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From Flashcardlet > 4.24 anti arrhythmics > Flashcards

4.24 anti arrhythmics Flashcards

(56 cards)

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0
Q

Parasympathetic (ACh) on SA/atria and AV

A

SA/atria:
decrease automaticity (decrease phase 4 depol, so decrease HR)
Decrease ERP (effective refractory period)
Increase CV

AV:
Increase ERP
Decrease CV

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1
Q

SNS (NE) on SA and AV nodes

A

SA: incr automaticity (incr phase 4 depol, so incr HR)

AV: incr AV conduction velocity

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2
Q

What part of MAP affects heart rate

A

Slope of phase 4

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3
Q

What factors increase heart rate

A

Ischemia
Catecholamines
Cardiac glycosides
Atropine

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4
Q

What factors decrease HR

A

ACh
Anti arrhythmic drugs
Beta blockers

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5
Q

MDP and HR

A

Decrease MDP increases HR

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6
Q

What decreases MDP

A

Acidosis

Glycosides

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7
Q

Automaticity is only in what parts of the heart

A

SA node

Purkinje cells

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8
Q

MDP and CV

A

When MDP increases, CV increases

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9
Q

Most drugs do what to the CV with the exception of what

A

Most decrease

Phenytoin increases CV

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10
Q

Most drugs do what to ERP

A

Increase it

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11
Q

What type of drug converts unidirectional to bidirectional block

A

Na channel blockers (decr CV)

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12
Q

What drugs abolish unidirectional block

A

Phenytoin (incr CV)

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13
Q

Class IA (Na channel blocker)

A

Procainamide
Quinidine
Disopyramide

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14
Q

Class IB (Na channel blocker)

A

Lidocaine
Phenytoin
Mexilitine

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15
Q

Class IC (Na channel blocker)

A

Flecainide

Propafenone

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16
Q

Class II

A

Beta blockers

Propranolol
Esmolol

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17
Q

Class III

A

Block K channels

Amiodarone 
Dronedarone
Sotalol
Ibutilide
Dofetilide
Bretylium
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18
Q

Class IV

A

CCBs (no DHPs)

Verapamil
Diltiazem
Bepridil

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19
Q

Unclassified

A

Adenosine

Cardiac glycosides

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20
Q

Only drugs known to reduce mortality after an MI

A

Amiodarone

Beta blockers

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21
Q

What drugs don’t suppress ectopic pacemakers

A

Bretylium

Cardiac glycosides

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22
Q

What drugs act on supra ventricular arrhythmias

Study These Flashcards
A

All except IB and IC

23
Q

What drugs work on ventricular arrhythmias

24
What drugs are used for life threatening supra ventricular arrhythmias
IC
25
What drugs are used for life threatening ventricular arrhythmias
IC | III (amiodarone, Dronedarone, and Sotalol only)
26
All anti arrhythmic drugs increase ERP except
IB (decrease) | IC (no effect)
27
What classes do you not use if have CHF
I | IV
28
Hypotension as ADR
IA IB IV
29
Can produce DADs
Cardiac glycosides
30
Treats glycoside induced arrhythmias
Lidocaine Phenytoin Propranolol Esmolol
31
Propafenone metabolized by
2D6
32
2D6 metabolized what drug
Propafenone
33
Causes a fib paradox Incr vent rate Decrease atrial rate Increase AV CV
Procainamide | Quinidine
34
May inhibit action of ACh and transients increase CV and decr ERP in AV node
Procainamide | Quinidine
35
Peripheral anti muscarinic effects (dry mouth, glaucoma, bladder)
IA
36
ADR lupus in slow acetylators
Procainamide
37
Rapid conversion of a flutter and a fib
Ibutilide | Dofetilide
38
Which Sotalol isomer is an anti arrhythmic
D isomer
39
What is the structural isomer of Sotalol
Ibutilide
40
Esmolol broken down by
Proerythrocyte esterasss
41
Raises electrical threshold required to cause fibrillation
Class III
42
Weak alpha blocking activity so decr BP
Verapamil
43
CI if ventricular tachycardia
Cardiac glycosides
44
Rapidly metabolized
Adenosine
45
Activate K channels in SA and AV causing hyperpol and decr Ca current
Adenosine
46
Low therapeutic index
Cardiac glycosides
47
Can produce DADs
Cardiac glycosides
48
ADR causes myocardial k loss from over inhibiting Na k pump
Cardiac glycosides
49
First signs of cardiac glycoside toxicity
GI Nausea Vomiting Anorexia
50
Blurred vision Abnormal color perception Halos ADR
Cardiac glycosides
51
How to treat cardiac glycoside ADRs
Administer K | Glycoside antibody
52
Black box warning for CHF patients
Dronedarone
53
Torsades promoting drugs
Ibutilide Dofetilide Sotalol
54
Cardiac glycoside changes MAP of ventricular and purkinje fibers
Incr slope phase 4 Decr slope phase 0 Decr MDP Decr APD
55
Binds to receptors in brain to increase PNS and increase vahal tone
Cardiac glycosides

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