Lecture 35 - Antiarrhythmics

Question 1

Torssade de Pointes is a particular type of arrhythmia characterized by long ____ interval with _______ (variability in the length of this interval that allows for the next beat to occur on top of the ___-wave).

Answer 1

long QT

Dispersion

T-wave

Question 2

Quinidine has ____ adrenergic blocking properties (what effect does this have on vasodilation?), so it should not be given to patients with low BP. Remember that it is more commonly used to treat ______, and it has side effects that include _______ and Cinchonism. Also remember it is hepatically eliminated and increases levels of which drugs?

Answer 2

Alpha adrenergic

Malaria

It causes vasodilation

Thrombocytopenia

Digoxin and Warfarin

Question 3

Procainimide has _______ blocking properties which can decrease _____ and lead to hypotension. It can be used to block a bypass conductance track in the heart or to unreveal _____ EKG appearance (particularly in Peruvian patients).

Answer 3

Ganglionic blocking

PVR

Brugada

Question 4

Disopyramide is contraindicated in patients with previous MI bc of its _____ _____ effects. For which patients would it be indicated bc of these effects?

Also, because it has anticholinergic effects, it causes ______ retention.

Answer 4

Negative Inotrope

It would be indicated in patients with hypertrophic cardiomyopathy.

Urinary

Question 5

When discussing conduction in the heart, automaticity typically refers to the _____, while reentry typically refers to the ______.

Answer 5

Atria

Ventricles

Question 6

Which among the class 1 antiarrhythmic drugs can prolong the QT interval, and which can not?

Answer 6

1A and 1C can, 1B cannot.

Question 7

Flecainide (and basically the Class 1C antiarrhythmics in general) must be used in tandem with an _____ nodal blocker (i.e. beta or calcium channel blocker) –> Remember that class 1Cs adjust the rhythm but NOT the _____.

Answer 7

AV

Question 8

The main side effect patients experience when taking Propafenone is a _____ taste in their mouth.

Answer 8

Metallic

Question 9

“Pill in the Pocket” is a treatment used for patients who can recognize when they have ____-fib and do NOT have other cardiac risk factors. The “Pill” is a class ____ antiarrhythmic.

Answer 9

A-fib

Class 1C

Question 10

Sotolol is a class _____ antiarrhythmic that acts as a non-selective ____ blocker.

Answer 10

Class 3

Non-selective Beta blocker

Question 11

Amiodarone has a long half life, up to ____ days, and a large volume of distribution.

Answer 11

100

Question 12

Dronedarone is a safer alternative to ______. It does not have the _____ ring. Remember that it cannot be given to patients with HEART FAILURE.

Answer 12

Amiodarone

Iodine ring

Question 13

Ibutilide is given for chemical conversion of ___-fib. Remember that it acts on Ikr (the rapid K+ channels), which are more abundant in the ____ than the _____. Keep in mind that if Ibutilide is not completely corrective alone, it can enhance _____ cardioversion.

Answer 13

A-fib

Atria than the Ventricles

Electric

Question 14

Whereas Ibutilide is given IV and for rapid Conversion only, _____ is give orally and can be used for maintenance as well.

Answer 14

Dofetilide

Question 15

Digoxin inhibits ___/___ATPase, and it is considered a POSITIVE _____. It also directly stimulates the ______ nerve –> inhibits the AV node.

Answer 15

Na+/K+ ATPase

Inotrope

Vagus

Question 16

Remember Digoxin has drug-drug interactions with _____ and _____.

Answer 16

Verapimil

Amiodarone

Question 17

Digoxin can cause heart ____, a ventricular _______ known as bidirectional ventricular tachycardia, and sometimes _____ vision.

Answer 17

Heart Block

Arrhythmia

Yellow vision

Question 18

Digoxin toxicity may cause hypo______ and/or hypo_______. Remember to supplement accordingly. Also, look for a backward ______ appearance of the QRS wave on EKG.

Answer 18

Hypokalemia

Hypomagnesemia

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