Cardiovascular drugs

Question 1

Describe the Antiarrhytmic drugs:

Answer 1

1. Ectopic impulse!
2. Cardiomyopathy
3. Re-entry
4. Drugs
5. Electrolite imbalances
6. Primary cause

Question 2

Give the groups of Vaughan-Williams conductance:

Answer 2

• Group 1 – Na-channel blockers (membrane stabilizers:
• -Group 3: K+ channel blockers ERP increases excellent in re-entryGroup 2 – Beta blockers = Beta receptor antagonists
• Group 4 – Ca2+ channel blockers:

Question 3

Name the drugs in group 1:

Answer 3

Quinidine, Procainamide, Lidocaine, Mexiletine

Question 4

Effect of Quinidine,

Answer 4

• Vagal effect (+direct effect)

- Negative inotropic (heart failure)

Question 5

Pharmacokinetics of Quinidine,

Answer 5

Dog: GI, CV side effects)

• Cat (short t1/2)
• Horse: IV or PO, frequent side effects
• supraventricular arrythmias

Question 6

Side effects of Procainamide:

Answer 6

negative inotropic, arrhytmogenic.

• Unfavorable pharmacokinetics
• Ventricular arrhythmias IV if refractory to lidocaine

Question 7

Effects of Lidocaine,

Answer 7

Immediate treatment of life threatning ventricular arrhythmias
-No supraventricular effect

Question 8

Pharmacokinetics of Lidocaine,

Answer 8

• Orally?

- IV, loading dose and then continuous infusion

Question 9

Side-effects of Lidocaine,

Answer 9

CNS ( diazepam)
-Heart (sick sinus syndrome)
-NO negative inotropic effect, hypotension, conductance failure
safe to use

Question 10

Effects of Mexiletine

Answer 10

Treatment of ventricular arrhythmias as home, DCM,HCM.

-Similar to lidocaine

Question 11

Pharmacokinetics of Mexiletine

Answer 11

• Orally

- Frequently combined with Beta blockers (antenolole,sotalole)

Question 12

Side effects of Mexiletine

Answer 12

rare

Question 13

Indications of groups 2

Answer 13

1. Supraventricular and ventricular arrhythmias
   - Preventing sudden death
2. HCM
3. Hyperthyroidism,methylxanthine poisoning

Question 14

Contraindications of group 2

Answer 14

Contraindications: severe bradycardia, AV-block

Question 15

Which groups do we split group 2 into?

Answer 15

1.generation)beta1+2), 2nd generation (beta 1) and 3rd generation (beta1 + peripherial)

Question 16

Name the drugs of the 1.generation)beta1+2)

Answer 16

Propanolol

Question 17

Name the drugs of the 2nd generation (beta 1)

Answer 17

Metoprolol
-Atenolol
-Esmolol
In ca: combination with mexiletine

Question 18

Name the drugs of the and 3rd generation (beta1 + peripherial)

Answer 18

Carvediolol

-Slowly developing effect

Question 19

Drugs of group 3:

Answer 19

Sotalol – excellent in boxer cardiomyopathy

Amiodarone – 1+2+3+4 effects! Supraventricular + ventricular

Question 20

Drugs of group 4:

Answer 20

1-Dihydropyridine type (vessels) amlodipine, nifedipine

2.Non-dihydropyridine type (heart) verapamil, diltiazem

Question 21

Mechanism of group 4:

Answer 21

SA-node and AV-node bradycardia (Bradycardia is a heart rate that’s too slow.)
Mainly supraventricular
Decreased Ca2+-influx decreased contraction and vasodilatation.