Cardiac Arrhythmic Drugs (Others)

Question 1

Name some anti-hypetensives that are not part of the 4 basic classes

Answer 1

Adenosine

Vernakalant

Ivabradine

Digoxin

Atropine

Question 2

Describe how adenosine works

Answer 2

Natural nucleoside that binds A1 receptors and activates K current in AV and SA nodes to decrease the AP duration and cause hyperpolarisation

Hyperpolarisation decrease the HR

It decreases Ca current to increase refractory period in AV node

Blocks AV node to prevent rhythms re-entering through AV node - slow AV node conduction

Question 3

Name some uses of adenosine

Answer 3

Convert re-entrant supraventricular arrhythmias

Diagnosis of cornary artery disease

Question 4

Describe how vernakalant works

Answer 4

Vernakalant blocks atrial specific K channels to slow atrial conduction

Has increased potentcy with higher HRs

Question 5

Name some uses and side effects of vernakalant use

Answer 5

Uses - convert recent onset AF to normal sinus rhythm

Side effects - hypotension, AV block, sneezing and taste disturbances

Question 6

Describe how ivabradine works

Answer 6

Ivabradine blocks the funny current channel in the SA node -> slows SA node but does not affect BP

Question 7

Name some uses and side effects of ivabradine

Answer 7

Uses - reduce inappropriate sinus tachycardia, reduce HR in HF and angina

Side effects - flashing lights, teratogenicity not known

Question 8

Descrieb how digoxin works

Answer 8

Digoxin enhances vagal activity by increasing K current, decreasing Ca currnent and increasing the refractory period

It slows AV conduction and slows HR

Acts on Na/K-ATPase in AV node to slow AV node conduction

Question 9

Name some uses of digoxin

Answer 9

Reduce ventricular rates in AF and atrial flutter

Question 10

Describe how atropine works and name some uses of it

Answer 10

Atropine is a selective muscarinic antagonist that blocks vagal activity to speed up AV conduction and increase HR

Used to treat vagal bradycardia

Question 11

Which drugs are used to treat AF

Answer 11

Rate control - bisoprolol, verapamil, diltiazem, +/- digoxin

Rhythm control - sotalol, flecainide with bisoprolol, amiodarone

Question 12

Which drugs are used to treat VT

Answer 12

Metoprolol/bisoprolol

Lidocaine/mexiletine

Amiodarone

Question 13

Name some drugs used to treat WPW syndrome

Answer 13

Flecainide

Amiodarone

Question 14

Name some drugs used to treat acute and chronic re-entrant SVT

Answer 14

Acute (IV) - adenosine, verapamil, flecainide

Chronic (PO) - bisoprolo, verapamil, sotalol, flecainide, procainamide, amiodarone

Question 15

Name some drugs used to treat ectopic beats

Answer 15

FIrst line - bisoprolol

Then flecainide, sotalol, amiodarone

Question 16

Name some drugs used to treat sinus tachycardia

Answer 16

Ivabradine

Bisoprolol

Verapamil