Treatment

Question 0

Verapamil

Answer 0

Class 4 calcium channel blocker
0.1mg/kg SLOWLY over 2 minutes
Maintenance: 4 - 8 mg/kg/day TID

Question 1

Adenosine

Answer 1

0.1mg/kg rapid bolus followed by saline flush

Question 2

Flecainide

Answer 2

Class Ic sodium channel blocker
2mg/kg over 5 minutes
Maintenance: 2-7 mg:kg/day BID
Watch QRS duration, kidney function

Question 3

Propafenone

Answer 3

Class Ic with beta blocker effects
Load: 2mg/kg over 2 hours
Infusion: 4 - 7 micrograms/kg/min
Maintenance: 200-600 mg/m2 or 10-15 mg/kg/day TID
Side effects: lupus like syndrome, low white count, metallic taste, bronchospasm
Watch QRS, kidney function

Question 4

Amiodarone

Answer 4

Class 3
Load: 10mg/kg over 1 hour
Maintenance: 10mg/kg BID
Infusion: 10mg/kg/day
NOTE: may need to give calcium po
Watch QT; stop if QT > 500 ms

Question 5

Procainamide

Answer 5

Class Ia sodium channel blocker

Question 6

Acute treatment of wide QRS tachycardia

Answer 6

Electrical cardioversion
Lidocaine
Amiodarone
Procainamide 
Esmolol 
Propranolol
Flecainide
Sotalol

Question 7

Lidocaine

Answer 7

Class 1a

1mg/kg bolus, then infusion 20-50 ug/kg/min

Question 8

Treatment of monomorphic VT

Answer 8

Electrical cardioversion
Propranolol
Lidocaine
Sotalol

Question 9

Sotalol

Answer 9

Class 3
Maintenance: 2-8 mg/kg/day BID
Watch QT; stop it QT > 500 ms

Question 10

AVNRT treatment

Answer 10

Beta blocker
Calcium channel blocker
Class 1c alone or with beta blocker