Exam 2SUPP

Question 1

Which type of class I:slow the rate of action potential rise and prolong ventricular effective refractory period

Answer 1

Type IA

Question 2

Antiarrhythmic drug with antimalarial and antipyretic effects

Answer 2

Quinidine

Question 3

Pharmacokinetic characteristics of quinidine gluconate

Answer 3

Rapid oral Absorption

Question 4

Quinidine antiarrhythmic activity

Answer 4

activated sodium channel blockade
depression of conduction velocity
reduced excitability

Question 5

Quinidine Effects on QT

Answer 5

PROLONGED

Question 6

Quinidine major clinical use

Answer 6

AFIB

AFLUTTER

Question 7

Quinidine is effective in suppressing__________ tachyarrhythmias due to _______

Answer 7

supraventricular Wolff-Parkinson-White syndrome:

Question 8

In management of atrial fibrillation: the purpose of administering digitalis before quinidine gluconate

Answer 8

digitalis enhances vagal tone and reduces AV nodal transmission

Question 9

Prominent quinidine-mediated actions at receptors:

Answer 9

muscarinic, cholinergic antagonist

alpha adrenergic antagonist

Question 10

quinidine effect on heart rate – mechanism

Answer 10

increased – antimuscarinic effects

Question 11

Quinidine - Side Effects (CHIT)

Answer 11

Cinchonism
HYPOTENSION
Immune –> LUPUS
T achycardia

Question 12

Quinidine ____warfarin levels which increases

bleeding risk

Answer 12

increases

Question 13

Quinidine ________ digoxin plasma concentration– may cause

Answer 13

increases; toxicity

Question 14

***QUINIDINE and NEUROMUSCULAR Transmission

Answer 14

1. Enhances the effect of neuromuscular-blocking drugs

2. Skeletal muscle paralysis postoperatively may reoccur with quinidine administration

Question 15

Antiarrhythmic drug: long-term use associated with a lupus-related side effect:

Answer 15

PROCAINAMIDE

Question 16

Antiarrhythmic drug with more antimuscarinic activity:

Answer 16

QUINIDINE

Question 17

More likely to be administered by IV infusion:-Effective in suppression of ___________and paroxysmal ___________ is this drug _____

Answer 17

premature ventricular contractions ;ventricular tachycardia:

PROCAINAMIDE

Question 18

Intravenous quinidine is rarely used due to causing

Answer 18

vasodilation and myocardial depression

Question 19

Antiarrhythmic: Electrophysiological basis for increasing heart rate:

Answer 19

increased slope of phase 4 depolarization

Question 20

Triggered automaticity: associated with significant action potential duration prolongation

Answer 20

Early afterdepolarization

Question 21

Factors that reduce resting membrane potential

Answer 21

sodium pump blockade
ischemic cells damage
hyperkalemia

Question 22

Principal ion responsible for action potentials in specialized conducting SA nodal and AV nodal tissues:

Answer 22

Calcium

Question 23

Most common cardiac conduction abnormality leading to arrhythmias:

Answer 23

re-entry

Question 24

mexiletine (Mexitil) is a 
Flecainamide
To and PRO cainamide
Amiodarone
Quinidine

Answer 24

Sodium channel blocker

Question 25

Action potential prolonging agent

Answer 25

Bretylium | Ibutilide

Question 26

amine analog lidocaine; suitable for oral administration

Answer 26

Mexiletine

Question 27

Effective in suppression of ventricular arrhythmias associated with digitalis toxicity

Answer 27

Phenytoin

Question 28

Anesthesia consideration for AmIO

Answer 28

Anesthesia Considerations: lowest O2 concentration possible during anesthetic delivery to prevent the formation of free O2 radicales

Question 29

Shortens QT interval more than any other antiarrhythmic drug, but with no significant effect on ST-T waves or QRS complex

Answer 29

PHENYTOIN

Question 30

Corneal microdeposits (which often are asymptomatic) leading to optic neuropathy and/or neuritis and visual impairment

Answer 30

Amiodarone

Question 31

Pulmonary Fibrosis

Answer 31

Amiodarone

Question 32

Amiodarone and Digoxin

Answer 32

amiodarone displaces digoxin from protein binding sites digoxin levels: may increase as much as 70%

Question 33

Amiodarone inhibits the __________________ | leading to dangerous elevations in INR

Answer 33

hepatic metabolism of warfarin

Question 34

An antiarrhythmic drug: 37 percent iodine by weight -- structurally similar to thyroxine

Answer 34

Amiodarone

Question 35

Major non-cardiac side effect associated with lidocaine administration:

Answer 35

CNS

Question 36

Which drug subclass of class I antiarrhythmic agents mainly shorten the cardiac action potential duration and some cardiac tissues and exhibit "RAPID KINETICS describing drug dissociation from the channel.

Answer 36

Class IC

Question 37

Example(s) of (an) antiarrhythmic drug(s) that do not fit the Class 1 - Class 4 categorization include(

Answer 37

Magnesium | Adenosime

Question 38

Class I antiarrhythmic drugs affect primarily this ion-channel

Answer 38

Sodium

Question 39

Drugs associated with this antiarrhythmic drug class mainly block cardiac calcium currents. These agents are associated with reduced (slower) conduction in specialized cardiac tissue such as the SA and AV nodes where the action potential upstroke is dependent on Calcium channel activation.

Answer 39

CLASS 4

Question 40

exhibit limited effects on the cardiac action potential duration and show "SLOW KINETICS" with respect to drug-receptor dissociation.

Answer 40

Class IC

Question 41

Drugs associated with this antiarrhythmic drug class are associated with cardiac action potential duration prolongation.

Answer 41

CLASS III

Question 42

agents mainly increase action potential duration and exhibit "INTERMEDIATE KINETICS" in dissociation from the channel

Answer 42

CLASS IA

Question 43

Prolongation of the cardiac action potential duration | Often block the fast component of the delayed rectifier potassium current, IKr.

Answer 43

CLASS III

Question 44

Dofetilide may be effective and safely used for atrial fibrillation conversion and recurrence prevention even in patients with congestive heart failure.

Answer 44

True

Question 45

Dofetilide used to treat | Donederane used to treat

Answer 45

Afib | Aflutter

Question 46

Dofetilide belongs to which class of antiarrhythmic drugs?

Answer 46

Class 3

Question 47

Choose the correct statement(s) concerning the pharmacology of dofetilide.

Answer 47

Dofetilide is classified as a pure IKr antagonist.

Question 48

Side effect/effects associated with activation of extrapulmonary ß-adrenergic receptors due to sympathomimetic amines used in treating asthma:

Answer 48

Tachycardia Hypokalmeia VQ mistmatch

Question 49

Theophylline is considered________ when compared with inhaled ß2 agonists in causing bronchodilation

Answer 49

less effective

Question 50

Theophylline appears to exhibit not only a bronchodilator effect but also

Answer 50

an anti-inflammatory effect in asthma.

Question 51

T/F

Answer 51

IV aminophylline has been used in treatment of acute, severe asthma..

Question 52

Dopamine (Intropin) -mediated renal vasodilation is caused by which receptor(s) system(s):

Answer 52

dopamine D1 and D2 postsynaptic receptors

Question 53

Cardiac effects of digitalis glycosides:

Answer 53

positive inotropism

Question 54

Agent of choice among the phosphodiesterase inhibitors for short term parenteral support in severe heart failure patients:

Answer 54

milrinone (Primacor)

Question 55

Adverse effects associated with clonidine (Catapres):

Answer 55

dry mouth sedation sexual dysfunction

Question 56

Mechanism by a which methoxamine might terminate paroxysmal supraventricular tachycardia:

Answer 56

causes increased vagal tone through reflex activation -- secondary to increase blood pressur

Question 57

Digoxin

Answer 57

Digoxin reduces cardiac automaticity and increases diastolic resting membrane potential in both atrial and atrioventricular nodes. C. ? Digoxin extends the effect refractory. And reduces AV nodal tissue conduction velocity. These effects on nodal tissue may result in sinus bradycardia,, sinus arrest, or AV block.

Question 58

Bipyridines -- phosphodiesterase inhibitors used in CHF:

Answer 58

Milrinone