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Drugs Flashcards

0
Q

What phase of the action potential does class Ia effect?

A

Prevents sodium influx in phase 0, and block potassium currents to lengthen the action potential.

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1
Q

What are the Class Ia drugs?

A

Quinidine - Cadioquin
Procainamide - Pronestyl
Disopyramide - Norpace

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2
Q

How does Class Ia drugs work?

A

Blocks Na channels and slows conduction velocity, decreasing the speed of depolarization.

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3
Q

Which class I slows the rate of the action potential rise and prolong ventricular effective refractory period?

A

IA

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4
Q

What is the pharmacokinetic characteristic of Quinidine?

A

Rapid oral absorption

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5
Q

What is the mechanism of Quinidine anti arrhythmic activity?

A

Active sodium channel blockade
Depression of conduction velocity
Reduced excitability

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6
Q

Is Quinidine effective in suppressing SVT/WPW?

A

True

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7
Q

What is the principal ion for the SA and AV node?

A

Calcium

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8
Q

What Drugs are Class Ib?

A

Lidocaine
Tocainide
Mexiletine
Phenytoin - Dilantin

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9
Q

What is a short acting B-adrenergic receptor agonist?

A

Esmolol (Brevilock)

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10
Q

What drug can delay after depolarizations?

A

digoxin toxicity

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11
Q

What receptors does Isoproterenol stimulate?

A

Beta 1&2.

Increase HR, enhanced conduction time through AV node. Causes arterial vasodilitation

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12
Q

What are Ic Drugs?

A

Flecainide

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13
Q

What effects can Quinidine have

A

Prolong QRS
Increase pacing and defib thresholds
Improve AVN conduction

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14
Q

What actions does Procainamide have?

A

Prolong P-R, QRS, QT interval
Increase pacing threshold
Choice for AFIB conducting down BT

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15
Q

What are Disopyramide actions

A

Prolong the QRS and QT interval

Negative Inotrope

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16
Q

What needs to be monitored when giving a Class 1a?

A

Watch QT interval want it to be <500ms

May cause EADs

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17
Q

What is the first line drug in the treatment of VT?

A

Lidocaine

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18
Q

What is the action of Mexiletine

A

Shortens action potential duration
Increases the ERP of the HIS outline system
Treat VT

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19
Q

What are the primary actions of Phenytoin?

A

Shortens QT
Used in children for LQTS when BB fail
DOC in dig toxicity by maintaining AV node conduction and inhibiting DADs

20
Q

What are the primary actions of Tocainide

A

PO form of lidocaine
Shortens action potential
Deceased ERP of HiS purkinje system

21
Q

What are the 1C drugs?

A

Moricizine - Ethmozine
FlecInide - Tambocor
Propafenone - Rhythmol

22
Q

How do class Ic drugs work?

A

Block sodium fast current

Depresses depolarization without changing action potential duration.

23
Q

What does 1c drugs treat?

A

SVT
Widens the QRS with inhibition of HIS
Depress upstroke of phase 0

24
Q

What does flecainide treat?

A

VT and SVT including WPW, AFIB, and AFlutter
Not for pts with structural heart disease.
Increase pacing thresholds and DFT
Decreases conduction velocity therefore prolongs P-R and QRS

25
Q

What does Moricizine treat?

A

-Increase a regrade and retrograde refractory in re entrant limbs of WPW
-Slows retrograde conduction AVNRT
-Exercise stress when initiated Tx
Not for patients with structural heart disease?

26
Q

What doe Propafenone treat?

A 
Used for VT, SVT, AF, AFL, WPW
Prolongs P-R and QRS with no effect on QT
Slows AV conduction
Mild BB and CAB effects
Increase pacing thresholds
27
Q

Considerations for Ic drugs

A

Arrhythmia a may be provoked with increase heart rate
Exercise stress test
Not for pts with underlying heart dx

28
Q

What are Class II drugs?

A

Beta Blockers
Block effects of catacholamines
Decrease SA and AV conduction
Increase refractory of AVN

29
Q

What are the Class II drugs?

A

propranolol - Inderal
Sotalol - Betapace
Cartelol
Carvedolol

30
Q

What are the class III drugs?

A 
Amiodarone
Sotalol
Bretylium
Ibutilide
Dofetilide - Tikosyn
31
Q

How do Class III drugs work?

A 
Prolongs action potential
Blocks potassium currents
Prolongs refractory pd
Prolongs QT interval
Little effect on conduction velocity
32
Q

How does Amiodarone work

A
  • Increases ERP of tissue
  • Prolongs AP duration
  • Slows conduction through AVN b/c beta receptor inhibition
  • calcium agonist
  • increase pacing thresholds and DFT
  • Tx VT and VF and maintaining SR
33
Q

How does Sotalol work?

A

Used to treat VT, VF, AFIB, AFL
Prolongs refractory pd in atrial, AVN, BT and ventricle
Increase pacing thresholds

34
Q

How does Ibutilide work?

A

QT and QTc prolongation
Prolongs repolarization
Pharmacological cardio version
Can cause torsades

35
Q

How does Tikosyn work?

A

Delays repolarization by blocking inward k rectifiers
Prolongs QT and QTc without effecting Ca currents
Decrease DFT
Mild negative ionotrope
Hospital loading for 72hrs to monitor QT

36
Q

What are Class IV drugs?

A

Calcium channel blockers
Vasodilator and decrease PVR
Negative Inotrope
Slows SA and AVN conduction

37
Q

What are the class IV drugs?

A 
Nifedipine
Verapamil
Diltiazem
Amyloid pine
Bepridil
38
Q

How does verapamil work?

A 
Used for SVT NOT WPW or LGL
Increases AVN ERP and AV block
Increase pacing threshold
Tx for exercise induced VT/RVOT
Tx HF post MI
Relaxes arteries throughout system
39
Q

What are Afterdepolarizations?

A

Early occur in phase 2 or 3
Late occur in phase 4
If early enough can initiate an action potential

40
Q

What is EAD

A

Early afterdwpolarizatjon

Proposed mechanism for Torsades
Hypomagnesemia, hypokalemia

41
Q

What increases EADs?

A 
Increase sympathetic tone
Hypoxia
Hypokalemia
Bradycardia
Sotalol, quinidine
n-acetylprocainamide
42
Q

What causes DADs?

A 
Dig toxicity
Tachycardia
Hypokalemia
Hypercalcemia
Catacholamines
43
Q

What drugs increase DFTs?

A 
Ecainide
Flecainide
Lidocaine
Amiodarone
Propafenone
Mexiletine
Moricizine
44
Q

WhT drugs decrease DFTs?

A

Ami
Sotalol
Procainamide

45
Q

What effect does diltiazem have on the AVN?

A

Slows conduction by blocking Ca channels

46
Q

Cardiac cells resting transmembrane potential is?

A

-90mV

47
Q

Which areas of the heart exhibit the type of action potential known as the “slow response” type?

A

SA and AVN

48
Q

A 33yo woman with paroxysmal AFIB has an evaluation that reveals normal physician exam, normal ECG and echo. The most reasonable anti arrhythmic agent to start her on as an outpatient?

A

Flecainide

Drugs (5 decks)

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