Other 11:

Question 1

1. Class 1 Antiarrhythmic

Answer 1

a. S/S
i. CNS depression
ii. GI irritation
iii. Cardiac toxicity/hypotension/arrhythmias

b. Labs
i. Electrolytes, Glucose, BUN, Cr, Liver enzymes, Thyroid panel (chronic amiodarone)

c. Treatment
i. Bicarb
1. QRS prolongation, bradyarrhythmias, hypotension
ii. Magnesium
1. QTc prolongation
iii. Repletion of potassium
iv. Overdrive pacing
v. Charcoal
vi. Dialysis not recommended
**do not use 1a drugs to treat arrhythmias caused by type 1a, 1c, or type III
drugs

Question 2

2. Antiarrhythmic classes

Answer 2

a. Ia
b. Ib
c. Ic
d. II
e. III

Question 3

a. Ia

Answer 3

i. Fast-channel blockers
1. Na+ channel block (intermediate)
2. K+ channel blocking effect
3. Affect QRS complex
4. Prolong QT

ii. Used for
1. V-arrhythmias
2. Afib
3. WPW

iii. Examples
1. Quinidine
2. Procainamide
3. Disopyramide

Question 4

b. Ib

Answer 4

i. Fast-channel blockers
1. Interfere with Sodium Channel (fast)
2. prolong QRS in OD

ii. Used for
1. Treatment/prevention after MI
2. Vtach

iii. Examples
1. Lidocaine
2. Phenytoin
3. Mexiletine
4. Tocainide

Question 5

c. Ic

Answer 5

i. Fast-channel blockers
1. Interfere with Sodium Channel (slow)
2. QT and QTS prolongation

ii. Used for
1. Prevents paroxysmal afib
2. Treats recurrent tachycardias
3. *contraindicated immediately after MI

iii. Examples
1. Encainide
2. Flecainide
3. Propafenone
4. Moricizine

Question 6

d. II

Answer 6

i. Anti-sympathetic nervous system agents.
1. Most are Beta Blockers

ii. Used for
1. Beta blocking
2. Propranolol also shows some class 1 action

iii. Examples
1. Carvedilol
2. Propranolol
3. Esmolol
4. Metoprolol
5. Atenolol
6. Nebivolol

Question 7

e. III

Answer 7

i. Affect K+ efflux
ii. Prolongs action potential

iii. Prolongs QTc
1. Sotalol is also a beta blocker
2. Amiodarone has Class I; II; III; and IV activity

iv. Uses
1. WPW
2. V-tach and afib (Sotalol)
3. A-flutter and afib (Ibutilide)
4. Stable V-tach (Amiodarone)

v. Examples
1. Amiodarone
2. Sotalol
3. Bretylium

Question 8

f. IV

Answer 8

i. Affect Ca+ channels and AV node

ii. Uses
1. Prevent recurrence of PSVT
2. Reduce Ventricular rate in afib

iii. Examples
1. Verapamil
2. Diltiazim

Question 9

g. Miscellaneous

Answer 9

i. Adenosine receptor agonist
1. Adenosine

ii. Increase vagal tone
1. Digoxin

iii. For torsades
1. Magnesium Sulfate

Question 10

3. Table Salt

Answer 10

a. Too much sodium can cause seizures, coma, and death
i. Cell shrinks (osmosis sends Na from inside cell to extracellular fluid)
ii. Increased fluid in extracellular space (swelling and cerebral edema)

b. Hypovolemic hypernatremia
i. Most common
ii. Have lost salt & water (but have lost more water than salt).
iii. Concentration increased in state of dehydration
iv. Tx with NS

c. Hypervolemic hypernatremia
i. Na+/water retention (more sodium retention)
ii. Over resuscitation with IVF, excessive bicarb admin, excess mineralcorticoid
(cushings)
iii. Tx diuretics (salt wasting) and free water

d. Isovolemic hypernatremia
i. Loss of free water
ii. Caused by diabetes insipidus (not enough ADH or no kidney response to ADH)
iii. Tx free water