Afib and svt

Question 1

propafenone moa

Answer 1

blocking the inward sodium current, and slow increase of action potential

and prolongs conduction

Question 2

propafenone side effect

Answer 2

nausea, vomiting, change in taste or headache

Question 3

propafenone with fluoxetine will cause

Answer 3

qt prolongation

Question 4

ariprazole (ambilify) is increased when it is taken with _______

Answer 4

propafenone

Question 5

propafenone is class

Answer 5

IC

Question 6

flecainide indication

Answer 6

paroxysmal a fib
paroxysmal svt

Question 7

propafenone indicated for

Answer 7

Afib

paroxysmal svt

Question 8

flecainide

Answer 8

slows conduction in the cardiac tissue by altering the transport of ions across cell membranes. , decreases rate and rise of action potential

Question 9

flecainide contraindicated if pt has what disease

Answer 9

structural heart disease

Question 10

metoprolol indicated for

Answer 10

Afib and svt (off label)

Question 11

metoprolol is what class

Answer 11

class 2

Question 12

metoprolol inhibitor of ______ adrenergic receptor

Answer 12

beta 1

Question 13

metoprolol caution in. what pt

Answer 13

diabetes, if pt is bradycardia, don’t want to do metoprolol

Question 14

special warning with metoprolol

Answer 14

do not abruptly stop need to do a slow taper for 1-2 weeks

Question 15

Metoprolol is a selective inhibitor of _______ adrenergic receptors

Answer 15

Beta 1

Question 16

Metoprolol is indicated for ______ and _____

Answer 16

Afib
SVT, off label

Question 17

Metoprolol, special warning

Answer 17

Do not withdraw abruptly, taper for 1-2 weeks

Question 18

Diseases related concerns with metoprolol

Answer 18

Thyroid disease, depression, diabetes bradycardia

Metoprolol may make it hard T recognize warning signs of overactive thyroid, because it can mask it just

Question 19

Metoprolol interaction

Answer 19

NSAIDs, sulfonylureas, theophylline

NSAIDs can reduce effectiveness of metoprolol

Question 20

Amiodarone moa

Answer 20

Adrenergic stimulation, alpha and beta blocking

decrease AV conduction and sinus node function

Prolongs action potential

Question 21

Amiodarone avoid in ______ impairments

Answer 21

Severe hepatic

Question 22

Amiodarone, black box warning for what

Answer 22

Pulmonary toxicity, constipation, vomiting,

Question 23

For amiodarone caution when adding a antipsychotic medication due to _____ prolongation, should obtain ______ first

Answer 23

QT.

EKG

Question 24

Amiodarone major interaction includes

Answer 24

Sofusbivir, (➡️severe bradycardia, watch for meds which can cause qt prolongation, such as antipsychotic

Question 25

Prior to administering amiodarone what should be checked

Answer 25

Baseline pulmonary function tests

Question 26

Dronedarone is indicated for

Answer 26

Paroxysmal or persistent a fib

Question 27

Dronedarone avoid with _______

Answer 27

Grapefruit

Question 28

Dronedarone moa

Answer 28

Decrease AV conduction (Similar to amiodarone) Prolongs action potential

Question 29

Dronedarone contraindicated in ______ impairment

Answer 29

Hepatic

Question 30

Dronedarone inhibit ______ channel

Answer 30

Sodium and potassium

Question 31

Dronedarone is class __

Answer 31

3

Question 32

Dronedarone and amiodarone are both class __ agents

Answer 32

3

Question 33

Dronedarone interactions (4)

Answer 33

Increases concentration for Atorvastatin Bradycardia with beta blockers Interact with calcium channel blockers Increase digoxin (want to decrease digoxin dose by 50%) Fentanyl is increased with dronedarone

Question 34

Sotalol is indicated for ______ and _______

Answer 34

Afib (symptomatic) SVT, off label

Question 35

Sotalol moa

Answer 35

Slows heart rate, decrease av nodal conduction, and beta 1 and beta 2 receptor blocking activity

Question 36

For Sotalol, Renal disease extend ____ if CrCl <__ ml

Answer 36

Interval 60

Question 37

Sotalol, avoid use with _____ and with ____

Answer 37

Asthma and with diabetes

Question 38

Sotalol can cause ___ prolongation

Answer 38

QT

Question 39

With Sotalol do not want to stop abruptly true or false

Answer 39

True, do not stop abruptly

Question 40

Pill in pocket approach what is it

Answer 40

Single oral dose outpatient tx used to terminate SVT,

Question 41

Pill in pocket who is a candidate

Answer 41

Infrequent (2-3 per year ) but prolonged SVT episodes that are hemodynamically tolerated,

Question 42

Pill in pocket drug options include

Answer 42

Calcium channel blockers Flecainide Propafenone Beta blocker

Question 43

Dofetilide moa

Answer 43

Blockage of cardiac potassium channel causing delay of repolarization

Question 44

Dofetilide is what class

Answer 44

Class 3

Question 45

Dofetilide indication

Answer 45

Afib SVT

Question 46

Dofetilide interactions

Answer 46

Cimetidine can increase concentration of dofetilide. Antifungals decrease metabolism of dofetilide will lead to toxicity Verapamil increases concentration of dofetilide

Question 47

What is diltiazem used for

Answer 47

Afib, rate control

Question 48

Diltiazem moa

Answer 48

Inhibit calcium from enetering slow channel during depolarization Relaxation of coronary vascular smooth muscle

Question 49

Verapamil moa

Answer 49

Ccb non dehydro Inhibit calcium ion from entering channels during depolarization, relax vascular smooth muscle

Question 50

Side effects verapamil

Answer 50

Constipation. Or headache, edema

Question 51

Verapamil can increase ____, and prolong ethanol

Answer 51

Fentanyl

Question 52

If patient has renal insuffiency dosing with digoxin will be what

Answer 52

Reduce by about 50% or should avoid digoxin altogether Can increase dose interval to every 48 hours

Question 53

Digoxin moa

Answer 53

Suppression of the AV NODE Positive inotropic agent Hypothyroid can increase digoxin levels Class 5

Question 54

Monitoring with digoxin

Answer 54

Correct electrolytes Hypercalcemia may cause toxicity , periodic ekgs, Digoxin level toxicity if over 2 ng, ml

Question 55

Hypothyroid may incre@se digoxin levels true or false

Answer 55

True

Question 56

Amiodarone increases digoxin levels true or false

Answer 56

True

Question 57

Nicotine enhances adenosine true or false

Answer 57

True

Question 58

Caffeine ______ effects of adenosine

Answer 58

Diminishes

Question 59

Adenosine moa

Answer 59

Slows conduction time through the av node interrupts the rentry pathways through the av node, restoring normal sinus rhythm

Question 60

Warfarin anticoagulant for Afib is good option for who

Answer 60

Patient with poor renal failure

Question 61

Warfarin good for those with mechanical prosthetic valve true or false

Answer 61

True

Question 62

Flecainide and propafenone are both class ____ and are sodium channel blocker

Answer 62

Class IC

Question 63

What med only is used in a fib and not ventricular Tachy due to caus8ng v tach

Answer 63

Dofetilide

Question 64

What is moa of med used to tx v fib and v tach pulseless

Answer 64

Potent alpha 1 and beta 1 agonist Epinephrine