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Pharm 2 > Class 7 Deck 1 > Flashcards

Class 7 Deck 1 Flashcards

1
Q

Antiarrhythmic drugs in class 1 do what?

A

-Block fast Na channels with or w/o K channel block

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2
Q

Name 2 class 1A antiarrhythmics.

A
  • Quinidine

- Procainamide

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3
Q

Class 1A antiarrhythmics do what?

A
  • Lengthen AP duration & effective refractory period (Na channel blockade)
  • Lengthen repolarization (K channel blockade)
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4
Q

What is procainamides MOA?

A
  • Na & K channel blocker
  • Decrease automaticity by decreasing phase 4 (depolarization)
  • Prevent reentry by converting unidirectional to bidirectional block
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5
Q

What are the indications for procainamide?

A
  • Ventricular tachydysrhythmias
  • Atrial tach w/ accessory pathways
  • SVT, AFib, PVCs, VT
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6
Q

Rapid infusion of procainamide can result in what?

A

-Severe hypotension from myocardial depression and vasodilation

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7
Q

Chronic use of procainamide can cause what?

A

-Lupus like symptoms

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8
Q

Procainamide toxicity can cause what?

A
  • Mycardial depression
  • Hypotension
  • QRS and QT prolongation
  • Heart block
  • Ventricular ectopy
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9
Q

Name the 2 main class 1B antiarrhythmic drugs.

A
  • Lidocaine

- Phenytoin

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10
Q

How do class 1B antiarrhythmics work?

A
  • Less powerful Na channel blocker

- Shorten AP duration and refractory period in normal ventricle

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11
Q

What is lidocaine’s (class 1B) MOA?

A
  • Na channel blocker
  • Decrease slope of phase 4 (depolarization) in purkinje fibers
  • Reduce automaticity
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12
Q

What are the indications for lidocaine?

A
  • First choice ventricular arrhythmias (particularly reentry)
  • PVC’s Vtach
  • Will not work for SVT
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13
Q

Lidocaine toxicity can cause what?

A
  • CNS depression or stimulation (convulsions)

- Depress LV performance

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14
Q

What is Phenytoin (class 1B) MOA

A
  • Na channel blocker
  • Depress phase 4 (depolarization)
  • Abolishes activity triggered by digitallis
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15
Q

What are phenytoin’s indications for use?

A
  • Suppress ventricular dysrhythmias associated with digitalis toxicity
  • Paradoxical VTach or Torsades associated with prolonged QT interval
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16
Q

Phenytoin administration tidbits.

A
  • Use with centeral line
  • Dilute in NS
  • Highly alkaline and can cause phlebitis
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17
Q

Phenytoin toxicity problems.

A
  • Rapid admin can cause respiratory arrest, hypotension, ventricular ectopy and death
  • Cerebellar signs (Drowsiness, nystagmus, nausea, vertigo)
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18
Q

Name 2 class 1C antiarrhythmic drugs

A
  • Flecanide

- Propafenone

19
Q

What is Flecainide’s (class 1C) MOA

A
  • Depress AP of phase 0
  • Prolong QRS and PR
  • May suppress SA node (like BB and CCB)
20
Q

When should Flecainide be used?

A
  • Suppress PVC’s and VTach

- Atrial tachydysrhythmias including WPW

21
Q

What are the side effects of flecainimide?

A
  • Negative inotropic effect
  • Vertigo
  • Difficulty in visual accommodation
22
Q

Class 2 antiarrhythmic drugs are called what?

A

-Beta Blockers

23
Q

What is propanolol (class 2 BB) MOA

A
  • Slowing of SA node
  • slowing ectopic pacemakers
  • Prolong AV conduction
  • Increased refractory of AV node
24
Q

What are the indications for propanolol use?

A
  • SVT
  • Convert atrial tachyarrhythmias to sinus rythm
  • Slow ventricular response to AFib and flutter
25
Q

Propanolol toxicity can cause what 3 things?

A
  • Bradycardia/asystole
  • LV failure
  • Bronchospasm
26
Q

antiarrhythmic drugs in class 3 are known as what?

A

-K channel blockade

27
Q

In addition to class 3 effects amiodarone has what other effects?

A
  • Class 1 = Na channel
  • Class 2 = Beta blockade
  • Class 4 = Ca channel
28
Q

Amiodarone is a structural analog of _______

A

-Thyroid hormone

29
Q

What is Amiodarone MOA

A
  • Potent inhibitor of abnormal automaticity
  • Prolongs refractory period and AP duration
  • Antiadrenergic effects
  • Prolong PR,QT, and QRS
  • May slow SA and AV conduction
30
Q

what are amiodarone’s indications for use?

A
  • Termination of Ventricular tachycardias
  • VFib or Vtach in patients unable to tolerate other agents
  • Maintaining SR in patients w/ AFib
  • WPW
31
Q

What drug is considered an alternative to amiodarone (multi-channel blocking agent)? and how is it different?

A
  • Dronedarone
  • Structurally non-ionated
  • Less efficacious but less side effects
32
Q

What is the indication for dronedraone use?

A

-AFib to maintain NSR

33
Q

What are the contraindications of dronedarone?

A
  • Increased risk in patients w/ heart failure or afib
  • 2nd/3rd degree heart blocks
  • Meds that inhibit CYP3A4 can prolong QT
  • Pregnancy
  • Liver disease
34
Q

What is Sotalol MOA?

A
  • Oral non-selective beta

- Lowers BP

35
Q

When is sotalol used?

A
  • PSVT
  • VTach/VFib
  • Antihypertensive
36
Q

What are class 4 antiarrhythmic drugs and name 2.

A
  • Calcium channel blockers

- Verapamil and diltiazem

37
Q

What is verapamil’s MOA?

A
  • Blocks slow Ca influx to cell
  • Prolongs AV conduction
  • Depresses SA node discharge
38
Q

What are the indications for Verapamil use?

A
  • SVT

- Slow ventricular rate in AFib and A flutter

39
Q

What is the major side effect in verapamil use?

A

-Hypotension

40
Q

When is diltiazem used?

A

-Slow ventricular rate in AFib/Flutter

41
Q

what is the MOA for digoxin?

A
  • Inhibits Na/K ATPase

- Slows ventricular response in afib

42
Q

Digoxin will indirectly _______ vagal activity and ______ sympathetic activity.

A
  • Increase

- Reduce

43
Q

Digoxin indications

A

-Ventricular rate control in AFib, AFlutter, SVT

44
Q

What will digoxin toxicity do?

A
  • Alterations in cardiac rate and rhythm may stimulate almost every known rhythm disturbance
  • PVCs most common
  • Enhanced by hypokalemia

Pharm 2 (23 decks)

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