Intro to Arrhythmias and Anti-arrhythmics

Question 1

_____ Afterdepolarizations: intracellular calcium leads to elevated Na/Ca exchange, resulting in net influx of positive charge (INCX)

Answer 1

Delayed

Question 2

_____ Afterdepolarizations: reactivation of Ca2+ channels in response to elevated intracellular calcium

Answer 2

Early

Question 3

_______ is a vagal inhibitor (anti-cholinergic) and an α-adrenergic antagonist

Answer 3

Quinidine

Question 4

Adenosine ____ funny current.

Answer 4

decreases

Question 5

Adenosine _____ Ca2+ current.

Answer 5

decreases

Question 6

Adenosine _____ K+ current.

Answer 6

increases

Question 7

Autosomal Dominant form of Long QT Syndrome

Answer 7

Romano-Ward Syndrome (RWS)

Question 8

Autosomal Recessive form of Long QT Syndrome

Answer 8

Jervell-Lange-Nielson Syndrome (JLNS)

Question 9

Class __ drugs: block beta-adrenergic receptors

Answer 9

II

Question 10

Class __ drugs: reduce funny current, L-type Ca2+ current, and K+ current

Answer 10

II

Question 11

Class ___ druges: use-dependent blockers stabilize the inactivated state of Na+ channels, reducing inactivation removal

Answer 11

I

Question 12

Class ___ drugs: block L-type Ca2+ channels

Answer 12

IV

Question 13

Class ___ drugs: reduced amplitude of action potential opens fewer K+ channels and slows repolarization

Answer 13

IV

Question 14

Class ___ drugs: slow Ca2+-dependent upstroke in slow response tissue, which slows conduction velocity

Answer 14

IV

Question 15

Class ___ drugs: slow upstroke of fast response by blocking Na+ channels

Answer 15

I

Question 16

Class ____ drugs: block K+ channels

Answer 16

III

Question 17

Class I__ drugs also prolong refractory period by prolonging Phase 2 via a Class III K+ channel block mechanism

Answer 17

a

Question 18

Class I__ drugs do not prolong Phase 2 of the action potential.

Answer 18

b

Question 19

Class I__ drugs prolong Phase 2 of the action potential.

Answer 19

a and c

Question 20

Class I__ drugs prolong the refractory period.

Answer 20

a, b, and c

Question 21

Class Ia drugs (3)

Answer 21

Quinidine, Procainamide, Disopyramide

Question 22

Class Ib drugs (3)

Answer 22

Lidocaine, Mixeletine, Phenytoin

Question 23

Class Ic drugs (3)

Answer 23

Propafenone, flecainide, encainide

Question 24

Class II drugs (3)

Answer 24

Propanolol, metaprolol, esmolol

Question 25

Class II drugs: increase refractory period by decreasing ______.

Answer 25

K+ current

Question 26

Class II drugs: reduce upstroke rate by decreasing ______.

Answer 26

Funny current and L-type Ca2+ current

Question 27

Class III drug: also acts as a β-blocker

Answer 27

sotalol

Question 28

Class III drug: reduces conduction velocity by blocking Na+ channels and decreases rate of diastolic depolarization in automatic cells

Answer 28

Amiodarone

Question 29

Class III drugs (5)

Answer 29

Ibutilide, Dofetilide, Amiodaron, sotalol, bretylium

Question 30

Class IV drugs (2)

Answer 30

Verapamil, Diltiazem

Question 31

Half-life of 10 minutes

Answer 31

Esmolol

Question 32

Half-life of 10 seconds

Answer 32

Adenosine

Question 33

Half-life of 13-100 days

Answer 33

Amiodarone

Question 34

Mechanisms of Long QT (2)

Answer 34

Incomplete Na channel inactivation; decreased K current

Question 35

Mechanisms of Reentry initiation (3)

Answer 35

Drugs, afterdepolarizations, MI

Question 36

Side Effect: Adenosine

Answer 36

Flushing, shortness of breath, brief AV block

Question 37

Side Effect: Amiodarone (5)

Answer 37

bradycardia, heart block, thyroid dysfunction, pulmonary fibrosis, corneal deposits

Question 38

Side Effect: Beta-blockers (4)

Answer 38

hypotension, exacerbation of heart failure, bronchospasm, impotence

Question 39

Side Effect: Flecainide and Propafenone

Answer 39

highly proarrhythmic

Question 40

Side Effect: Lidocaine (4)

Answer 40

paresthesias, tremors, seizures, confusion

Question 41

Side Effect: Procainamide

Answer 41

Lupus-like Syndrome in 1/3 of patients

Question 42

Side Effect: Sotalol (5)

Answer 42

bradycardia, heart block, thyroid dysfunction, pulmonary fibrosis, corneal deposits

Question 43

Side Effect: Verapamil

Answer 43

Negative cardiac inotropy

Question 44

Use-dependent block is seen in Class _____ anti-arrhythmic drugs.

Answer 44

I and IV