Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular Medicine-Unit 2 > Drugs For Cardiac Arrhythmias (Konorev) > Flashcards

Drugs For Cardiac Arrhythmias (Konorev) Flashcards

1
Q

What are the 1B Na channel blocking drugs?

A

Lidocaine

Mexiletine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which cell types have a fast AP?

A

Ventricular contractile cardiomyocytes
Atrial cardiomyocytes
Purkinje fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which cell types have a slow (pacemaker) AP?

A

SA node cells

AV node cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 1C Na channel blocking drugs?

A

Flecainide

Propafenone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the class 2 antiarrhythmic drugs?

A

Beta blockers

Esmolol and propanolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are class 3 antiarrhythmic drugs?

A 
K channel blocking drugs
Amiodarone
Dronedarone
Sorta lol
Dofetilide
Ibutilide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are class 4 antiarrhythmic drugs?

A

Cardioactive Ca channel blockers

Verapamil and Diltiazem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Class 1A drugs preferentially bind to __ channels

A

Open (activated) Na

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Class 1A drugs have what effects on the following:

  • K channels: ___
  • AP duration: ___
  • QRS and QT intervals: ___
A

Block

Prolong

Prolong

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

This 1a drug is used to tx sustained V tach, directly depresses the activities of SA and AV nodes, and possesses antimuscarinic activity

A

Procainamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are adverse effects of Procainamide?

A

Cardiac –> QT prolongation, induce Torsade de pointes and syncope

Extracardiac –> lupus syndrome, nausea, diarrhea, and agranulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

This 1a drug is a natural alkaloid from Cinchona bark that is used occasionally for restoring rhythm in A flutter/fib pts with normal (but arrhythmic) hearts

A

Quinidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are adverse effects of quinidine?

A

Cardiac –> QT prolongation, induce Torsades

Extracardiac –> GI side effects, headache, dizziness, tinnitus, thrombocytopenia, hepatitis, fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

This 1a drug is used for tx of recurrent V Tac

A

Disopyramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are adverse effects of Disopyramide?

A

Cardiac –> QT prolongation, induce torsades, negative inotropic effect

Extracardiac –> atropine-like symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Class 1B drugs bind to ___ channels

A

Inactivated Na , preferentially bind to depolarized cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

This 1B drug blocks inactivated Na channels-selectively blocks conduction in depolarized tissue, making damaged tissue completely “electrically silent”. It is used in mono- and polymorphic V Tac

A

Lidocaine: extensive 1st pass metabolism and only by IV route

This is the least toxic of all Class I drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

__ is an orally active 1B drug used for ventricular arrhythmias, to relieve chronic pain (esp pain d/t diabetic neuropathy and nerve injury)

A

Mexiletine

Adverse effects: tremor, blurred vision, nausea, lethargy

19
Q

Class 1C drugs block Na channels to slow impulse conduction and preferentially bind to __ Na channels

A

Open (activated)

They also block certain K channels

20
Q

What do 1C drugs do to the QRS complex?

A

Prolong QRS

21
Q

This 1C drug blocks Na and K channels and has no antimuscarinic effects. It is used to tx pts with normal hearts, supraventricular arrhythmias including AF, paroxysmal SVT (AVNRT, AVRT).

A

Flecainide

22
Q

This 1C drug possesses weak B-blocking activity and used to prevent paroxysmal AF and SVT in pts without structural disease and also used in sustained ventricular arrhythmias

A

Propafenone

23
Q

What are some adverse effects of Propafenone and what should you no combine with?

A

Exacerbates ventricular arrhythmias
Metallic taste
Constipation

Do NOT combine with CYP2D6 and CYP3A4 inhibitors as risk of proarrhythmia may be increased

24
Q

What effects do class 2 drugs have on the following:

  • SA node: ___
  • AV node: ___
  • Ventricular myocardium: ___
A

SA node: decrease HR (Increase RR interval)
AV node: decrease AV conductance (Increase PR interval)
Ventricular myocardium: decrease Ca overload, prevent delayed after-depolarizations

25
Q

What are clinical indications for Propanolol (class 2)?

A

Arrhythmias associated with stress
Re-entrant arrhythmias that involve the AV node
A fib and flutter
Arrhythmias associated with MI

26
Q

This class 2 drug is a selective B1 blocker with a short half life (10 min) on continuous IV fusion

A

Esmolol

27
Q

What effects do Class 3 drugs have on the following:

  • AP: ___
  • QT interval: ___
  • Refractory period:___
A

Prolong AP duration

Prolong QT interval

Prolong refractory period

28
Q

This class 3 drug blocks K and inactivated Na channels, prolongs QT interval and APD uniformly over wide range of HR’s. It possesses adrenolytic activity, has Ca channel blocking activities, cuases bradycardia and slows AV conduction. It can also cause peripheral vasodilation and is used to Tx ventricular arrhythmias

A

Amiodarone

29
Q

Amiodarone is metabolized by ___

A

CYP3A4

1/2 life affected by drugs that inhibit CYP3A4 (Cimetidine) or induce it (Rifampin)

30
Q

What are some adverse effects of Amiodarone?

A

Cardiac –> AV block and bradycardia

Extracardiac –> fatal pulm fibrosis, hepatitis, photodermatitis, depositis of drug in cornea and other eye tissues, blocks peripheral conversion of thyroxine to triiodothyronine

31
Q

This class 3 drug blocks multiple K channels, blocks Na current, blocks L-type Ca current, and has stronger antiadrenergic effects than Amiodarone

A

Dronedarone

32
Q

What is the Black box warning for Dronedarone?

A

Increases risk of mortality in pts with decompensated HF (Class IV) and in pts with a recent decompensation of HF requiring hospitalization

33
Q

This drug is a class 2 (non-selective B blocker) and class 3 agent (prolongs APD). It is used to tx life-threatening ventricular arrhythmias and maintenance of sinus rhyth in pts with A fib.

A

Sorta lol

34
Q

What are adverse effects of Sotalol?

A

Depress cardiac function

Provoke Torsades

35
Q

This class 3 drug specifically blocks rapid component of delayed rectifier K current. It has a very narrow therapeutic window and used to convert AF to the sinus rhythm and maintain sinus rhythm after cardioversion.

A

Dofetilide

36
Q

What are adverse effects of Dofetilide?

A

QT prolongation and increased risk of ventricular arrhythmias

37
Q

What effects do Class 4 drugs have on the following:

  • Slope of phase 0 depolarization: ___
  • SA node depolarization: ___
  • AV node conduction time: ___
  • AP duration and refractory period in AV node: __
A

Decrease slope of phase 0 depolarization
Slow SA node depol., causing bradycardia
Prolong AV node conduction time
Prolong AP duration and refractory period in AV node

38
Q

What are clinical uses of Diltiazem?

A

Prevention of paroxysmal SVT

Rate control in A fib and A flutter

39
Q

What are adverse effects of class 4 drugs?

A

Cardiac –> negative inotropy, AV block, SA node arrest, bradyarrhythmias, hypotension

Extracardiac–> constipation (Verapamil)

40
Q

This drug activates K current and inhibits Ca funny currents, causing marked hyperpolarization and suppression of APs in pacemaker cells. It inhibits AV conduction and increases nodal refractory period. It is used clinically to convert sinus rhythm in paroxysmal SVT

A

Adenosine

41
Q

What are adverse effects of adenosine?

A 
SOB
Bronchoconstriction
Chest burning
AV block
Hypotension
42
Q

Which antiarrhythmic drug classes can cause long QT syndrome and torsade de pointes arrhythmias?

A

Class 1a and 3

43
Q

What are the 1A Na channel blocking drugs?

A

Quinidine
Procainamide
Disopyramide

Cardiovascular Medicine-Unit 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions