Exam 2: Case Lectures: Cardiac

Question 1

What are the class I sodium channel bloackers?

Antiarrhythmics
1. Distinguish the etiology and types and arrhythmias (do NOT need to know how to interpret and ECG)
2. For each drug in red, recall:
* Which Vaughn Williams class it belongs to and its specific mechanism of action
* Major effects on conduction velocity, effective refractory period, action potential duration, and/or AV nodal conduction
* General therapeutic usage & potential contraindications

Answer 1

**Procainamide (moderate): Na+ & K+ channel blocker (Class IA), Due to K+ channel blocker effects
Lidocaine (weak): Rapidly metabolized by the liver, Binds to inactivated state of sodium channel, YOU USE LIDOCAINE IN DAMAGED HEART TISSUE, won’t effect rest of heart, will localize.
(Mexiletine)
Flecainide (strong): Low-risk atrial fibrillation; life-threatening sustained VT
**

Atenolol
Sotalol
Amiodarone
Diltiazem
Verapamil
Digoxin
Adenosine

Question 2

What are the class II beta blockers?

Antiarrhythmics
1. Distinguish the etiology and types and arrhythmias (do NOT need to know how to interpret and ECG)
2. For each drug in red, recall:
* Which Vaughn Williams class it belongs to and its specific mechanism of action
* Major effects on conduction velocity, effective refractory period, action potential duration, and/or AV nodal conduction
* General therapeutic usage & potential contraindications

Answer 2

**Atenolol(selective):
Sotalol(non-selective): **

Question 3

What are your class III K+ channel blockers?

Modulators of Cardiac Contraction
1. Recall basic physiological properties of congestive heart failure. 2. For each drug in red, recall:
* Specific mechanisms of action (relevant to cardiac contractility)
* Major effects on cardiac output and/or peripheral resistance
* Adverse effects and/or major contraindications

Answer 3

Amiodarone
Sotalol [also class II]

Question 4

What are your class IV Ca2+ channel blockers?

Modulators of Cardiac Contraction
1. Recall basic physiological properties of congestive heart failure. 2. For each drug in red, recall:
* Specific mechanisms of action (relevant to cardiac contractility)
* Major effects on cardiac output and/or peripheral resistance
* Adverse effects and/or major contraindications

Answer 4

Diltiazem (cardiac and vascular)
Verapamil (cardiac and vascular)

Question 5

What are your misc antiarrythmetics drugs?

Modulators of Cardiac Contraction
1. Recall basic physiological properties of congestive heart failure. 2. For each drug in red, recall:
* Specific mechanisms of action (relevant to cardiac contractility)
* Major effects on cardiac output and/or peripheral resistance
* Adverse effects and/or major contraindications

Answer 5

Digoxin (slows AV nodal conduction)
Adenosine (slows AV nodal conduction)

Question 6

What are your three RAAS vasodilator drugs?

Vasodilators
1. Recall basic physiological principles of excitation-contraction coupling and intracellular signaling pathways.
2. For each drug in red, recall:
* Specific mechanisms of action (relevant to vasodilation)
* Major effects on total peripheral resistance and blood pressure
* Whether it targets pre-load (venous) or after-load (arterial)
* Adverse effects and/or major contraindications

Answer 6

Aliskiren
Enalapril
Losartan