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CRRAB I Final > Class III > Flashcards

Class III Flashcards

1
Q

What drugs are Class III?

A
  • Amniodarone
  • Dofelititde
  • Ibutilide
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2
Q

What is the mechanism of Class III drugs?

A
  • K+ Channel Blockers
  • Slows repolarization (increases AP duration and effective refractory period)
  • Lengthens QT
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3
Q

What are the cardiac effects of Amniodarone?

A
  • Prolongs AP (also potent Na+ channel blocker, weak beta blocker and Ca2+ blocker)
  • Slows SA and AV node conduction
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4
Q

What are the cardiac effects of Dofelitide?

A
  • Very selective K+ channel blocker
  • Prolongs AP
  • Increases QT interval (prolonged refractory period in His-Purkinje system & ventricles)
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5
Q

What are the cardiac effects of Ibutilide?

A
  • Prolongs AP (also slow inward Na+ activator which delays repolarization)
  • This increases Na+ inactivation –> increased ERP
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6
Q

What are the extra cardiac effects of Amniodarone?

A

Peripheral vasodilation

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7
Q

What are the extra cardiac effects of Dofelitide?

A

Hypokalemia or hypomagnesemia

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8
Q

What are the extra cardiac effects of Ibutilide?

A

Minimal

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9
Q

What are the pharmacokinetics of Amniodarone?

A
  • Hepatic Metabolism (CYP3A4)
  • Metabolite is bioactive
  • Half life is complex –> effects last 1-3 months past cessation of use
  • Can also inhibit many Cyp enzymes affecting Statins, digoxin and warfarin
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10
Q

What are the pharmacokinetics of Dofelitide?

A
  • 100% bioavailable

- Hepatic metabolism (CYP3A4)

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11
Q

What are the pharmacokinetics of Ibutilide?

A
  • Hepatic metabolism

- Mainly really excreted but also some fecal elimination

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12
Q

What toxicity is associated with Amniodarone?

A
  • Bradycardia with heart block in pots. w/SA or AV node disease
  • Drug accumulates in tissues
  • Blocks peripheral conversion of T4 to T3
  • Dose related pulmonary toxicity
  • Abnormal liver function and hypersensitivity hepatitis
  • Photodermatitis (gray blue skin in sun exposed areas)
  • Corneal microdeposits (halos develop in peripheral visual fields)
  • Hypo and hyperthyroidism
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13
Q

What toxicity is associated with Dofelititde?

A

-Life threatening ventricular arrhythmias

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14
Q

What toxicity is associated with Ibutilide?

A
  • Excessive AP prolongation and QT duration can lead to Torsades
  • Can cause life threatening ventricular arrhythmias
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15
Q

What are the therapeutic uses of Amniodarone?

A
  • VTACH
  • VFIB
  • AFIB
  • Atrial flutter
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16
Q

What are the therapeutic uses of Dofelititde?

A
  • Maintains and restores normal sinus rhythm in AFIB

- DO NOT use in Long QT, bradycardia or hypokalemia

17
Q

What are the therapeutic uses of Ibutilide?

A
  • Acute conversion of Atrial flutter and AFIB to normal sinus rhythm
  • More effective in flutter (20 min)

CRRAB I Final (21 decks)

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