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LECOM pharmacology notecards > Chapter 23- Pharm Of Cardiac Rhythm > Flashcards

Chapter 23- Pharm Of Cardiac Rhythm Flashcards

1
Q

What is the general goal of class 1 anti-arrhythmias

A

Sodium channel blockers

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2
Q

What is the goal of class 2 anti-arrhythmias

A

Beta adrenergic receptor antagonists

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3
Q

What is the goal of class 3 anti-arrhythmics

A

K+ channel blockers

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4
Q

What is the goal of class 4 anti-arrhythmics

A

Calcium Channel blockers

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5
Q

How is quinine administered

A

Orally

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6
Q

What are the class 1A antiarrhythmics

A

Quididine, procainamide, disopyramide

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7
Q

What are some side effects of quinidine

A

SLE, headache, lightheadedness, diarrhea, cinchonism

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8
Q

What are some contraindications for quinidine

A

Myasthenia gravis, conduction defects, history of tornadoes de pointed or prolonged QT interval

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9
Q

What drug toxicity can quinidine induce

A

Digoxin toxicity

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10
Q

What is a major contraindication of procainamide use

A

SLE

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11
Q

What pretreatment should be considered when using procainamide

A

Cardiac glycoside

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12
Q

What is the drug of choice for life-threatening ventricular arrhythmias

A

Disopyramide

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13
Q

What drug impairs the antiarrhythmic activity of disopyramide

A

Rifampin

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14
Q

Who is disopyramide often prescribed to

A

Patients that cannot tolerate quinidine or procainamide

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15
Q

What anti-arrhythmic is best for post-MI

A

class 1B

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16
Q

What are the class 1B anti-arrhythmics

A

Lidocaine/mexiletine, phenytoin

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17
Q

What class 1B anti-arrhythmic can be used for status epilepticus

A

Lidocaine/mexiletine

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18
Q

What is the first sign of lidocaine toxicity in severely ill patients

A

Seizures

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19
Q

What can intramuscular injection of lidocaine cause large increases in the level of

A

Creatine kinase

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20
Q

What are some contraindications of phenytoin

A

Hydantoin hypersensitivity, SA node block, stokes-Adams syndrome

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21
Q

What are the class 1C anti-arrhythmics

A

Encainide, flecainide, miricizine, propafenone

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22
Q

What are some clinical uses for class 1C

A

Sustained ventricular tachycardia, paraoxysmal supraventricular tachycardia

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23
Q

What anti-arrhythmics are associated with excessive mortality and non-fatal cardiac arrest

A

Class 1C

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24
Q

What levels must be monitored with class 1C

A

Levels in patients with significant hepatic impairment

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25
What class of antiarrhythmics are only approved for life-threatening situations
Class 1C
26
What are the class 3 anti-arrhythmics
Ibutilide, dofetilide, sotalol, bretylium, amiodarone, dronedarone
27
What is the clinical application of ibutilide
Conversation of atrial fibrillation or atrial flutter to normal sinus rhythm
28
What does the block of K+ channels caused by class 3 result in
Longer action potential plateau and prolonged repolarization
29
What are contraindications of ibutilide
History of polymorphic ventricular tachycardia (tostadas de pointes), pre-existing long QT syndrome
30
What must be monitored when ibutilide is administered
QT interval
31
How is dofetilide administered
Orally
32
What is a unique contraindication of dofetilide
Patients with creatinine clearance less than 20mL/min
33
Who is dofetilide use reserved to patients with
With highly symptomatic atrial fibrillation and/or atrial flutter
34
What is dofetilide excreted by
Kidney
35
What class 3 antiarrhythmic is also a class 1
Sotalol
36
Who sotalol most frequently used in
Patients that cannot tolerate amiodarone
37
Who must satalol be used with caution in
Patients with impaired renal function or DM
38
What antiarrhythmic is contraindicated in patients with asthma
Sotalol
39
What is a contraindication for bretylium use
Digitalis-induced arrhythmias
40
What class 3 can be used in patients with depressed ejection function
Dofetilide
41
What anti-arrhythmic can act as all classes
Amiodarone
42
What antiarrhythmic can cause HF, severe pulmonary toxicity, thyroid dysfunction, corneal microdeposits, blue-gray skin pigmentation and photosensitivity
Amiodarone
43
What side effect is most common at high doses of amiodarone
Pulmonary toxicity
44
What antiarrhythmic can cause gasping syndrome in neonates
Amiodarone
45
What drug can cause amiodarone increased elimination when co-administered
Cholestyramine
46
Why is dronedarone less lipophilic than amiodarone
Lacks iodine moieties
47
What anti-arrhythmic is contraindicated in pregnancy
Dronedarone
48
Who should dronedarone be used with caution in
Patients with systolic heart failure
49
What anti-arrhythmic increases creatinine without affecting glomerular filtration rate
Dronedarone
50
What are common side effects of adenosine use
Facial flushing, bronchoconstriction in patients with asthma, headache, hypotension
51
What anti-arrhythmic opens G protein coupled K+ channels and suppresses Ca++ dependent action potential, thereby inhibiting SA nodal, atrial and AV nodal conduction
Adenosine
52
What may occur at onset of adenosine infusion
Transient arrhythmia
53
What anti-arrhythmic is notably less effective when used with caffeine
Adenosine
54
What is the clinical use of ranolazine
Chronic angina pectoris
55
What antiarrhythmic improves exercise capacity and reduces anginal events; inhibits fatty acid beta oxidation
Ranolazine
56
What are some common side effects of ranolazine
Constipation, dizziness, headache
57
On what phase(s) of the cardiac AP do amiodarone and sotalol wrk
Phase 0 and 3
58
On what phase(s) of the cardiac AP do lidocaine, flecainide, and quinidine work
Phase 0
59
On what phase(s) of the cardiac AP do beta blockers work
Phase 2 and 4
60
What is responsible for depolarization of SA and AV nodal fibers
Calcium ion (inward)
61
What ion current is responsible for the repolarization of SA and AV nodal fibers
Potassium ion (outward)
62
Where is the SA node located
Right atrium
63
What class of antiarrhythmic agents has membrane stabilizing effects
Beta-blockers
64
What is the general mechanism of class 1
Sodium channel blockers
65
What is the general mechanism of class 2
Beta blockers
66
What is the general mechanism of class 3
Potassium channel blockers
67
What is the mechanism of class 4
Calcium channel blockers
68
Magnesium is used to treat what specific type of arrhythmia
Torsades de pointes
69
What 2 drugs can antagonize the effects of adenosine
Theophylline and caffeine
70
What is the only subgroup of class1 that increase Ap duration and ERP
Class 1A
71
Drugs that affect AV conduction velocity are referred to as what types of agents
Dromotropes
72
What class 1a antiarrhythmic can cause peripheral vasoconstriction
Disopyramide
73
What class 1B antiarrhythmic can cause pulmonary fibrosis
Tocainide
74
Verapamil should not be given in what types of arrhythmias
Wolff-Parkinson's-white (WPW) syndrome; ventricular tachycardia
75
Digoxin-induced arrhythmias are treated by what drugs
Lidocaine; phenytoin

LECOM pharmacology notecards (22 decks)

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