Drugs Used In Cardiac Arrythmia

Question 1

The normal RMP of ventricles

Answer 1

is about –85 to –95 mV

Question 2

The membrane is most permeable to

Answer 2

K+

Question 3

The main cation that

determines the RMP of cardiac cell

Answer 3

K+

Question 4

No of phases in action potential of vent fibre

Answer 4

5

Question 5

Rmp is in

Answer 5

Phase 4

Question 6

Phase 4 assted with

Answer 6

Diastole

Question 7

Phase 0 aka

Answer 7

Rapid depolarization phase

Question 8

Vmax

Answer 8

Max depol rate during phase 1

Question 9

Phase 0 due to

Answer 9

Opening of na channels

Question 10

Forms of na channel

Answer 10

Open closed inactivated

Question 11

Pattern of na channel

Answer 11

Activated inactivated closed

Question 12

If the

membrane potential is at its baseline (about -85 mV) channels will be

Answer 12

Closed

Question 13

If memb pot is less neg

Answer 13

Then only few channel will open may lead to arrhythmia due to lower vmax

Question 14

If resting mp becomes too positive

Answer 14

It may lead to arrythmia

Question 15

Phase 1 due to

Answer 15

Inactivation of na channel , downward def due to k and cl channels

Question 16

Phase 2

Answer 16

Pla2

Question 17

Phase 2 due to

Answer 17

Inward movement of ca through l type and outward movement of k through slow delayed rectifiers

Question 18

Phase 3 due to

Answer 18

K+ channel cont opening

Question 19

In phase 3 k+ closes at

Answer 19

• 80-85 mv

Question 20

Moa of anti arrhythmic drugs

Answer 20

Inc apd
Inc threshold pot
Make max diastolic pot more neg
Dec slope of phase 4

Question 21

Drugs dec autonomic rhythm 4 types

Answer 21

Inc apd
Inc threshold
Maximum diastolic pot more neg
Decrease slope of phase 4

Question 22

Inc apd

Answer 22

K blocker

Question 23

Inc threshold

Answer 23

Na c blocker

Question 24

More NEG RMP

Answer 24

Ach and adenosine

Question 25

Slope of phase 4 dec

Answer 25

Beta blockers

Question 26

Class 1 anti arrythmic

Answer 26

Na blocker

Question 27

Class 2 anti arrhythmic

Answer 27

Beta blocker

Question 28

Class 3 anti arty

Answer 28

K+

Question 29

Class 4 anti arrythmic

Answer 29

Ca blocker

Question 30

Class 5 anti arrythmic

Answer 30

Misc drugs

Question 31

Classification of anti arrhythmic

Answer 31

Singh and Vaughan Williams classification

Question 32

Class 1 moa

Answer 32

Dec phase 0 slope

Question 33

Class 1 agent

Answer 33

Use dependant blockers

Question 34

Class 1 agent further classified on

Answer 34

Action on k+ channel

Question 35

Class 1a and k

Answer 35

Blocks k channels

Question 36

Class 1 a apd

Answer 36

Prolonged

Question 37

Class 1 a side effect

Answer 37

Qt prolongation and torsades des pointed formation

Question 38

Class 1 a example

Answer 38

Quinidine procainamide disopyridine

Question 39

Quinidine is

Answer 39

Class 1 a

Question 40

Disopyramide is

Answer 40

Class 1a

Question 41

Quinidine overdose

Answer 41

``` Cinchonism Tinnitus Vertigo Deafness Headache Visual disturbance Mental changes ```

Question 42

Quinidine and digoxin adr

Answer 42

Dec release Urinary digoxin Biliary digitoxin

Question 43

Procainamide metabolism

Answer 43

Acetylation in liver

Question 44

Procainamide forms after metabolism

Answer 44

N acetyl procainamide - retains k block activity

Question 45

Type 1 a prone to drug induced SLE in SLOW ACETYLORS

Answer 45

procainamide

Question 46

Procainamide or quinidine must always be used with

Answer 46

Av blocking agent

Question 47

Class1b agents ex

Answer 47

Lignicaine phenytoin tocainide

Question 48

Class 1b moa

Answer 48

Block na.Channel in inactivated state possess k+ opening property

Question 49

Class 1b kinetics

Answer 49

Fast onset offset - more effects at faster heart rates

Question 50

Procainamide doc

Answer 50

For wpw syndrome atrial fib

Question 51

Class 1b apd and refractories

Answer 51

Dec refractories and apd

Question 52

Slope of phase 0 and 1b drugs

Answer 52

Dec vmax

Question 53

Class 1b used for

Answer 53

Only used for vent arrythmia

Question 54

Apd in depol class 1b

Answer 54

Changes it dec

Question 55

Apd in non depol

Answer 55

No change

Question 56

Lignocaine mode of admin

Answer 56

Only iv v high fpm

Question 57

Excess ligno effect

Answer 57

Neuro toxicity myocardial depression

Question 58

Ligno doc for

Answer 58

Ventricular arrhythmia due to digitalis toxicity

Question 59

Lignocaine in afib

Answer 59

Useless

Question 60

Lignocaine use in mi induced ventricular Arrythmia

Answer 60

1st line drug

Question 61

Mexiletine

Answer 61

Class 1b

Question 62

Mexiletine and lignocaine

Answer 62

Same action only that ligno only iv but mex can be given orally

Question 63

Phenytoin

Answer 63

Also used as alternative for digitalis induced v arrhythmia

Question 64

Tocainide class and adv

Answer 64

Class 1b agranulocytosis

Question 65

Class 1 c sod and k channel

Answer 65

Sod - max effect of blocking | K no change

Question 66

Ex class 1c

Answer 66

Flecainide Moricizine Encainide Propafenone

Question 67

Flecainide is

Question 68

Moricizine is

Question 69

Propafenone is

Question 70

Encainide is

Question 71

Class 1c is used only for resisting cases since

Answer 71

They are most pro arrhythmic

Question 72

Flecainide used for

Answer 72

Wpw syndrome

Question 73

Wpw syndrome treatment of choice

Answer 73

Radiofreq ablation

Question 74

Class 2 anti Arrhythmic drugs

Answer 74

Beta blocker

Question 75

Moa of class 2

Answer 75

Blocks affects of adrenaline in by b1 receptor

Question 76

Class 2 useful in

Answer 76

Supraventricular tac

Question 77

Shortest acting beta blocker

Answer 77

Esmolol

Question 78

Use of esmolol

Answer 78

If for controlling ventricular rate in afib

Question 79

Class 3 agents moa

Answer 79

K blocker prolongs repol

Question 80

Class 3 and torsades

Answer 80

Possibility present due to qt prolongation

Question 81

Class 3 anti arrhythmic drugs

Answer 81

``` BINDAS BRETYLIUM IBUTILIDE DIFERILIDE AMIODARONE SOTALOL ```

Question 82

AMIODARONE properties

Answer 82

Longest acting Anti arrhythmic drug Actions of all classes Widest anti arrhythmic spectrum Less chances of wpw despite qt prolongation Contains iodine and can result in both hyper and hypothyroidism

Question 83

AMIODARONE risk

Answer 83

``` Peripheral neuropathy Myocardial depression Pulmonary fibrosis Corneal microdeposits Photosensitivity ```

Question 84

DRONEDARONE and AMIODARONE diff

Answer 84

Same prop except doesn’t contain iodine hence no thyroid side effects

Question 85

AMIODARONE treatment indication

Answer 85

Refractory vt cfm

Question 86

AMIODARONE contraindicated in

Answer 86

Torsades does pointes

Question 87

BRETYLIUM | Considered as

Answer 87

Pharmacological defib

Question 88

SOTALOL properties

Answer 88

Lipid insoluble beta blocker Atrial tachycardia V tac Av reenterant arrythmia

Question 89

IBUTILIDE

Answer 89

Structural analog of SOTALOL Treats afib and flutter Converts afib to normal sinus rhythm

Question 90

DRONEDARONE

Answer 90

Similar to AMIODARONE but doesn’t help as much

Question 91

Vernalakant

Answer 91

Multi ion channel blocker | Converts afib to sinus rhythm

Question 92

Class 4 agents

Answer 92

Blockers of ca channel

Question 93

Verapamil doc for

Answer 93

Treatment of svt and prophylaxis of psvte

Question 94

Adenosine doc for

Answer 94

Doc for psvt

Question 95

Adenosine and theophylline

Answer 95

Inhibition hence dec activity

Question 96

Adenosine and dipyridamole

Answer 96

Penetration and potentiation

Question 97

Mg used for

Answer 97

Congenital and acquired long qt syndrome