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Pharma Cardio > Drugs Used In Cardiac Arrythmia > Flashcards

Drugs Used In Cardiac Arrythmia Flashcards

1
Q

The normal RMP of ventricles

A

is about –85 to –95 mV

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2
Q

The membrane is most permeable to

A

K+

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3
Q

The main cation that

determines the RMP of cardiac cell

A

K+

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4
Q

No of phases in action potential of vent fibre

A

5

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5
Q

Rmp is in

A

Phase 4

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6
Q

Phase 4 assted with

A

Diastole

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7
Q

Phase 0 aka

A

Rapid depolarization phase

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8
Q

Vmax

A

Max depol rate during phase 1

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9
Q

Phase 0 due to

A

Opening of na channels

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10
Q

Forms of na channel

A

Open closed inactivated

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11
Q

Pattern of na channel

A

Activated inactivated closed

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12
Q

If the

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

A

Closed

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13
Q

If memb pot is less neg

A

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

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14
Q

If resting mp becomes too positive

A

It may lead to arrythmia

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15
Q

Phase 1 due to

A

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

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16
Q

Phase 2

A

Pla2

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17
Q

Phase 2 due to

A

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

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18
Q

Phase 3 due to

A

K+ channel cont opening

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19
Q

In phase 3 k+ closes at

A
  • 80-85 mv
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20
Q

Moa of anti arrhythmic drugs

A

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

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21
Q

Drugs dec autonomic rhythm 4 types

A

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

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22
Q

Inc apd

A

K blocker

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23
Q

Inc threshold

A

Na c blocker

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24
Q

More NEG RMP

A

Ach and adenosine

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25
Q

Slope of phase 4 dec

A

Beta blockers

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26
Q

Class 1 anti arrythmic

A

Na blocker

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27
Q

Class 2 anti arrhythmic

A

Beta blocker

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28
Q

Class 3 anti arty

A

K+

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29
Q

Class 4 anti arrythmic

A

Ca blocker

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30
Q

Class 5 anti arrythmic

A

Misc drugs

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31
Q

Classification of anti arrhythmic

A

Singh and Vaughan Williams classification

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32
Q

Class 1 moa

A

Dec phase 0 slope

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33
Q

Class 1 agent

A

Use dependant blockers

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34
Q

Class 1 agent further classified on

A

Action on k+ channel

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35
Q

Class 1a and k

A

Blocks k channels

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36
Q

Class 1 a apd

A

Prolonged

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37
Q

Class 1 a side effect

A

Qt prolongation and torsades des pointed formation

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38
Q

Class 1 a example

A

Quinidine procainamide disopyridine

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39
Q

Quinidine is

A

Class 1 a

40
Q

Disopyramide is

A

Class 1a

41
Q

Quinidine overdose

A 
Cinchonism
Tinnitus
Vertigo
Deafness 
Headache
Visual disturbance
Mental changes
42
Q

Quinidine and digoxin adr

A

Dec release
Urinary digoxin
Biliary digitoxin

43
Q

Procainamide metabolism

A

Acetylation in liver

44
Q

Procainamide forms after metabolism

A

N acetyl procainamide - retains k block activity

45
Q

Type 1 a prone to drug induced SLE in SLOW ACETYLORS

A

procainamide

46
Q

Procainamide or quinidine must always be used with

A

Av blocking agent

47
Q

Class1b agents ex

A

Lignicaine phenytoin tocainide

48
Q

Class 1b moa

A

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

49
Q

Class 1b kinetics

A

Fast onset offset - more effects at faster heart rates

50
Q

Procainamide doc

A

For wpw syndrome atrial fib

51
Q

Class 1b apd and refractories

A

Dec refractories and apd

52
Q

Slope of phase 0 and 1b drugs

A

Dec vmax

53
Q

Class 1b used for

A

Only used for vent arrythmia

54
Q

Apd in depol class 1b

A

Changes it dec

55
Q

Apd in non depol

A

No change

56
Q

Lignocaine mode of admin

A

Only iv v high fpm

57
Q

Excess ligno effect

A

Neuro toxicity myocardial depression

58
Q

Ligno doc for

A

Ventricular arrhythmia due to digitalis toxicity

59
Q

Lignocaine in afib

A

Useless

60
Q

Lignocaine use in mi induced ventricular Arrythmia

A

1st line drug

61
Q

Mexiletine

A

Class 1b

62
Q

Mexiletine and lignocaine

A

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

63
Q

Phenytoin

A

Also used as alternative for digitalis induced v arrhythmia

64
Q

Tocainide class and adv

A

Class 1b agranulocytosis

65
Q

Class 1 c sod and k channel

A

Sod - max effect of blocking

K no change

66
Q

Ex class 1c

A

Flecainide
Moricizine
Encainide
Propafenone

67
Q

Flecainide is

A
68
Q

Moricizine is

A
69
Q

Propafenone is

A
70
Q

Encainide is

A
71
Q

Class 1c is used only for resisting cases since

A

They are most pro arrhythmic

72
Q

Flecainide used for

A

Wpw syndrome

73
Q

Wpw syndrome treatment of choice

A

Radiofreq ablation

74
Q

Class 2 anti Arrhythmic drugs

A

Beta blocker

75
Q

Moa of class 2

A

Blocks affects of adrenaline in by b1 receptor

76
Q

Class 2 useful in

A

Supraventricular tac

77
Q

Shortest acting beta blocker

A

Esmolol

78
Q

Use of esmolol

A

If for controlling ventricular rate in afib

79
Q

Class 3 agents moa

A

K blocker prolongs repol

80
Q

Class 3 and torsades

A

Possibility present due to qt prolongation

81
Q

Class 3 anti arrhythmic drugs

A 
BINDAS
BRETYLIUM
IBUTILIDE
DIFERILIDE
AMIODARONE
SOTALOL
82
Q

AMIODARONE properties

A

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

83
Q

AMIODARONE risk

A 
Peripheral neuropathy
Myocardial depression
Pulmonary fibrosis
Corneal microdeposits
Photosensitivity
84
Q

DRONEDARONE and AMIODARONE diff

A

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

85
Q

AMIODARONE treatment indication

A

Refractory vt cfm

86
Q

AMIODARONE contraindicated in

A

Torsades does pointes

87
Q

BRETYLIUM

Considered as

A

Pharmacological defib

88
Q

SOTALOL properties

A

Lipid insoluble beta blocker
Atrial tachycardia
V tac
Av reenterant arrythmia

89
Q

IBUTILIDE

A

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

90
Q

DRONEDARONE

A

Similar to AMIODARONE but doesn’t help as much

91
Q

Vernalakant

A

Multi ion channel blocker

Converts afib to sinus rhythm

92
Q

Class 4 agents

A

Blockers of ca channel

93
Q

Verapamil doc for

A

Treatment of svt and prophylaxis of psvte

94
Q

Adenosine doc for

A

Doc for psvt

95
Q

Adenosine and theophylline

A

Inhibition hence dec activity

96
Q

Adenosine and dipyridamole

A

Penetration and potentiation

97
Q

Mg used for

A

Congenital and acquired long qt syndrome

Pharma Cardio (9 decks)

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