Cardiology - Anti-Arrhythmic Drugs

Question 1

Class IA antiarrhythmics? MoA? Effects?

Answer 1

Quinidine, procainamide, disopyramide

Na and K blockade

#Decreases depolarization ; rate
#PROLONGS repolarization

Question 2

Class IB antiarrhythmics? MoA? Effects?

Answer 2

Decreases speed of depolarization

Lidocaine, mexiletine, phenytoin

Na channel blockade

Question 3

Class IC antiarrhythmics? MoA? Effects?

Answer 3

Flecainide, propafenone

Na channel blockade

#Decreases depolarization rate 
#SHORTENS repolarization

Question 4

Class IA Antiarrhythmics - use for which arrhythmias?

Answer 4

#SVT, AFib (procainamide)
#Brugada (quinidine)
#Ventricuar

Question 5

Class IB Antiarrhythmics - use for which arrhythmias?

Answer 5

Ventricular

Question 6

Drug for pre-excitied atrial fibrillation?

Answer 6

Procainamide

Question 7

Class II antiarrhythmics? MoA? Effects?

Answer 7

Beta-blockers; Beta-Blockers

#Decreases SNS tone
#Decreases Automaticity
#Decreases SA and AV node conduction

Question 8

Class II antiarrhythmics - use for which arrhythmias? Avoid if?

Answer 8

#Rate control (atrial)
#SVT
#Ventricular

Preexcitation is present

Question 9

Class IC Antiarrhythmics - use for which arrhythmias?

Avoid in?

Answer 9

#Afib (pill in pocket)
#SVT
#Ventricular arrhythmias

CAD/structural heart disease

Question 10

Class III antiarrhythmics? MoA? Effects?

Answer 10

Sotalol, dofetilide

K blockade - prolongs action potential duration

Question 11

Class III antiarrhythmics - use for which arrhythmias? Avoid in?

Answer 11

Afib, Aflutter
Ventricular arrhythmias

CKD

Question 12

Class IV antiarrhythmics? MoA? Effects?

Answer 12

Verapamil, diltiazem

Non-ihydropyridine CCBs

Suppresses SA and AV node conduction

Question 13

Class IV antiarrhythmics - use for which arrhythmias? Avoid if?

Answer 13

#rate control, SVT
#Triggered arrhythmias (outflow tract VT)

pre-excitation is present

Question 14

Adenosine - Effect? Use for?

Answer 14

Blocks SA/AV node conduction

Termination of SVT

Question 15

Digoxin - MoA? Effect?

Answer 15

Increases vagal activity

Slows AV node conduction

Question 16

Avoid Class IC drugs in these patients? Why?

Answer 16

(Flecainide, propafenone)

CAD or structural heart disease

Ventricular arrhyhmias and death

Question 17

Antiarrhythmic drug class that increases QTc?

Answer 17

Class III (sotalol, dofetilide)

Question 18

Preferred antiarrhyhmic in patients with structural heart disease? Also good in these patients?

Answer 18

Amiodarone

Heart Failure patients

Question 19

Patients on amiodarone need routine monitoring of?

Answer 19

#Thyroid function
#Liver function
#Pulmonary function
#Ophthalmologic evals

Question 20

Amiodarone prolongs the effect of these medications?

Answer 20

#warfarin
#statins
#digoxin