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Cardio Step 1 > Pharmacology Part 2 > Flashcards

Pharmacology Part 2 Flashcards

1
Q

Class 1 Antiarrhythmics are what and act as what?

A

Na Channel blockers that act as local anesthetics

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2
Q

What is the mechanism of class I antiarrhythmics?

A
  • Slow or block conduction
  • Decrease slope of phase 0 depolarization
  • Increase threshold for firing in abnormal pacemaker cells
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3
Q

Class I antiarrhythmics are ______ dependant and selectively depress what?

A

state

tissue that is frequently depolarized (tachycardia)

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4
Q

______ causes increased toxicity for all class I drugs

A

Hyperkalemia

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5
Q

Name the Class Ia antiarrhythmic drugs

A

Double Quarter Pounder:
Disopyramide
Quinidine
Procainamide

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6
Q

What is the mechanism of class IA antiarrhythmics?

A
  1. Incease AP duration
  2. Increase ERP
  3. Increase QT interval
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7
Q

What is class Ia used for?

A
  • Atrial arrhytmia
  • ventricular arrhythmia
  • reenterant/ectopic SVT and VT
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8
Q

What is Quinidines toxicity?

A

Cinchonism-headache, tinnitus

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9
Q

What is Procainamides toxicity?

A

Reversible SLE-like syndrome

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10
Q

What is disopyramides toxicity?

A

Heart failure

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11
Q

What toxicity is caused by all type Ia antiarrhythmics?

A

thrombocytopenia

torsades de pointes due to long QT interval

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12
Q

What are the class IB drugs?

A

Lettuce Tomato Mayo:
Lidocaine
Tocainide
Mexiletine

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13
Q

What does class IB do?

A

Decrease AP duration

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14
Q

Class IB preferentially affects hat?

A

ischemic or depolarized purkinje and ventricular tissue

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15
Q

What is class IB used in?

A
  • Acute Ventricular Arrhythmia (esp post-MI)

- Digitalis induced arrhythmia

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16
Q

What is the toxicity with class IB?

A
  • Local anesthetic
  • CNS stimulation/depression
  • CV depression
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17
Q

Class IB is best used when?

A

post-MI

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18
Q

What other drug can fall in the class IB category?

A

Phenytoin

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19
Q

What are the class IC drugs?

A

Fries Please:
Flecainide
Propafenone

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20
Q

What is the effect on AP duration of class Ic?

A

NONE

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21
Q

What is Class IC useful in?

A
  • Ventricular tachycardia that progress to VF
  • intractible SVT
  • Last resort in refractory tachyarrhythmias
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22
Q

Class IC is for patients without what?

A

structural abnormalities

23
Q

What is the toxicity of class IC?

A
  • Proarrhythmic (esp Post-MI…contraindicated)

- Prolongs refractory period in AV node

24
Q

What type of antiarrhythmics are class II?

A

Beta blockers

25
Q

Name the class II antiarrhythmics?

A 
Metoprolol
Propranolol
Esmolol
Atenolol
Timolol
26
Q

What is the mechanism of class II?

A

Decrease SA/AV node activity by decreasing cAMP and Ca currents

27
Q

Class II suppresses abnormal pacemakers by doing what?

A

decreasing slope of phase 4

28
Q

Which node is particularly sensitive to class II and what is prolongued?

A

AV node, PR interval

29
Q

Which class II drug is very short acting?

A

Esmolol

30
Q

What are the toxcitiy of class II?

A
  • Impotence
  • Exacerbation of asthma
  • CV effects
  • CNS effects
  • Masks signs of hypoglycemia
31
Q

What are the CV side effects from class II?

A

bradycardia
AV block
CHF

32
Q

What are the CNS side effects from class II?

A

sedation

sleep alterations

33
Q

Metoprolol can cause what side effect and how do you treat overdose of this?

A

dyslipidemia, glucagon

34
Q

Propranolol can exacerbate what?

A

vasospasm in Prinzmetal’s angina

35
Q

What do the class III antiarrhythmics do?

A

K channel blockers?

36
Q

What are the class III antiarrhythmics?

A 
AIDS?
Amiodarone
Ibutilide
Dofetilide
Sotalol
37
Q

What is the mechanism of class III?

A

Increase AP duration and ERP

Increases QT interval

38
Q

When are class III used?

A

When other antiarrhythmics fail

39
Q

What is the toxicity with Sotalol?

A

Torsades de pointes

Excess Beta Block

40
Q

What is Ibutilides toxicity?

A

Torsades de pointes

41
Q

What are amiodarones toxicity?

A
  • Pulmonary Fibrosis
  • hepatotoxicity
  • hypo/hyperthyroidism (bcz 40% iodine by weight)
  • Corneal deposits
  • Skin deposits (blue/gray)–>photodermatitis
  • Neurologic effects
  • Constipation
  • CV effects (bradycardia, Heart block, CHF)
42
Q

Amiodarone has class I, II, III, and IV effects why?

A

Alters the lipid membrane

43
Q

With amiodarone remember to check what?

A

PFT, LFT, TFT

44
Q

What do the Class IV drugs do?

A

Ca channel blockers

45
Q

What are the class IV drugs?

A

Verapamil

Diltiazem

46
Q

What is the mechanism for class IV?

A
  • Decrease conduction velocity
  • increase ERP
  • increase PR interval
47
Q

What are class IV used to prevent?

A

Nodal arrhythmias (eg. SVT)

48
Q

What is the toxicity of class IV?

A
  • Constipation
  • Flushing
  • Edema
  • CV effects (CHF, AV block, sinus node depression)
49
Q

What is the mechanism of adenosine?

A

Increased K out of cells causes hyperpolarizing of the cell and decreased intracellular Ca

50
Q

What is adenosine the drug of choice in?

A

Diagnosing/abolishing SVT

51
Q

Is adenosine long or short acting?

A

Short (15 sec)

52
Q

What is the toxicity of Adenosine?

A
  • Flushing
  • Hypotension
  • Chest pain
53
Q

Effects of adenosine are blocked by what?

A

Theophylline and caffeine

54
Q

What is Mg2+ effective in?

A
  • Torsades de pointes

- Digoxin Toxicity

Cardio Step 1 (14 decks)

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