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Pharmacology > Cardiovascular 2 Anti-arrhythmics > Flashcards

Cardiovascular 2 Anti-arrhythmics Flashcards

1
Q

Drug class for Procainamide

A

class 1A Na channel

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2
Q

MoA for Procainamide

A

Decreases myocardial excitability and conduction velocity and may depress myocardial contractility, by increasing the electrical stimulation threshold of ventricle, His-Purkinje system and through direct cardiac effects (UtD)

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3
Q

Indications for Procainamide

A

life threatening ventricular arrhythmias

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4
Q

SE/ADRs for Procainamide

A

hypotension, N/V/D, SLE sxs, agranulocytosis (w/ prolonged use), QTc prolongation

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5
Q

Contra-indications for Procainamide

A

complete heart block, 2nd deg AV block, SLE, tornadoes de pointes

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6
Q

Dx-Dx interactions for Procainamide

A

other anti-arrhythmics

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7
Q

Monitoring for Procainamide

A

ECG, BP, eGFR, BUN, CBC, ANA titers, liver function, procainamide/NAPA conc (in liver disease)

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8
Q

PG category for Procainamide

A

PG C

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9
Q

Drug class for Lidocaine

A

class 1B Na channel

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10
Q

MoA for Lidocaine

A

blocks both the initiation and conduction of nerve impulses by decreasing the neuronal membrane’s permeability to sodium ions,suppresses automaticity of conduction tissue, by increasing electrical stimulation threshold of ventricle, His-Purkinje system, and spontaneous depolarization of the ventricles during diastole (UtD)

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11
Q

Indications for Lidocaine

A

suppression of existing ventricular arrhythmias

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12
Q

SE/ADRs for Lidocaine

A

arrhythmias, CV collapse, increase defib threshold, edema, heart block, hypotension, agitation, anxiety, metallic, taste, bronchospasm

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13
Q

Contra-indications for Lidocaine

A

severe SA, AV interventricular heart block w/out pacemaker, corn allergy

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14
Q

Dx-Dx interaction for Lidocaine

A

multiple (prolonged use)

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15
Q

Monitoring for Lidocaine

A

liver function, serum concentration, ECG, BP

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16
Q

PG category for Lidocaine

A

PG B

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17
Q

Drug class for Flecainide

A

class 1C Na channel

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18
Q

MoA for Flecainide

A

slows conduction in cardiac tissue by altering transport of ions across cell membranes; causes slight prolongation of refractory periods; increases electrical stimulation threshold of ventricle, His-Purkinje system

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19
Q

Indications for Flecainide

A

ventricular arrhythmias (prevention); PSVT (prevention); paroxysmal A fib/flutter

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20
Q

SE/ADRs for Flecainide

A

dizziness, blurred vision, dyspnea, palpitations, HA, pro-arrhythmic potential

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21
Q

Contra-indications for Flecainide

A

pre-existing 2 or 3 deg heart block, RBBB w/out pacemaker, cardiogenic shock

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22
Q

Dx-Dx interactions for Flecainide

A

multiple

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23
Q

Monitoring for Flecainide

A

ECG, BP, HR, periodic trough serum levels w/ renal or liver impairment

24
Q

PG category for Flecainide

A

PG C

25
Q

Flecainide should not be used for what chronic arrhythmia?

A

A fibrillation

26
Q

Drug class for Amiodarone

A

Class 3 Repolarization delay

27
Q

MoA for Amiodarone

A

inhibits adrenergic stimulation (alpha/beta) affecting Na, K, Ca channels; prolongs action potential & refractory period in cardiac tissues; decrease AV conduction & sinus node function

28
Q

Indications for Amiodarone

A

life-threatening recurrent VF, unresponsive or unstable VT refractory to other anti-arrhythmic; off label- AF, PSVT, adjunct to ICD to suppress ventricular tacky in otherwise optimally tx patients w/ HF

29
Q

SE/ADRs for Amiodarone

A

pulm toxicity, exacerbation of arrhythmias, optic neuritis, photosensitivity

30
Q

Contra-indications for Amiodarone

A

hypersensitivity to iodine, cardiogenic shock, severe sinus node dysfunction, 2nd or 3rd deg HB or severe bradycardia without pacemakers

31
Q

Dx-Dx interactions for Amiodarone

A

multiple, avoid grapefruit juice

32
Q

Monitoring for Amiodarone

A

BP, HR, EKG, PE for lethargy, edema, wt loss, pulm toxicity, LFT, electrolytes, thyroid function, eye exams w/ long term use

33
Q

PG category for Amiodarone

A

PG D

34
Q

Drug class for Adenosine

A

other

35
Q

MoA for Adenosine

A
  • PSVT: slows conduction time through AV node, interrupting the re-entry pathways & restoring normal sinus rhythm
  • Stress test: causes coronary vasodilation & increases blood flow in normal coronary arteries w/ little or no increase in stenotic coronary arteries
36
Q

Indications for Adenosine

A

PSVT, pharmacologic stress testing

37
Q

SE/ADRs for Adenosine

A

new arrhythmias, chest pain, HA, flushing, dyspnea, bronchospasm

38
Q

Contra-indications for Adenosine

A

2nd or 3rd deg AV block, sick sinus syndrome, symptomatic brady (except ones w/ pacemaker), known bronchoconstrictive or bronchospastic lung disease, asthma

39
Q

Dx-Dx interactions for Adenosine

A

agents that have vascular impact (nicotine, caffeine); dipyridamole, carbamazepine, digoxin

40
Q

Monitoring for Adenosine

A

EKG, HR, BP

41
Q

PG category for Adenosine

A

PG C

42
Q

Drug class for Digoxin

A

other: cardiac glycoside

43
Q

MoA for Digoxin

A

inhibits Na/K ATPase pump in myocardial cells promoting influx Ca leadings to increased contractility; also direct suppressor of AV node which decreases ventricular rate

44
Q

Indications for Digoxin

A

mild to moderate HF; A fib rate control

45
Q

SE/ADRs for Digoxin

A

incomplete heart block may proceed to complete block, digoxin toxicity, SSS

46
Q

Contra-indications for Digoxin

A

V fib, co-existing thyroid disorders, recent MI

47
Q

Dx-Dx interactions for Digoxin

A

Amiodarone, verapamil; multiple others

48
Q

Monitoring for Digoxin

A

HR & rhythm, serum dig level, serum K+, eGFR, electrolytes, serum Ca, Mg, K, mental state (confusion, depression)

49
Q

PG category for Digoxin

A

PG D

50
Q

Drug class for MgSO4

A

other

51
Q

MoA for MgSO4

A

unknown

52
Q

Indications for MgSO4

A

digitalis induced arrhythmias w/ low serum Mg; low Mg induced arrhythmias (VF, VT); off label-torsades (severe exacerbation asthma in kids)

53
Q

SE/ADRs for MgSO4

A

flushing, hypotension, hypermagnesemia

54
Q

Contra-indications for MgSO4

A

heart block

55
Q

Dx-Dx interactions for MgSO4

A

multiple

56
Q

Monitoring for MgSO4

A

EKG, vital signs, serum Mg, K, Ca; eGFR, SaO2

57
Q

PG category for MgSO4

A

avoid

Pharmacology (16 decks)

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