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Pharm > Cardiovascular Drugs: Antidysrhythmics > Flashcards

Cardiovascular Drugs: Antidysrhythmics Flashcards

1
Q

What is happening during the P wave

A

atrial depolarization

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2
Q

What is happening during the PR interval

A

impulse pauses at AV node

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3
Q

What is happening during the QRS complex?

A

ventricles depolarize

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4
Q

What is happening during ST interval?

A

ventricles pause before repolarization

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5
Q

What is happening during T wave?

A

ventricles repolarize

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6
Q

Where in the EKG do the atria repolarize?

A

Hidden within the QRS complex

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7
Q

What ions are involved with electrophysiology of myocyte?

A

Na+, K+, Cl-, Ca++

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8
Q

Which ion rushes into the myocyte to elicit contraction?

A

Na+

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9
Q

Which ion leaves the myocyte to allow for repolarization?

A

K+

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10
Q

Which ion prolongs repolarization in the myocyte?

A

Ca++

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11
Q

Which ion initiates depolarization of the SA node?

A

Na+ (funny current)

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12
Q

Which ion rushes in and elicits depolarization of SA node?

A

Ca++

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13
Q

Efflux of which ion results in SA node repolarization?

A

K+

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14
Q

List supraventricular arrhythmias

A

atrial fibrillation
atrial flutter
atrial tachycardia (like SVT)

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15
Q

List ventricular arrhythmias

A

ventricular fibrillation (vfib)
ventricular tachycardia (vtach)
PVCs
torsades

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16
Q

Two bradycardic arrhythmias

A

heart block
sick sinus syndrome

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17
Q

What ion do Class I antidysrhythmics inhibit?

A

Na+

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18
Q

What do class II antidysrhythmics inhibit?

A

B1 receptors

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19
Q

What ion do class III antidysrhythmics inhibit?

A

K+

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20
Q

What ion do class IV antidysrhythmics inhibit?

A

Ca++

21
Q

List some class I antidysrhythmics

A

quinidine
procainamide
lidocaine
flecainide
propafenone

22
Q

How do the class subtypes of class I antidysrhythmics differ?

A

IA = increase AP, ERP, QT interval
IB = decrease AP, ERP
IC = increase ERP in AV node only

23
Q

which subtype of beta blockers are used as class II antidysrhythmics?

A

cardioselective usually

24
Q

results of beta 1 antagonism

A

decreased HR
decreased contractility
decreased conduction through AV node

25
Q

adverse effects of beta antagonism

A

bradycardia
hypotension

26
Q

name a class III antidysrhythmic

A

amiodarone

27
Q

What is amiodarone used for

A

ventricular dysrhythmias

28
Q

how long is amiodarone’s half life?

A

25-60 days

29
Q

adverse effects of amiodarone

A

pulmonary fibrosis
hypothyroidism
hepatotoxicity
*pro-dysrhythmic: torsades, bradycardia, AV block

30
Q

What is a dihydropyridine

A

ca++ channel blocker that only impacts the vasculature (results in arteriole vasodilation)

31
Q

What is a nondihydropyridine

A

ca++ channel blocker that works on the arteries (arterial vasodilation) AND on the heart (decreased contractility, HR, AV node conduction)

32
Q

Which type of Ca++ blocker is used in treatment of dysrhythmias

A

nondihydropyridines

33
Q

List some dihydropyridines

A

amlodipine
nifedipine
nicardipine

34
Q

list some nondihydropyridines

A

diltiazem
verapamil

35
Q

Which two classes of antidysrhythmics are contraindicated together?

A

Class II & Class IV
(beta blockers and Ca++ channel blockers)

36
Q

What does adenosine do?

A

hyperpolarize cardiac membranes = no AP can occur

(kinda stops the heart for a sec!)

37
Q

half life of adenosine

A

10 seconds

38
Q

How to administer adenosine

A

rapid IV push followed immediately by rapid saline flush

39
Q

adverse effects of adenosine

A

flushing
transient hypotension
transient flat line
transient chest pain

40
Q

mechanism of action of digoxin

A

Na+/K+ ATPase inhibition = increased Na+ and therefore increased Ca++
= increased contractility

41
Q

drug class of digoxin

A

cardiac glycoside

42
Q

does digoxin cause tachycardia or bradycardia?

A

bradycardia potentially

43
Q

adverse effect of digoxin

A

arrhythmias
AV block
toxicity

44
Q

contraindications of digoxin

A

heart block
hypokalemia (can lead to drug toxicity)
WPW
advanced CKD

45
Q

What class of medication is atropine

A

anticholinergic

(or muscarinic antagonist)

46
Q

Cardiac effects of atropine

A

increased HR

47
Q

uses for atropine as an antidysrhythmic

A

symptomatic bradycardia (1mg Q3-5mins)

48
Q

adverse effects of atropine

A

decreased GI/GU
dry mouth
mydriasis

Pharm (26 decks)

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