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Mod 6- Antiarrythmic Agents Flashcards

1
Q

What electrolytes can alter action potentials of the heart?

A

sodium, potassium, calcium and magnesium

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2
Q

What is the action of Class 1 Antiarrhythmics?

A

Blocks the sodium channels in the cell membrane during an action potential

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3
Q

What is the action of Class II Antiarrhythmics?

A

Blocks beta-receptors (beta adrenergic), causing depression of phase 4 of the action potential

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4
Q

What is the action of Class III Antiarrhythmics?

A

Prolongs Phase 3

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5
Q

What is the action of Class IV Antiarrhythmics?

A

Blocks calcium channels; works on phase 2

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6
Q

Ia Antiarrhythmic Drugs

A

Disopyramide
Procainamide
Quinidine

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7
Q

Ib Antiarrhythmic Drugs

A

lidocaine

mexiletine

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8
Q

Ic Antiarrhythmic Drugs

A

Flecainide

propafenone

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9
Q

What phase do Class I Antiarrhythmics impact?

A

Phase 0

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10
Q

Indications for a Class I Antiarrhythmic

A

management of acute ventricular arrhythmias during cardiac surgery or MI

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11
Q

Contraindications for Class I Antiarrhythmics

A 
Allergy 
bradycardia or heart block 
CHF 
hypotension or shock
electrolyte disturbances
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12
Q

Cautions for Class I Antiarrhythmics

A

Renal/ hepatic dysfunction

pregnancy

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13
Q

ADE of Class I Antiarrhythmics

A

*CNS: dizziness, fatigue, slurred speech
GI- N/V
*CV- arrhythmia
respiratory depression
Misc.- rash, loss of hair, bone marrow suppression

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14
Q

Drug/ Drug interactions for Class I Antiarrhythmics

A

quinidine & digoxin- inc. digoxin toxicity
oral coagulants- inc. bleeding
digoxin & beta blockers- inc. risk for arrhythmias

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15
Q

Drug/ Food interactions of Class I Antiarrhythmics

A

Foods that alkalinize the urine- citrus, vegetables, antacids, milk products
Grapefruit juice

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16
Q

Antiarrhythmic Prototype

A

Lidocaine

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17
Q

Class I pneumonic: Double Quarter Pounder
Lettuce, Mayo, Tomato
More Fries Please

A

Disophyramide, Quinidine, Procainamide
Lidocaine, Mexiletine, Tocainide
Moricizine, Flecainide, Propefanone

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18
Q

What is the suffix of Class II Antiarrhythmics?

A

“-olol”
acebutolol
esmolol
propanolol

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19
Q

What is the action of Class II Antiarrhythmics?

A

Slows down the HR

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20
Q

When are Class II Antiarrhythmics indicated?

A

used for super ventricular tachycardia >150bpm

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21
Q

Contraindications for Class II Antiarrhythmics?

A

Sinus bradycardia, AV block, cardiogenic shock, CHF, asthma (can cause bronchospasm), respiratory depression, pregnancy, lactation

22
Q

Caution for Class II Antiarrhythmics

A

diabetics- can mask signs of hypoglycemia
thyroid dysfunction- can mask signs
renal/ hepatic dysfunction

23
Q

ADE of Class II Antiarrhythmics

A

Blocking the SNS
*CNS- diziness, insomnia, dreams, fatigue
*CV- hypotension, bradycardia, AV block, arrhythmias
Respiratory- bronchospasm, dyspnea
GI- N/V, anorexia
Misc.- loss of libido, dec. exercise tolerance, alterations in blood glucose levels

24
Q

Drug/ drug interactions of Class II Antiarrhythmics

A

Verapamil- increased drug effects

Insulin- risk of hypoglycemia

25
Class II Antiarrhythmic Prototype
Propranolol
26
Action of Class III Antiarrhythmics
Blocks the potassium channels and slows outward movement of potassium- prolongs action potentials
27
Class III Antiarrhythmic Medications
Amiodarone Dofetilide Sotalol (-alol belong to potassium channel blockers)
28
Indications for Class III Antiarrhythmics
Life threatening ventricular arrhythmias | maintenance of sinus rhythm after conversion of atrial arrhythmias
29
Contraindications for Class III Antiarrhythmics
None bc situation is life threatening
30
Caution for Class III Antiarrhythmics
Shock, hypotension, respiratory depression, prolonged QT interval, renal/ hepatic disease
31
ADE of Class III Antiarrhythmics
N/V, weakness, dizziness, arrhythmias
32
Drug/ Drug interactions of Class III Antiarrhythmics
Digoxin or quinidine- increase of serious toxicity | Consult a drug guide unless given during emergency
33
What specific toxicity can happen with the first dose of Class III Antiarrhythmic Amiodarone?
pulmonary toxicity and vision changes happen when on it long term
34
Class III Antiarrhythmic Prototype
Amiodarone
35
Class III Antiarrhythmics- SAD Banana
Potassium channel blockers- Sotalol Amiodarone Dofelitide
36
Class IV Antiarrhythmic Medications
Diltiazem | Verapamil
37
Class IV Antiarrhythmic actions
block movement of calcium; slow conduction through the AV node
38
Indications for Class IV Antiarrhythmics
``` supraventricular tachycardia (SVT) control the ventricular response to rapid atrial rates ```
39
Contraindications for Class IV Antiarrhythmics
allergy, sick sinus syndrome or heart block, pregnancy, lactation, CHF, hypotension
40
Cautions for Class IV Antiarrhythmic
idiopathic hypertrophic subaortic stenosis | renal/ liver impairment
41
ADE of Class IV Antiarrhythmics
CNS- weak, dizzy on standing, hypotension
42
Drug/ Drug interactions of Class IV Antiarrhythmics
MANY consult drug guide
43
Class IV Antiarrhythmic Prototype
Diltiazem
44
Class IV Antiarrhythmic | Very Dairy
r/t calcium Verapamil Diltiazem
45
McDonald's Salt Shaker is the mnemonic for which antiarrhythmic?
Class I- sodium channel blockers
46
How is adenosine used to treat arrhythmias?
basically stops all electrical activity in the heart, very painful
47
How is digoxin used to treat arrhythmias?
Negative chronotrope that slows the HR | slows calcium from leaving the cells
48
How is dronedarone used to treat arrhythmias?
used to reduce risk of hospitalization in pts w/ persistent AF or flutter who have risk factors for CVD and scheduled to be converted to sinus rhythm
49
What blood tests do we monitor for antiarrhythmic agents?
CBC, Liver & kidney function
50
What needs to be continually monitored while on an antiarrhythmic?
Cardiac rhythm
51
Is it better to administer antiarrhytmics paternally or orally
Oral if feasible

Pharm Exams (25 decks)

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