Week 12: Antidysrhythmic drugs (13 questions)

Question 1

Antidysrhythmic Drugs?

Class 1?
Class 2?
Class 3?
Class 4?

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Miscellaneous drugs?

Answer 1

Class 1: Sodium Channel Blockers
Class 2: Beta Blockers
Class 3: Potassium Channel Blockers
Class 4- Calcium Channel Blockers (Non-DHPs)

Digoxin and Adenosine

Question 2

Atrial Fibrillation (Afib)

Can lead to?
Occasionally…?

Answer 2

Most common type of treated heart dysrhythmia (SVT)

Can lead to a stroke due to blood clots

Occasionally, the atrium may have a normal heartbeat, shooting the clot out = STROKE RISK

Question 3

Class 1- Sodium Channel Blockers

1A?
1B?
1C?

Answer 3

1A- Disopyramide, Quinidine, ProCAINamide (short term)

1B- LidoCAINe and Mexiletine

1C- FleCAINide and Propafenone

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FriesPlease

Question 4

Class 1- Sodium Channel Blockers

Used for?
Report what for Quinidine?
Report what for Procainamide?

Answer 4

Various dysrhythmias

report any auditory / visual changes

Procainamide:
fatigue (anemia)

bruising/bleeding (thrombocytopenia)

fever/sore throat (neutropenia)

Question 5

Class II Drugs- Beta Blockers:

metoprolol
(Never stop suddenly)

can be used for?
Contraindications?

Answer 5

A wide variety of dysrhythmias
Can be used for Atrial Fibrillation

Decompensated heart failure
First degree heart block

Question 6

Class III Drugs: amiodarone (pacmAn)

used for?
avoid?

Answer 6

Used for dysrhythmias that are difficult to treat

**Life-threatening ventricular tachycardia or fibrillation

**atrial fibrillation

avoid grapefruit juice

Question 7

Class III Drugs: Amiodarone

ADVERSE EFFECTS
4
what other adverse effect?

Answer 7

1. Pulmonary toxicity- Pulmonary fibrosis
2. Cardio toxicity
3. Ophthalmic Effects
4. Thyroid toxicity

BLUE PIGMENTATION OF THE SKIN (photosensitivity)

Question 8

What’s less effective on inducers?

Answer 8

Birth control
take an alternative form

Question 9

Inhibitors: PACMAN loves Grapefruit juice!?

Answer 9

P – protease inhibitor (HIV)
A – azole antifungal (fluconazole, ketoconazole)
C – cimetidine(H2RAs)
M – macrolides(Azithromycin, ACE!)
A – amiodarone
N – non-DHP Calcium Channel Blockers (diltiazem, verapamil)

♥’s
Grapefruit juice

Question 10

CLASS IV- NON DHP Calcium Channel Blockers:

Verapamil and diltiazem
Very Nice Drugs for DA

USED TO TREAT?

Answer 10

Dysrhythmias (primary use!)***

Atrial fibrillation*******

Question 11

verapamil and diltiazem

ADVERSE EFFECTS?
Verapamil adverse effect?

avoid what?

Answer 11

Peripheral edema
Hypotension (postural/ortho)
Bradycardia

**Constipation (verapamil big time)
Verapamil = very constipated

ALL CALCIUM CHANNEL BLOCKERS

NO GRAPEFRUIT JUICE!

These drugs are enzyme inhibitors
pacmaN loves….

Question 12

Adenosine

Used to treat?

Answer 12

**Paroxysmal SVT

pharmacologic stress test

Question 13

Adenosine (stops heart)

No what?
Immediately do what afterwards?
Instruct patients?
Half life?
Pick an iv line where?
Give how?

Answer 13

NO CAFFEINE/THEOPHYLLINE

IMMEDIATELY FLUSH THE LINE AFTERWARDS WITH NORMAL SALINE (20 ml)

Instruct patients their heart is going to stop. Continue to monitor

Half-life is < 10 seconds

Pick an IV line close to the heart (central line preferred)

Give drug as a rapid push!
Watch the EKG