Cardiovascular II

Question 1

digoxin

Answer 1

cardiac glycoside

Question 2

digoxin MOA

Answer 2

inhibit Na/K ATPase

• indirect inhibition Na/Ca exchanger
• increased Ca - positive inotropy

stimlate vagus nerve - decreased HR

Question 3

clinical use digoxin

Answer 3

HF - increased contractility

A-fib - decreased conduction at AV and suppression SA node

Question 4

adverse digoxin

Answer 4

cholinergic - N/V, diarrhea, blurry yellow vision, arrythmia, AV block

hyperK - indicator of poor prognosis

Question 5

antidote for digoxin

Answer 5

normalize K
cardiac pacer
anti-digoxin Fab fragments
Mg

Question 6

class I antiarrhythmics

Answer 6

sodium channel blockers

slow phase 0 depolarization
-state dependent

Question 7

quinidine

Answer 7

class IA antiarrhythmic

Question 8

procainamide

Answer 8

class IA antiarrhythmic

Question 9

disopyramide

Answer 9

class IA antiarrhythmic

Question 10

class IA antiarrhythmic MOA

Answer 10

increased AP duration
increased effective refractorr period in ventricular action potential
increased QT interval

Question 11

tx re-entrant and ectopic SVT and VT

Answer 11

class IA antiarrhythmic

Question 12

adverse class IA antiarrhythmic

Answer 12

HA, tinnitus
reversible SLE syndrome
HF
thrombocytopenia

torsades - with long QT

Question 13

lidocaine

Answer 13

class IB antiarrhythmic

Question 14

mexiletine

Answer 14

class IB antiarrhythmic

Question 15

class IB antiarrhthmic MOA

Answer 15

decrease AP duration

preferentially affect ischemic or depolarized purkinje fibers and ventricular tissue

Question 16

tx ventricular arrythmia post MI

Answer 16

class IB antiarrhythmic

Question 17

adverse class IB antiarrhythmic

Answer 17

CNS stimulant/depressant

cardiovasc depression

Question 18

flecainamide

Answer 18

class IC antiarrhythmic

Question 19

propafenanone

Answer 19

class IC antiarrhythmic

Question 20

class IC antiarrhythmic MOA

Answer 20

prolong effective refractory period in AV node

no effect in purkinje and ventricular tissue

minimal effect AP duration

Question 21

decreased slope of phase 0 depolarization

Answer 21

sodium channel blockers - class I antiarrhythmics

Question 22

adverse class IC antiarrhythmic

Answer 22

proarrhythmic

CI post MI and structural heart disease

Question 23

class II antiarrhythmic

Answer 23

beta-blocker

Question 24

metoprolol

Answer 24

class II antiarrhythmic

Question 25

propranolol

Answer 25

class II antiarrhythmic

Question 26

esmolol

Answer 26

class II antiarrhythmic

Question 27

atenolol

Answer 27

class II antiarrhythmic

Question 28

timolol

Answer 28

class II antiarrhythmic

Question 29

carvedilol

Answer 29

class II antiarrhythmic

Question 30

MOA class II antiarrhythmic

Answer 30

beta-blocker - decreased SA and AV node activity - decreased cAMP, decreased Ca current decrease slope phase 4 pacemaker

Question 31

esmolol

Answer 31

short acting beta blocker

Question 32

dyslipidemia

Answer 32

with metoprolol

Question 33

exacerbate prinzmetal angina vasospasm

Answer 33

propranolol

Question 34

unopposed alpha1 agonist

Answer 34

if give beta-blocker alone with pheochromocytoma or cocaine toxicity

Question 35

tx beta-blocker overdose

Answer 35

saline, atropine, glucagon

Question 36

class III antiarrhythmic

Answer 36

potassium channel blocker

Question 37

amiodarone

Answer 37

class III antiarrhythmic

Question 38

ibutilide

Answer 38

class III antiarrhythmic

Question 39

dofetilide

Answer 39

class III antiarrhythmic

Question 40

sotalol

Answer 40

class III antiarrhythmic

Question 41

class III antiarrhythmic MOA

Answer 41

K channel blocker increased AP duration increased effective refractory period increased QT interval

Question 42

adverse sotalol

Answer 42

torsades | excessive beta-blockade

Question 43

adverse ibutilide

Answer 43

torsades

Question 44

adverse amiodarone

Answer 44

``` pulmonary fibrosis hepatotoxic hypothyroid/hyperthyroid - 40% iodine hapten - corneal deposit - skin deposits neuro effects constipation CV effects - brady, heart block HF ``` monitor pulmonary, liver, thyroid function tests

Question 45

class IV antiarrhythmic

Answer 45

calcium channel blocker

Question 46

verapamil

Answer 46

class IV antiarrhythmic

Question 47

diltiazem

Answer 47

class IV antiarrhythmic

Question 48

class IV antiarrhythmic MOA

Answer 48

calcium channel blocker - decreased conduction velocity - increased effective refractory period - increased PR interval

Question 49

adverse class IV antiarrhythmics

Answer 49

constipation flushing edema CV effects - HF, AV block, sinus node depression

Question 50

adenosine MOA

Answer 50

more K out of cell | -hyperpolarize and decreased Ca in cell

Question 51

DOC for abolishing SVT

Answer 51

adenosine very short acting

Question 52

blunt effects of adenosine

Answer 52

theophylline and caffeine

Question 53

adverse of adenosine

Answer 53

flushing, hypotension, chest pain, sense impending doom, bronchospasm

Question 54

tx of torsades

Answer 54

Mg2+