyperkalemia

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17
Q

Class1A toxicity tx

A

Na lactate

Vasopressor

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18
Q

Used for all types of arrhythmias

A

Procainamide

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19
Q

Class1B drugs (3)

A

Lidocaine
Mexiletine
Phenytoin

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20
Q

Shortens AP duration

Rapid dissociation

A

Group1B

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21
Q

selectively affects ischemic or depolarized Purkinje and ventricular tissue and have little effect on atrial tissue

A

Group1B

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22
Q

Blocks inactivated and activated Na ch especially Purkinje and ventricular cells

In depolarized cells, inc inactivation and slower unbinding leading to depression of conduction

A

Lidocaine

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23
Q

Shortest AP fast dissociation Group1B

A

Lidocaine

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24
Q

Used for acute ischemic ventricular arrhythmias after MI, digitalis induced arrhythmias

A

Lidocaine

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25
Q

Lidocaine SE (2)

A

Neurologic - covulsion

Hyootension

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26
Q

Group1B least cardiotox

A

Lidocaine

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27
Q

For chronic arrhythmias, neuropathic pain ventricular arrhythmias

A

Mixelitine

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28
Q

Digitalis induced arrhythmias, seizure

A

Phenytoin

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29
Q

Group1B toxicity (5)

A 
Convulsion
Cardiovascular depression
Allergy
Arrhythmia
Hyperkalemia
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30
Q

Group1B ECG change

A

No significant change

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31
Q

Group1C drugs (3)

A

Flecainide
Propafenone
Movicizine

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32
Q

Minimal effect on AP

Slowly dissociating

A

Group1C

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33
Q

Powerful depressants of sodium current

Markedly slow conduction velocity in atrial and ventricular cells

A

Group1 C

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34
Q

For refractory ventricular tachycardias

Intractable supraventricular arrhythmia

A

Group1C

35
Q

Na and K ch blocker with slow unblocking

For PVCs Svtacs
No QT AP prolongation

A

Flecainide

36
Q

Weak beta blocker, Na and K ch blocker for SVTAC

A

Propafenone

37
Q

Propafenone SE (2)

A

Metallic taste

Constipation

38
Q

Group1C SE (4)

A

Proarrhythmic
Local anesthetic like CNS tox
Hyperkalemia
Inc QRS duration

39
Q

GroupII

A

Propranolol
Esmolol
Sotalol

40
Q

cardiac beta adrenoreceptor blockade

reduces cAMP leading to dec in sodium and calcium currents and supression of abnormal pace makers

A

Beta blocker

41
Q

Used for atrial arrhythmias

A

Beta blocker

42
Q

Postmyocardial infarction prophylaxis against sudden death ventricular fibrillation

Thyrotoxicosis

A

Beta blocker

43
Q

Beta blocker toxicity (5)

A 
Bronchospasm
Cardiac depression
AV block
Hypotension
prolongs PR interval
44
Q

beta blocker with direct membrane effect
Na ch blockade prolonging AP
Slows SA automaticity, AV node velocity

A

Propranolol

45
Q

Intraoperative and acute antiarrhythmics

A

Esmolol

46
Q

Non selective beta blocker that prolongs AP

A

Sotalol

47
Q

Group III blocks

A

Phase 3

48
Q

GroupIII (5)

A 
Dofetilide
Ibutilide
Sotalol
Amiodarone
Dronedarone
49
Q

Blocks K ch leading to AP prolongation inc effective refractory period
dec ability of heart to respond to rapid tachycardia

A

Group III

50
Q

Prolongs AP and QT interval by blocking K ch, Ca Ch and is also beta blocker
Also blocks inactivated Na ch

But low torsade de pointes risk

A

Amiodarone

51
Q

Multichannel blocking, also beta blocker but removed iodine atoms

Must be taken with food to inc absorption 3-4x

A

Dronedarone

52
Q

10-15 reduction in bp

Dec mortality in atrial fibrillation

A

Dronedarone

53
Q

Class II and III drug causing prolonged AP and drug of choice for pediatric arrhythmia

A

Sotalol

54
Q

K ch blocker prolongs AP and effective refractory period

A

Dofetilide

55
Q

Sinus rhythm restoration in afib

A

Ibutilide

56
Q

Treatment and prophylaxis of atrial fibrillation

A

Dofetilide, ibutilide

57
Q

Ventricular arrhythmia and atrial fibrillation

A

Sotalol

58
Q

Refractory arrhythmia

broad spectrum

A

Amiodarone

59
Q

Amiodarone SE (7)

A 
Hypo/hyperthyroidism
Pulmonary toxicity pulmo fibrosis
Hepatotoxicity
Deposit in skin, cornea
Bradycardia, AV block
Optic neuritis
Torsade (rare!)
60
Q

Has half life and duration of 1-10 weeks

A

Amiodarone

61
Q

Group IV AA block

A

Phase 2 Ca L type

62
Q

GroupIV (3)

A

Verapamil
Diltiazem
Amiodarone

63
Q

Blocks activated inactivated L type Ca channels
prolonged SA, AV conduction and refractory period
Allows peripheral vasodilation

Avoid ventricular tachy

A

Verapamil

64
Q

Reduces inward calcium current during AP and during Phase 4 leading to

Conduction velocity slowing in AV node

Prolonged refractoriness

Dec pacemaker activity

A

Calcium L type Ch blocker Group 4

65
Q

For AV nodal arrhythmia prohylaxis

A

Verapamil

66
Q

For rate control in atrial fibrillation

Avoid in ventricular fib

A

Diltiazem

67
Q

Verapamil SE (2)

A

Lassitude

Edema

68
Q

Diltiazem SE (2)

A

Hypotension

Bradyarrhythmia

69
Q

Class IV SE (5)

A 
Excessive cardiac depression
Dec AV conduction
Hypotension
Constipation
Inc PR interval
70
Q

Activates inward rectifier K channel, blocks Ca ch leading to complete AV blockade

A

Adenosine

71
Q

Extremely short duration of action (15s)

A

Adenosine

72
Q

DOC for AV nodal arrhythmia

A

Adenosine

73
Q

Adenosine SE (4)

A

Flushing
Chest tightness
Hypotension
Bronchoconstriction

74
Q

Depresses ectopic pacemaker by
Inc K permeability K current
Serum level measured and normalized

A

potassium

75
Q

Inc incidence of arrhythmia (digitalis induced)

A

Hypokalemia

76
Q

Depresses conduction and can cause reentry arrhythmia

A

Hyperkalemia

77
Q

Potassium SE

A

reentrant arrhythmia

78
Q

Interacts with NaK atpase, K Ca ch

Similar depressant effect as potassium on digitalis-induced arrhythmia

A

Magnesium

79
Q

Drug for torsade and digitalis-induced arrhythmia

A

Magnesium

80
Q

Magnesium SE

A

muscle weakness

81
Q

New agents for angina with anti arrhythmic activity

Effective for Sinus arrhythmia only since acts on SA node

A

Ranolazine

Ivabradine

82
Q

Hyperpolarization activated cyclic nucleotide-gated channel blocker

A

Ivabradine

83
Q

Beta blockers that slow progression of CHF

Dec mortality
Attenuates effects of catecholamine
Upregulated beta receptor
Dec HR and remodelling

But not given in acute hf if with systolic dysfxn

A

Carvedilol
Metoprolol succinate
Bisoprolol
Labetalol

Pharma (26 decks)

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