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pharm unit 4 > treating arrhythmias > Flashcards

treating arrhythmias Flashcards

1
Q

acute A-fib or flutter primary treatment

A

verapamil, diltiazem, betas, digoxin, DC cardiovert,

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2
Q

acute A-fib or flutter secondary treatment

A

IV procainamide, ibutilide, dofetilide or large dose of flecainide or propafenone.

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3
Q

chronic A-fib/flutter primary

A

verapamil, diatiazem, betas, digoxin. must maintain sinus rhythm with amioderone, sotalol, flecainide, propafenone, or dofetilide, RF ablation.

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4
Q

chronic A-fib/flutter secondary

A

quinidine, procainamide, disopyramide

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5
Q

acute SVT primary

A

IV adenosine, verapamil, diltiazem.

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6
Q

acute SVT secondary

A

IV esmolol, digoxin.

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7
Q

chronic SVT primary

A

betas, verapamil, diltiazem, flecainide, propafenone, amiodarone, sotalol, digoxin, DC.

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8
Q

chronic SVT secondary

A

quinidine, procainamide, disopyramide.

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9
Q

PVC or non-sustained VT primary with no structural or asym

A

nothing. if symptomatic give betas.

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10
Q

PVC or non sustained VT secondary

A

NONE

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11
Q

sustained VT primary

A

amiodarone, ICD

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12
Q

sustained VT secondary

A

procainamide lidocaine.

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13
Q

V-fib primary

A

amiodarone ICD

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14
Q

V-fib secondary

A

procainamide, lidocaine.

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15
Q

cardiac glycoside induced arrhtyhmia primary

A

digoxin immune fragments digifab

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16
Q

cardiac glycoside induced arrhtyhmia secondary

A

DC, betas, procainamide

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17
Q

drug-induced TdP primary

A

discontinue the drug, give Mg-sulfate and KCl

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18
Q

drug-induced TdP secondary

A

cardiac pacing, isoproteranol.

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19
Q

class 1A

A

block fast (open) Na channels. this causes prolonged refractory period and prolonged APD. most are secondary drugs.

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20
Q

quinidine characteristic

A

1A. used for a flutter, a fib, SVT.

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21
Q

what is quinidine never used for

A

V tach

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22
Q

qunidine tox

A

diarrhea, LQT (TdP), hepatitis, cinchronism (digoxin interaction). fever, nausea.

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23
Q

procainamide characteristic

A

1A. used for a fib, flutter, V-tach. local anesthetic.

24
Q

procainamide tox

A

SLE syndrome. LQT (TdP). hypotension

25
Q

disopyramide characteristic

A

1A. has prominent anticholinergic acitivity. LQT

26
Q

class 1b characteristic

A

sodium channel blockers open when inactivated. these actually prefer ischemic tissue ( depolarized tissue). they reduce the APD.

27
Q

lidocaine characteristic

A

1b. alternative. suppression of V fib. emergency VT/VF. cardioversion, digitalis toxicity

28
Q

do we use lidocaine for atrial arrhythmia

A

NO

29
Q

lidocaine SE

A

tremors, seizures, nausea.

30
Q

mexiletine characteristic

A

oral lidocaine GI toxic.

31
Q

class 1c characteristic

A

Na channel blockers. they prolong the depolarization. this prolongs recovery for Na channels. causes prolonged PR, QRS, QT with no EAD or TdP. f

32
Q

flecainide/propafenone

A

1c. alter for the treatment of A fib and SVT. maintenance of sinus rhythm in a fib and SVT. only in patients without structural HD>

33
Q

SE of 1c

A

may increase the ventricular response to atrial fib. contraindicated in HF.

34
Q

when do we not use 1c

A

HF.

35
Q

flecainide SE

A

blurred vision. can cause bradycardia. bronchospasm.

36
Q

class 2 characteristic

A

beta blockers. decrease the SA/AV nodal activity. stop the conduction of a fib and flutter to ventricles. terminate SVT. can be B1 selective or non selective.

37
Q

propanolol characteristic

A

nonselective. membrane stabilizing. CNS effects.

38
Q

uses for propranolol

A

exercise induced tachy, MI, digitalis induced arrhythmia

39
Q

propanolol SE

A

hypotension, bronchospasm, bradycardia

40
Q

other BB to use in arrythmia

A

metoprolol, acebutolol, esmolol.

41
Q

what are BB contraindicated in

A

WPW

42
Q

class 3 characteristic

A

K channel blockers. long APD. risk of TdP/

43
Q

sotalol characteristic

A

class 3. non selective BB. also blocks K. preferred over quinidine for chronic AF. risk of TdP.

44
Q

SE for sotalol.

A

decreased HR, AVN conduction, TdP, EADs.

45
Q

ibutilide characteristic

A

class 3 used in IV termination of A flutter and fib.

46
Q

amiodarone characteristic

A

class 3. most common. thyroxine analog. mimics all classes of antiarrhythmics.

47
Q

what currents does amiodarone inhibit

A

K, Ca, Na.

48
Q

why is aiodarone tough to use

A

half life of 80 days.

49
Q

what do we use amiodarone for?

A

almost all arrhythmias. AF, SVT, VF, prophylaxis

50
Q

what do we not use amiodarone for

A

digitalis toxicity

51
Q

amiodarone SE

A

photosensitivity (blue0gray skin). QT syndrome, pulmonary fibrosis, peripheral neuropathy, hepatic dysfunction, corneal deposits.

52
Q

verapamil and diltriazem uses

A

slow ventricular rate during a flutter, and a fib. prevent or terminate reentrant SVT.

53
Q

what are verapamil and diltriazem contraindicated in>

A

WPW

54
Q

SE of verapamil and diltriazem

A

don’t give with BB or digoxin because their effect is additive. hypotension, bradycardia, constipation, dizziness,

55
Q

adenosine uses

A

decreases SA/AV node. increases the AV refractoriness. works for PSVT, and AVN reentrant.

56
Q

can’t use adenosine for what?

A

a fib, a flutter, multifocal tachycardia. WPW>

57
Q

what do methyl xanthines do to adenosine and what are the SE of adenosine

A

antagonize it. as well as sedation, dyspnea, hypotension,

pharm unit 4 (4 decks)

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