Dr Lawson Arrhythmic Functional Classification Flashcards
What does the mnemonic below relate to in terms of cardiac mediation?
- Some
- Block
- Potassium
- Channels
- Some = Sodium channel blockers
- Block = B-blockers
- Potassium = K+ channel blockers
- Channels = Ca2+ channel blockers
If a patient has sinus tachycardia and we wont to reduce AV node firing, which of the following drugs would be most effective?
1 - Bisoprolol
2 - Flecainide
3 - Amiodarone
4 - Verapamil
1 - Bisoprolol
- B-blocker
- B1 adrenergic receptors are present on pacemaker and cardiomyocytes
B-blockers are indicated for treating sinus tachycardia and reduce AV node firing, essentially reducing HR and correcting tachycardia. Although present on pacemaker and non-pacemaker cells, do beta blockers have a larger effect on pacemaker or non-pacemaker cells?
- pacemaker cells
Beta blockers inhibit noradrenaline and adrenaline from binding to B1 adrenergic receptors. This reduces the number of which channels from opening?
1 - Na+ (funny current)
2 - L-type Ca2+
3 - Na+
4 - K+
2 - L-type Ca2+
- reduces Ca2+ being released at end of stage 4 and start of phase 3
- decreases slope on graph
- reduces SA node firing and HR
- reduces conduction through AV node
What affect do B-blockers have on non-pacemaker cells?
1 - increased chronotropic affect
2 - increase Ca2+ in cells
3 - negative ionotropic affect
4 - positive ionotropic affect
3 - negative ionotropic affect
- reduce force of contraction and HR
If a patient has atrial tachycardia and we wont to reduce atrial arrhythmia, all of the following could work, EXCEPT?
1 - Flecainide,
2 - Bisoprolol
3 - Amiodarone
4 - Amlodipine
4 - Amlodipine = class IV (Ca2+ blocker) BUT works mainly on smooth muscles
1 - Flecainide = class I (Na+ blocker)
2 - Bisoprolol = class II (B-blocker)
3 - Amiodarone = class III (K+)
If there is a problem in the AV node, all of the following drugs could be used EXCEPT which one?
1 - Bisoprolol
2 - Verapamil
3 - Diltiazem
4 - Amiodarone
5 - Atenolol
6 - Digoxin
7 - Adenosine
5 - Atenolol
If a patient has an issue with the ventricular myocardium, we could use all of the following drugs, EXCEPT which one?
1 - Flecainide
2 - Bisprolol
3 - Diltiazem
4 - Amiodarone
3 - Diltiazem
- Mg+ can also be effective here
If we want to inhibit an accessory pathway, which 2 of the following would be best?
1 - Flecainide
2 - Bisprolol
3 - Diltiazem
4 - Amiodarone
1 - Flecainide (class I - Na+)
4 - Amiodarone (class IV - K+)
- such as WPW syndrome
Typically, which medication is used to treat ectopic beats (atrial or ventricular), other than doing nothing?
1 - Propranolol
2 - Amiodarone
3 - Bisoprolol
4 - Adenosine
1 - Propranolol (B-blocker)
- given at a low dose
Typically when treating ventricular tachycardias, which 2 of the drugs are used clinically?
1 - Propranolol
2 - Amiodarone
3 - Bisoprolol
4 - Adenosine
2 - Amiodarone (Class III - K+)
3 - Bisoprolol (Class II - B-blocker)
Typically, clinically which 2 of the following drugs are used to terminate a supraventricular tachycardia?
1 - Verapamil
2 - Amiodarone
3 - Bisoprolol
4 - Adenosine
1 - Verapamil (class IV - Ca2+)
4 - Adenosine (others - mixed effects)
Typically, clinically which of the following drugs is used to prevent atrial and Atrioventricular nodal reentry tachycardia (AVNRT)?
1 - Verapamil
2 - Amiodarone
3 - Bisoprolol
4 - Adenosine
3 - Bisoprolol (class II - B blocker)
Which 2 of the following drugs are used to try and prevent accessory pathways clinically?
1 - Flecainide
2 - Bisprolol
3 - Diltiazem
4 - Amiodarone
1 - Flecainide (class I - Na+)
4 - Amiodarone (class III - K+)
In atrial fibrillation, if we want to slow AF clinically, we can use an AV node blocker. Which of the following drugs are commonly used clinically?
1 - Bisoprolol
2 - Diltiazem
3 - Digoxin
4 - Amiodarone
5 - all of the above
5 - all of the above
- Bisoprolol, Diltiazem and Digoxin all slow HR and have a negative ionotropic effect
- Amiodarone = prolong QT interval and reduce HR
In atrial fibrillation, if we want to maintain sinus rhythm, we would use an atrial stabiliser. The following drugs are commonly used clinically, EXCEPT which one?
1 - Bisoprolol
2 - Flecainide
3 - Digoxin
4 - Amiodarone
3 - Digoxin
- can be very toxic
- also increases QT interval that can cause torsade des pointes
If a patient has sinus tachycardia, typically, which drug is used?
1 - Bisoprolol
2 - Flecainide
3 - Digoxin
4 - Amiodarone
1 - Bisoprolol
- reduces Ca2+ being released at end of stage 4 and start of phase 3
- decreases slope on graph
- reduces SA node firing and HR
- reduces conduction through AV node
If a patient has bradycardia, typically, which drug is used?
1 - Bisoprolol
2 - Flecainide
3 - Atropine
4 - Amiodarone
3 - Atropine
