CVS pharma

Question 1

A heart patient being treated by his physician, presents to you with increased ANA titers, and a malar rash.
What antibodies can confirm the diagnosis?
Which drug must have prescribed to this patient?
What would be the possible heart condition for what this patient was being treated with that drug?

Answer 1

1. Anti-histone antibodies in patient with increased ANA titers are characteristic of drug-induced lupus.
2. Procainamide is an anti-arrhythmic that causes drug induced lupus.
3. Procainamide is classlically used to treat re-entrant tachycardia or WPW syndrome.

Question 2

The order of affinity of drugs binding to block Na-channels?

Answer 2

CAB.

C having the strongest affinity/dissociate the slowest

Question 3

Which of the class 1 anti-arrhythmic can be given in post-MI induced ventricular arrythmias?

Answer 3

Lidocaine, Mexeltin, Phenytoin.
(Class IB drugs—> only act on dead/ ischemic/ depolarized myocardial tissue)

It has no side effect of torsades de point—> because it REDUCES THE AP, QT interval/ ERP

Question 4

What can be treated with Class IC drugs?

Answer 4

Atrial fibrillation because IC drugs acts strongly on the  ERP of AV-NODE but no effect on the ERP of ventricular tissue/purkinje system. (guy with flakes is watching TV )
Only class 1 drug that has no effect on AP duration!

Question 5

What’s special about Beta-blockers that are both e α- and β-antagonists, and also name them?

Answer 5

Labeta-car. (Labetalol, carvedilol)

Pure B-blockers cause unopposide α1-AGONISM–> which causes crisis in pheochromocytoma and cocaine toxicity.

Question 6

Which class 2 anti-arrythmic should be avoided in a patient who has hyperlipidemia?

Answer 6

Metoprolol.

Question 7

Class 2 anti-arrythmics block what kind of receptors and where?

Answer 7

They work on NODAL CELLS.
In, Nodal action potential they prolong phase 4. (Phase 4 mein funny Na-current and T-type channels are working.)
Beta blockers decrease camp, and hence, ca. This prolongs phase 4 of the nodal action potential.

Question 8

Which Beta-blocker can be given in emergency settings of SVT?

Answer 8

The upper heart is lit up in this sketchy image.

Esmolol—> Given IV in hospitals because it is the shortest acting of all.

Question 9

Which class 2 anti-arrythmic has the least risk of causing torsades-de pointes?

Answer 9

Amiodarone.