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Cardiovascular module > Pharmacology: Katzung antiarrythmic drugs > Flashcards

Pharmacology: Katzung antiarrythmic drugs Flashcards

1
Q

Procainamide, Disopyridamide, and quinidine belong to which group of drugs?

A

They are group 1A anti-arrythmics

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2
Q

What is the MOA for Procainamide, Disopyridamide, and quinidine?

A

They block either inward sodium or inward potassium channels. This slows the conduction velocity, slows pacemaker activity and prolongs action potential and refractory period.

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3
Q

What are the clinical applications for Procainamide, Disopyridamide, and quinidine?

A

(1) Atrial and ventricular arrythmias particularly after myocardial infarction.

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4
Q

What are the adverse effects associated with Procainamide, Disopyridamide, and quinidine?

A

(1) increased arrythmias
(2) Hypotension
(3) Lupus like syndrome

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5
Q

What makes disopyramide different than the other group 1A antiarrythmics?

A

disopyramide has a longer duration of action and has extra toxicities that include antimuscarinic effects and heart failure.

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6
Q

What differnetiates quinidine from the other group 1A anti-arrythmics?

A

Quinidine has an extra toxicity called cinchonism which includes

(1) tinnitus
(2) headache
(3) GI disturbance

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7
Q

To which group of drugs do Lidocaine and Mexiletine belong?

A

They are Group 1B anti-arrythmics?

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8
Q

What is the MOA for Lidocaine and Mexiletine?

A

Highly selective and state dependent block of inward Na channels. Minimal effect in normal tissue.

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9
Q

What are the clinical applications for Lidocaine and Mexiletine?

A

(1) Ventricular arrythmias post myocardial infarction

(2) digoxin-induced arrythmias.

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10
Q

What are the adverse effects associated with Lidocaine and Mexiletine?

A

CNS sedation or exitation

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11
Q

What differentiates mexiletine from lidocaine?

A

Mexiletine has oral activity and a longer duration of action.

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12
Q

To what group of drugs does Flecainide belong to?

A

Flecainide is a group 1C anti-arrythmic

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13
Q

What is the MOA for Flecainide?

A

it causes a selective and state dependent block of inward Na channels. This leads to slowed conduction velocity and slowed pacemaker activity.

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14
Q

What are the clinical applications for flecainide?

A

refractory arrhythmias.

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15
Q

What adverse effects are associated with Flecainide?

A

(1) increased arrhythmias

(2) CNS excitation

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16
Q

To what class of arrhythmics do propranolol and Esmolol belong to?

A

The are Group 2 arrhythmics. (also they are beta blockers)

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17
Q

What is the MOA for propranolol and Esmolol?

A

They block beta receptors thus slowing pacemaker activity?

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18
Q

What are the clinical applications for propranolol and Esmolol?

A

(1) post MI as prophylaxis against death
(2) ventricular fibrillation
(3) Thyrotoxicosis

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19
Q

What are the adverse effects associated with propranolol and Esmolol?

A

(1) Bronchospasm
(2) Cardiac depression
(3) AV block
(4) Hypotension

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20
Q

To what class of anti arrhythmics do Amiodarone, Sotalol, Ibutilide and dofetilide belong to?

A

They are group 3 anti arrhythmics.

21
Q

What is the MOA of amiodarone?

A

Strong inward K channel blocker that produces marked prolongation of the action potential and refractory period. Group 1 activity slows conduction velocity. Group 2 and 4 activity confer additional anti-arrhythmic activity.

22
Q

What are the clinical applications for amiodarone?

A

(1) refractory arrhythmias

2) used off label in many arrhythmias. (broad spectrum of action

23
Q

What are the adverse effects associated with amiodarone?

A

(1) thyroid abnormalities
(2) deposits in the skin and cornea
(3) pulmonary fibrosis
(4) optic neuritis

24
Q

What is the MOA for Sotalol?

A

It blocks inward K channels and beta adrenoreceptors

25
Q

What are the clinical applications for sotalol?

A

(1) ventricular arrhythmias

(2) atrial fibrillation

26
Q

What are the adverse effects associated with sotalol?

A

(1) dose dependent torsade de pointes

(2) Cardiac depression

27
Q

What is the MOA of Ibutilide?

A

Selective inward K blocker the prolongs the action potential and the QT interval

28
Q

What is the clinical application for ibutilide?

A

atrial fibrillation

29
Q

What are the adverse effects associated with ibutilide?

A

Torsade de pointes

30
Q

What is the MOA of Dofetilide?

A

Selective inward K blocker the prolongs the action potential and the QT interval

31
Q

What are the clinical applications for dofetilide?

A

treatment and prophylaxis of atrial fibrillation

32
Q

What adverse effects are associated with defetilide?

A

Torsade de pointes

33
Q

What class of anti-arrhythmics are verpamil and diltiazem?

A

They are Group 4 anti-arrhythmics

34
Q

What is the MOA for verpamil and diltiazem?

A

They cause state and use dependent inward Ca channel blockage that slows conduction in the AV node, slows pacemaker activity, and prolongs the PR interval.

35
Q

What are the clinical applications for verpamil?

A

AV nodal arrhythmias especially in prophylaxis

36
Q

What are the clinical applications for Diltiazem?

A

rate and control in atrial fibrillation

37
Q

What are the adverse effects associated with verpamil and diltiazem?

A

(1) cardiac depression
(2) constipation
(3) hypotension

38
Q

Which drugs are considered miscellaneous anti-arrhythmics?

A

adenosine
Postassium ion
Magnesium ion

39
Q

What is the anti-arrhythmic MOA for adenosine?

A

It increases diastolic inward K current of the AV node. this causes hyperpolarization and conduction block. It also reduces inward Ca.

40
Q

What are the clinical applications for adenosine?

A

acute nodal tachycardias

41
Q

What is the anti-arrhythmic MOA of Potassium Ion?

A

(1) increase in all K currents
(2) decreased automaticity
(3) decreased digitalis toxicity

42
Q

What are the anti-arrhythmic clinical applications of postassium ion?

A

(1) Digitalis toxicity

(2) other arrhythmias if K is low.

43
Q

What are the adverse effects associated with potassium ion?

A

(1) arrhythmogenesis (hyper and hypo kalemia)

2) cardiac arrest (severe hyperkalemia

44
Q

What is the anti-arrhythmic MOA for magnesium Ion?

A

Poorly understood possible increase in Na/K ATPase activity.

45
Q

What are the clinical applications for Magnesium Ion?

A

(1) Digitalis arrhythmias

(2) Other arrhythmias if Mg is low

46
Q

What are the adverse effects associated with magnesium ion?

A

(1) muscle weakness
(2) respiratory paralysis
(severe hypermagnesemia)

47
Q

What are the general characteristics of group 1A anti-arrhythmics?

A

They are sodium channel blockers that prolong the action potential duration

48
Q

What are the general characteristics of group 1B anti-arrhythmics?

A

They are sodium channel blockers that shorten the action potential

49
Q

What are the general characteristics of group 1C anti-arrhythmics?

A

They are sodium channel blocker that have no effect on Action potential duration.

Cardiovascular module (11 decks)

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