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PHA 415 - Therapeutics III > Exam 4 - Antiarrhythmic Drugs > Flashcards

Exam 4 - Antiarrhythmic Drugs Flashcards

1
Q

Depolarization = ______, while Repolarization = ______.

A

Depolarization = CONTRACTION, while Repolarization = RELAXATION.

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2
Q

__ wave = atrial polarization

A

P wave = atrial polarization

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3
Q

QRS = _____ depolarization

A

QRS = Ventricular depolarization

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4
Q

__ wave = ventricular repolarization

A

T wave = ventricular repolarization

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5
Q

How many msec is the PR interval?

A

120 msec

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6
Q

If the PR interval increases above 200 msec, then its ___ ____ ___ ____.

A

If the PR interval increases above 200 msec, then its FIRST DEGREE AV BLOCK.

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7
Q

How long is the QRS duration?

A

80 msec

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8
Q

The QRS duration = rapid ________

A

The QRS duration = rapid DEPOLARIZATION

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9
Q

Which interval is involved in monitoring antiarrhythmic drug therapy?

A

QT interval

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10
Q

What is the name of a drug-induced polymorphic VT?

A

TORSADES

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11
Q

What is the time of normal QT interval?

A

360 msec, <400-500 is acceptable

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12
Q

What is the name of the classification of antiarrhythmic drugs?

A

Vaughn Williams Classification

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13
Q

What are the classes of drugs in the Vaughn Williams Classification?

A
  • Class I (IA, IB, IC)
  • Class II
  • Class III
  • Class IV
  • Misc.
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14
Q

Which class of drugs are the Na channel blockers?

A

Class I

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15
Q

Which class of drugs are the beta blockers?

A

Class II

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16
Q

Which class of drugs are the K channel blockers?

A

Class III

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17
Q

Which class of drugs are the Non-dihydropyridine (non-dhp) calcium channel blockers?

A

Class IV

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18
Q

Which two classes of drugs are the representative classes of drugs?

A
  • Class I

- Class III

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19
Q

Which classes are in the Class IA (“DPQ”)?

A

D- Disopyramide
P- Procainamide
Q- Quinidine

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20
Q

Which drugs are in the Class IB (“LM”)?

A

L - Lidocaine

M - Mexiletine

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21
Q

Which drugs are in the Class IC (“FP”)?

A

F- Flecainide

P- Propafenone

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22
Q

Which drugs are in the Class III (“DAD IS potassium”)?

A

D- Dofetilide
A- Amiodarone
D- Dronedarone

I- Ibutilide
S- Sotalol

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23
Q

Which drugs are in Class IV (“VD”)?

A

V-Verapamil

D- Diltiazem

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24
Q

Which Class I drug classes have increased effects on the ECG?

A

Class IA and Class IC

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25
What do Class IA and Class IC increase on an ECG?
PR QRS QT
26
Which Class I subset had no effect on an ECG?
Class IB
27
What other class of drugs also increases PR, QRS, and QT on an ECG?
Class III
28
Which class of drugs only increases PR on an ECG?
Class II Class IV Misc. (Adenosine, Digoxin)
29
Which class of drugs is about 50/50 hepatic/renal clearance?
Class IA drugs
30
Which of the 3 Class IA drugs (DPQ) has no oral formulation?
Procainamide
31
Which of the 3 Class IA drugs (DPQ) is not used?
Disopyramide
32
T/F: All three Class IA drugs have high bioavailability.
TRUE
33
Which of the 2 Class IB drugs (LM) has the highest hepatic clearance?
Lidocaine (98% hepatic, 2% renal)
34
T/F: Class IB drugs are more hepatically cleared.
TRUE
35
Which of the 2 Class IB drugs (LM) has the best bioavailability?
Mexiletine (87%)
36
Which of the 2 Class IB drugs (LM) has no active metabolite?
Mexiletine
37
How are the Class IC drugs (FP) cleared?
HEPATICALLY
38
Which of the 2 Class IC drugs (FP) has the better bioavailability?
Flecainide (60-80%)
39
Which of the 2 Class IC drugs (FP) has an active metabolite?
Propafenone
40
In which class of drugs does a deficiency in CYP2D6 matter?
Class IC | -ability to metabolize is diminished
41
Which of the Class III drugs (DAD IS) has the highest volume of distribution and longest half-life?
AMIODARONE - Vd = 66 - T 1/2 = 53 days
42
What does the high Volume of Distribution for Amiodarone mean?
That is distributes everywhere and has a big 3rd space to fill up which means big/prolonged loading dose
43
T/F: Amiodarone is highly lipid or lipophilic.
TRUE
44
How does Amiodarone clear the body?
100% HEPATICALLY
45
T/F: Amiodarone's active metabolite has equal potency.
TRUE
46
Which of the Class III (DAD IS) drugs is water soluble, taken BID, and not well absorbed, requiring administration with food?
DRONEDARONE
47
How is Dronedarone cleared from the body?
HEPATICALLY (90%)
48
Which two drugs in Class III require dose adjustment with CrCl guidelines?
Dofetilide and Sotalol
49
Which 3 Class III drugs do not have an active metabolite?
Dofetilide Ibutilide Sotalol
50
Which of the Class III (DAD IS) drugs is used for pharmacologic conversion of AFib and is IV only?
Ibutilide
51
How long is the half-life of Adenosine?
10 seconds
52
How long is the half-life of Digoxin?
36 hours
53
How is Digoxin cleared from the body?
RENALLY (70%)
54
Which of the antiarrhythmic drugs is the only one monitored?
DIGOXIN
55
T/F: Digoxin requires renal adjustment with poor CrCl.
TRUE
56
Which drug is used to terminate super ventricular tachy-arrhythmias?
Adenosine
57
Which two antiarrhythmic drugs has a PO loading dose?
Amiodarone | Digoxin
58
Which drugs are not given IV?
- Disopyramide (Class IA) - Mexiletine (Class IB) - Flecainide (Class IC) - Propafenone (Class IC) - Sotalol (Class III) - Dofetilide (Class III)
59
What is the dose of Disopyramide (PO maintenance only available)?
IR 100-200 mg Q6H | SR 300-400 mg Q12H
60
What is the dose of Mexiletine (PO maintenance only available)?
100-300 mg Q6-8H
61
What is the dose of Flecainide (PO maintenance only available)?
50-200 mg Q12H
62
What is the dose of Propafenone (PO maintenance only available)?
IR 150-300 mg Q8H | SR 225-425 mg Q12H
63
What is the dose of Sotalol (PO maintenance only available)?
80 mg qd to 160 mg bid
64
What is the dose of Dofetilide (PO maintenance only available)?
125 mcg to 500 mcg bid
65
What proarrhythmia do Class IA drugs (DPQ) cause?
TORSADES
66
What proarrhythmia do Class IC drugs (FP) cause?
MONOMORPHIC VT
67
What proarrhytmia do three of the Class III drugs (D IS) cause?
TORSADES
68
Which drugs cause Torsades?
D- Disopyramide P- Procainamide Q- Quinidine D- Dofetilide I- Ibutilide S- Sotalol
69
Which drugs cause monomorphic VT?
Flecainide | Propefenone
70
Which class of drugs has no cardiac toxicity?
Class IB (LM - Lidocaine - Mexiletine
71
Which drugs cause HF (decreased contractility)?
P- Procainimide Q- Quinidine F- Flecainide P- Propafenone Dr- Dronedarone S- Sotalol
72
Which drugs cause decreased SVR (with IV)?
P- Procainimide Q - Quinidine A from Class III - Amiodarone
73
Which drugs cause AV block?
D- Disopyramide P- Procainamide Q- Quinidine F- Flecainide P- Propafenone D- Dofetilide A- Amiodarone D- Dronedarone I- Ibutilide S- Sotalol
74
Which drugs cause decreased heart rate (SA node)?
P (from FP) - Propafenone A (from DAD IS) - Amiodarone Dr (from DAD IS) - Dronedarone S (from DAD IS) - Sotalol
75
What does any affect at the AV node cause?
1st or 2nd degree heart block
76
What is the name of the Class III drug that is a beta blocker with antiarrhythmic activities?
SOTALOL
77
Which are the two Class III drugs that are the safest in HF patients with Left Ventricular dysfunction (Do and A from DAD IS)?
Do- Dofetilide | A- Amiodarone
78
What is the main non-cardiac toxicity associated with Class IB (LM)?
CNS
79
What is the main non-cardiac toxicity associated with Class IB Mexiletine?
CNS, GI
80
What is the main non-cardiac toxicity associated with Class IC (FP)?
CNS (dizziness, visual disturbances, HA), GI
81
What are the main non-cardiac toxicities associated with Class III (DAD IS - Do and I)?
CNS, GI
82
What are the main non-cardiac toxicities associated with Sotalol?
Beta-blocking effects
83
What are the non-cardiac toxicities associated with Dronedarone?
increased mortality
84
What are the CNS side effects associated with Amiodarone?
Tremor Ataxia Peripheral neuropathy
85
Which is more common in Amiodarone, hyperthyroidism or hypothyroidism?
HYPOTHYROIDISM

PHA 415 - Therapeutics III (17 decks)

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