Pharmacology: Anti-Arrhythmic

Question 1

Which medication is used in the category of potassium channel blockers? (name 1 of them)

Answer 1

Amiodarone (Thing to know about this drug: can cause blue skin)

Question 2

Do you think quinidine is safe to use for a patient receiving macrolide antibiotics?

Answer 2

Increases chances of lethal ventricular arrythmias – both prolong QT interval

Question 3

Which medication causes cinchonism?

Answer 3

Quinidine

Question 4

What is the mechanism of action for atenolol?

Answer 4

Beta blocker selective, B1

Question 5

An example of a calcium channel blockers? The one that puts patient at risk for orthostatic hypotension?

Answer 5

Verapamil & Diltiazem

end of lecture recaps

Question 6

shortening or prolongation of what EKG values indicate arrhythmia?

Answer 6

PR, ST, QT

Question 7

these type of arrhythmias slow the heart:

Answer 7

bradyarrhythmias

Question 8

these type of arrhythmias speed up the heart:

Answer 8

tachyarrhythmias

Question 9

location of non-lifethreatening tachyarrhythmia:

Answer 9

supraventricular

Question 10

location of lifethreatening tachyarrhythmia:

Answer 10

ventricular

Question 11

which type of arrhythmias cannot be fixed with medication?

Answer 11

bradyarrhythmias

Question 12

how are bradyarrhythmias treated?

Answer 12

pacemaker

Question 13

bradyarrhythmias are caused by:

Answer 13

Failure of impulse generation -* ‘sick sinus syndrome’*
Failure of impulse conduction - ‘heart block’

Question 14

class I anti-arrythmia drugs:

Answer 14

Na+ channel blockers

Question 15

Class II anti-arrythmia

Answer 15

Beta-blocker

Question 16

Class III

Answer 16

K+ channel blockers

Question 17

Class IV anti-arrythmia:

Answer 17

Ca+ channel blockers

Question 18

this class 1A drug is a K+ and Na+ channel blocker, but has side effects of GI upset, polymorphic VT (long QT) , and cinchonism:

Answer 18

Quinidine

Question 19

this class IB drug is associated with confusion, dizziness and seizures: (rapid binding and dissociation)

Answer 19

Lidocaine

Question 20

these class I drugs have been know to cause lethal arrhythmia in the presence of structural cardiac disease:

(potent receptor binding & slow dissociation)

Answer 20

Flecainide
Propafenone

Question 21

**non β1 blocker selective **that should NOT be used in patients with asthma or COPD:

Answer 21

Propanolol

*beta blockers are type 2)

Question 22

these selective β blockers are a better anti-arrhythmia option to treat patients with asthma or COPD:

Answer 22

Atenolol, Metoprolol

B1 in heart

Question 23

this** class III anti-arrhythmia drug blocks all ion channels**, all receptors, has high toxicity profile (pulmonary, cutaneous, thyroid, hepatic, ocular) and is associated with polymorphic VT (long QT):

Answer 23

Amiodarone

Question 24

these class IV anti-arrhythmia drug block Ca++ channels, used to decrease HR, but cause **negative inotrope **effect causing orthostatic hypotension:

also dec HR an/or BP, constipation

what does negative inotrope mean?

Answer 24

Verapamil, Diltiazem

drug decreases the efficiency of contractility of the cardiac muscles.

Question 25

drugs such as ________ can also prolong the QT interval and thus caution must be used if prescribing one of these agents to a patient taking an antiarrhythmic drug

Answer 25

macrolide and quinolone antibiotics, azole antifungals, TCA antidepressants and atypical antipsychotics

Question 26

which drugs have DDI with codeine because it is a** 2D6 inhibitor **and will reduce the analgesic effect??

Answer 26

Quinidine and Amiodarone

Question 27

this drug will cause antimuscarinic actions and will be additive with muscarinic antisialogogues:

Answer 27

Quinidine

Question 28

this drug is metabolized by CYP2D6 - due to genetic variations in 2D6 expression, patient monitoring of drug effects and dose titration required
Administration to patients after an MI increases mortality rate 2-3 fold, thus usage in that situation is limited

Answer 28

Flecainide

Question 29

group of symptoms where a patient presents with excessive sweating, blurred vision, ringing sensation in ears & confusion.

Unique side-effect for medications.

Answer 29

Cinchonism

Question 30

relatively safe and can’t precipitate any sort of arrythmia

Answer 30

Lidocaine

Question 31

not good idea for a patient with a congenital heart defect (ex: tetralogy of Fallot)

Answer 31

Flecainide propafenone

Question 32

Explain propranolol selectivity

Answer 32

Propranolol is non-selective, so it can affect B1 in the heart and B2 in lungs.

*If B2 bronchodilation is blocked, results in bronchoconstriction and this can be bad for asthmatic patients.
*

Question 33

implications for dentistry

Answer 33

Question 34

what class is this?
relatively safe, work mainly on calcium channels

Answer 34

class 4