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Pharm Exams > Mod 6- Antiarrythmic Agents > Flashcards

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
Q

Class II Antiarrhythmic Prototype

A

Propranolol

26
Q

Action of Class III Antiarrhythmics

A

Blocks the potassium channels and slows outward movement of potassium- prolongs action potentials

27
Q

Class III Antiarrhythmic Medications

A

Amiodarone
Dofetilide
Sotalol (-alol belong to potassium channel blockers)

28
Q

Indications for Class III Antiarrhythmics

A

Life threatening ventricular arrhythmias

maintenance of sinus rhythm after conversion of atrial arrhythmias

29
Q

Contraindications for Class III Antiarrhythmics

A

None bc situation is life threatening

30
Q

Caution for Class III Antiarrhythmics

A

Shock, hypotension, respiratory depression, prolonged QT interval, renal/ hepatic disease

31
Q

ADE of Class III Antiarrhythmics

A

N/V, weakness, dizziness, arrhythmias

32
Q

Drug/ Drug interactions of Class III Antiarrhythmics

A

Digoxin or quinidine- increase of serious toxicity

Consult a drug guide unless given during emergency

33
Q

What specific toxicity can happen with the first dose of Class III Antiarrhythmic Amiodarone?

A

pulmonary toxicity and vision changes happen when on it long term

34
Q

Class III Antiarrhythmic Prototype

A

Amiodarone

35
Q

Class III Antiarrhythmics- SAD Banana

A

Potassium channel blockers-
Sotalol
Amiodarone
Dofelitide

36
Q

Class IV Antiarrhythmic Medications

A

Diltiazem

Verapamil

37
Q

Class IV Antiarrhythmic actions

A

block movement of calcium; slow conduction through the AV node

38
Q

Indications for Class IV Antiarrhythmics

A 
supraventricular tachycardia (SVT) 
control the ventricular response to rapid atrial rates
39
Q

Contraindications for Class IV Antiarrhythmics

A

allergy, sick sinus syndrome or heart block, pregnancy, lactation, CHF, hypotension

40
Q

Cautions for Class IV Antiarrhythmic

A

idiopathic hypertrophic subaortic stenosis

renal/ liver impairment

41
Q

ADE of Class IV Antiarrhythmics

A

CNS- weak, dizzy on standing, hypotension

42
Q

Drug/ Drug interactions of Class IV Antiarrhythmics

A

MANY consult drug guide

43
Q

Class IV Antiarrhythmic Prototype

A

Diltiazem

44
Q

Class IV Antiarrhythmic

Very Dairy

A

r/t calcium
Verapamil
Diltiazem

45
Q

McDonald’s Salt Shaker is the mnemonic for which antiarrhythmic?

A

Class I- sodium channel blockers

46
Q

How is adenosine used to treat arrhythmias?

A

basically stops all electrical activity in the heart, very painful

47
Q

How is digoxin used to treat arrhythmias?

A

Negative chronotrope that slows the HR

slows calcium from leaving the cells

48
Q

How is dronedarone used to treat arrhythmias?

A

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
Q

What blood tests do we monitor for antiarrhythmic agents?

A

CBC, Liver & kidney function

50
Q

What needs to be continually monitored while on an antiarrhythmic?

A

Cardiac rhythm

51
Q

Is it better to administer antiarrhytmics paternally or orally

A

Oral if feasible

Pharm Exams (25 decks)

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