Dysrhythmias

Question 1

ventricular arrhythmias

Answer 1

tachycardia, fibrillation

Question 2

atrial arrhythmias

Answer 2

flutter, fibrillation

Question 3

AV junction arrhythmias

Answer 3

AV nodal reentry, acute SVT

Question 4

Class I actions

Answer 4

all block sodium
IA- slows phase 0 depol
IB- shortens phase 3 repol
IC- markedly slows phase 0 depol

Question 5

class II actions

Answer 5

B Blocker

suppress phase 4 depol

Question 6

class III actions

Answer 6

K blocker

prolongs phase 3 repol

Question 7

class IV actions

Answer 7

Ca blocker

shortens AP

Question 8

indicated for atrial and vent arrhythmias, used to maintain rhythm post cardioversion. Class IA

Answer 8

quinidine

Question 9

contraindicated in heart block, SA node dysfunction, cardiogenic shock, severe uncompensated HF, SLE

Answer 9

class IA antiarrhythmics (quinidine)

Question 10

ADRs include arrhythmias, N/V/D, cinchonism,

Answer 10

class IA antiarrhythmics (quinidine)

Question 11

drug metab inhibited by cimetidine. Induced by phenytoin, rifampin, barbiturates. Decreases digoxin clearance

Answer 11

class IA antiarrhythmics (quinidine)

Question 12

metabolized to N-acetylprocainamide, which prolongs duration of AP

Answer 12

procainamide

Question 13

ADRs: hypotension, lupus erythematosus like syndrome, aystole or ventricular arrhythmias, depression, hallucinations, psychosis

Answer 13

procainamide

Question 14

produces negative inotropic effect- contraindicated in HF, causes peripheral vasoconstriction

Answer 14

disopyramide

Question 15

ADRs- anticholinergic, proarrhythmic

Answer 15

disopyramide

Question 16

prototype and DOC for emergency treatment of cardiac arrhythmias post mI. No negative inotropic effect, no impairment of LV dysfunction

Answer 16

lidocaine

Question 17

extensive 1st pass metabolism, dose adjustment in liver failure

Answer 17

lidocaine

Question 18

contraindicated in SA disorders, AV block

Answer 18

lidocaine

Question 19

ADRs- confusion, slurred speech, drowsiness, parasthesias, agitation, cardiac arrhythmias

Answer 19

lidocaine

Question 20

used in chronic vent arrhythmias associated with previous MIs

Answer 20

mexiletine, tocainide

Question 21

associated with pulmonary toxicity that can lead to fibrosis

Answer 21

tocainide

Question 22

questionable safety- blocks Na channels, indicated for refractory ventricular arrhythmias (PVCs)

Answer 22

flecainide

Question 23

have negative inotropic effects (not used in CHF). ADRs include dizziness, blurred vision, HA, nausea, can aggravate pre-existing arrhythmias or induce life threatening vent tachy

Answer 23

class IC- flecainide

Question 24

indicated post MI vent arrhythmias, tachyarrhythmias caused by increased sympathetic activity, atrial flutter and fib, AV nodal reentrant tachycardia

Answer 24

class II- B Blockers

Question 25

block potassium channels, prolonging repolarization and duration or AP. Indicated in vent and supraventricular arrhythmias

Answer 25

class II- B Blockers

Question 26

effective in preventing arrhythmia recurrence and decreasing mortality in patients with sustained VTACH

Answer 26

sotalol

Question 27

ADR includes torsade de pointes

Answer 27

sotalol

Question 28

has class I, II, III, and IV actions (dominant class III). Antianginal and antiarrhythmic activity

Answer 28

amiodarone

Question 29

indicated for refractory SVT and ventricular tachyarrhythmias

Answer 29

amiodarone

Question 30

Long half life. ADRs include pulmonary fibrosis, GI intolerance, tremor, ataxia, hyper/hypo thyroidism, neuropathy, muscle weakness, blue skin discoloration

Answer 30

amiodarone

Question 31

slowed phase 4 spontaneous depol and slowed conduction in tissues dependent on calcium currents (AV node)

Answer 31

CCBs

Question 32

indicated for atrial arrhythmias, reentrant suprevent tachy, reducing vent rate in atrial flutter and fib, HTN, angina

Answer 32

CCB

Question 33

ADRs: hypotension. Contraindicated in pts with preexisting depressed cardiac function due to its negative inotropic properties

Answer 33

CCB

Question 34

endogenous nucleoside that acts at tissues in lungs, afferent nerves, and platelets

Answer 34

adenosine

Question 35

has a short DOA. Decreases conduction velocity, prolongs the refractory period and decreases automaticity in the AV node

Answer 35

adenosine

Question 36

contraindicated in 2nd and 3rd degree heart block

Answer 36

adenosine

Question 37

DOC for abolishing supraventricular tachycardia

Answer 37

adenosine

Question 38

ADRs- transient facial flushing, chest pain, dyspnea, bronchospasm

Answer 38

adenosine

Question 39

shortens refractory period in atrial/vent cells while prolonging effective refractory period and decreasing conduction velocity in purkinje fibers

Answer 39

digoxin

Question 40

indicated to control vent rate in Afib and Aflutter. ADRs include ectopic vent beats- VTACH and VFIN

Answer 40

digoxin

Question 41

this should be considered in all afib patients who are severely symptomatic or hemodynamically unstable

Answer 41

immediate DCC

Question 42

all afib patients need

Answer 42

anticoagulation ventricular rate control restoration of normal sinus rhythm

Question 43

when would you chose long term pharm rate control (rather than cardioversion)

Answer 43

no deterioration in sx w afib and HR controlled normal LV function duration of afib > 1 year failure to maintain NSR despite cardioversion

Question 44

when would you chose cardioversion

Answer 44

symptomatic with NSR LVH duration of afib < 1 year young, active patients