CCRN

Question 1

Procainamide

Answer 1

Supraventricular and ventricular dysrhythmias

IA antidysrhythmic

increases atrial refractoriness, decreases automaticity, conductivity, and contractility, causes vasodilation

Question 2

Lidocaine

Answer 2

VF/VT

IB antidysrhythmic

decreases ventricular automaticity and excitability,
increases ventricular fibrillation threshold

Question 3

Flecainide

Answer 3

Life-threatening or refractory ventricular dysrhythmias,
atrial or ventricular dysrhythmias that do not respond to other drugs

IC antidysrhythmic

Blocks Na+ influx, depressing rate of depolarization, doesn’t change repolarization and action potential duration

Can cause VT, PVCs, PACs

Question 4

Propafenone

Answer 4

Life-threatening or refractory ventricular dysrhythmias,
atrial fibrillation

IC antidysrhythmic

Blocks Na+ influx, depressing rate of depolarization, doesn’t change repolarization and action potential duration

Can cause VT, PVCs, PACs

Question 5

Propanolol

Answer 5

Supraventricular and ventricular dysrhythmias, HTN, angina, pheochromocytoma, hyperthyroid crisis, MI, hypertrophic CM

Noncardioselective beta-blocker *bronchospasm

Class II antidysrhythmic

Decreases HR, contractility, automaticity, excitability, conductivity
Depresses sinus node automaticity
Increases AV nodal refractoriness and decreases conduction velocity
Decreases myocardial oxygen consumption

May potentiate insulin -> hypoglycemia

Question 6

Esmolol

Answer 6

Supraventricular tachycardia

Cardioselective beta-blocker

Class II antidysrhythmic

Decreases HR, contractility, automaticity, excitability, conductivity
Depresses sinus node automaticity
Increases AV nodal refractoriness and decreases conduction velocity
Decreases myocardial oxygen consumption

May potentiate insulin -> hypoglycemia

Question 7

Metoprolol

Answer 7

HTN, angina, MI

Cardioselective beta-blocker

Class II antidysrhythmic

Decreases HR, contractility, automaticity, excitability, conductivity
Depresses sinus node automaticity
Increases AV nodal refractoriness and decreases conduction velocity
Decreases myocardial oxygen consumption

May potentiate insulin -> hypoglycemia

Question 8

Sotalol

Answer 8

Life threatening or refractory ventricular dysrhythmias

Class II and III antidysrhythmic

Depresses SA node automaticity 
Increases refractory period of atrial and AV junctional tissue to slow conduction
Shortens action potential duration
Inhibits sympathetic activity
Blocks K+ during phase III
Increases action potential duration

Question 9

Amiodarone

Answer 9

Life threatening or refractory ventricular dysrhythmias, refractory supraventricular dysrhythmias, esp WPW

Class III antidysrhythmic
Prolongs action potential and effective refractory period

Can cause PVCs, vt, torsades, pacs, supraventricular tachy

Question 10

Verapamil

Answer 10

Supraventricular dysrhythmias, angina, HTN, hypertrophic CM

Calcium channel blocker

Class IV antidysrhythmic

Depresses rate of SA node, increases refractoriness of AV node, relaxes vascular smooth muscle, decreasing SVR, BP

Question 11

Diltiazem

Answer 11

Angina, coronary artery spasm, mild HF, HTN, hypertrophic CM, supraventricular tachycardia

Calcium channel blocker

Relaxes vascular smooth muscle, decreasing preload and afterload, relieves coronary artery spasms, slows SA and AV nodal conduction times

Question 12

Digitalis

Answer 12

HF, supraventricular tachycardias

Cardiac glycoside

Increases contractility and CO, increases refractory period of AV node, decreaes sinus node firing rate, decreases atrial automaticity, increases GFR and UO

Question 13

Adenosine

Answer 13

Supraventricular tachycardia, not effective in AF/flutter, but may slow rate so flutter can be identified

Endogenous nucleoside

Unclassified antidysrhythmic

Slows conduction through AV node, interrupts reentry pathways through AV node

Question 14

Atropine sulfate

Ipratropium

Answer 14

Symptomatic sinus brady, asystole
Brady dose: 0.5mg
Asystole dose: 1mg

Anticholinergic

Decreases vagal tone, increases sinus rate, increases onduction through AV node, relaxes smooth muscle, prevents bronchospasm, decreases GI, tracheobronchial secretions

Pupils will be dilated and nonreactive

Question 15

Isopreterenol

Answer 15

Bradycardia refractory to other drugs, torsades

Unclassified antidysrhythmic, beta selective adrenergic agent
Increases HR, contractility, conductivity, shortens repolarization and QT interval, causes bronchodilation

Question 16

Enalapril

Answer 16

HF, HTN

ACE inhibitor
Prevents vasoconstriction and aldosterone secretion to decrease preload and afterload

Question 17

Hydralazine

Answer 17

HTN, afterload reduction

Vasodilator antihypertensive
Relaxes arteriolar smooth muscle, decreasing SVR, afterload, and BP

Question 18

Nicardipine

Answer 18

HTN, angina pectoris

Calcium channel blocker
Relaxes smooth muscle decreasing preload and afterload

Question 19

Nitroglycerin

Answer 19

Acute angina, prophylactic use before activies, HF

Nitrates

Relaxes smooth muscle to reduce preload (PAOP), and afterload (SVR) if >1mcg/kg/min
Dilates coronary collateral circulation
Relieves coronary artery spasm

Question 20

Nitroprusside

Answer 20

HTN crisis, HF, cardiogenic shock,

Vasodilator antihypertensive

Relaxes smooth muscle, decreasing preload and afterload

Question 21

Labetalol

Answer 21

HTN, HTN crisis, hTN in aortic dissection

Alpha and beta adrenergic blocker

Decreases BP without reflex tachycardia, causes decrease in HR

Question 22

Phentolamine

Answer 22

HTN, pheochromocytoma, MAOI-tyramine interaction, infiltration of vasopressors

Alpha-adrenergic blocker
Decreases BP without reflex tachy