Anti-arrhythmic

Question 1

What is the MOA for a class 1 anti-arrhythmic drug

Answer 1

Sodium channel blocker

Question 2

What class is Quinidine (Quinidex)

Answer 2

Class 1a

Question 3

What are the indications for Quinidine (quinidex)

Answer 3

A-flutter, A-fib, AV and ventricular arrhythmias

Question 4

What are the side-effects of Quinidine (Quinidex)

Answer 4

Potentially pro-arrhythmic, nausea, vomiting, diarrhea. Cinchonism

Question 5

What are the symptoms of cinchonism

Answer 5

Visual changes, altered sensorium, N/V, psychosis

Question 6

What rhythm may result from Quinidine use

Answer 6

Torsade de Pointes

Question 7

What class is Mexiletine (Mexitil)

Answer 7

Class 1b

Question 8

What is the MOA of Mexiletine (mexitil)

Answer 8

Blocks open sodium channels thereby shortening phase 3 repolarization

Question 9

What is the most common side effect of all anti-rhythmic drugs

Answer 9

a different dysrhythmia

Question 10

what class is Flecainide (Tambocor)

Answer 10

Class 1c

Question 11

What is the indication for flecainide (Tambocor)

Answer 11

supraventricular tachycardia dysrhythmias, including Wolff-Park-White syndrome

Question 12

What class is atenolol (Tenormin)

Answer 12

Class 2

Question 13

What is the MOA for atenolol (tenormin)

Answer 13

Beta 1 blockade reduces sympathetic effects on myocardium. Reduced phase 4 depolarization and decreased automaticity in the SA node, AV node and the Purkinje fibers

Question 14

What are the side effects for atenolol

Answer 14

nightmares, impotency, depression, bradycardia, hypotension

Question 15

What class is amiodarone (cordarone)

Answer 15

Class 3

Question 16

What is the MOA of amiodarone (Cordarone)

Answer 16

Potassium channel blockade. Prolongs phase 3

Question 17

What are the side-effects of amiodarone (Cordarone)

Answer 17

Dizziness and light headedness. Pulmonary fibrosis possible. Blue-gray coloring of skin can occur as a result of iodine deposition

Question 18

What are the indications of Amiodarone (cordarone)

Answer 18

ventricular arrhythmias

Question 19

What class is verapamil (Isoptin, Calan)

Answer 19

Class 4 (calcium channel blocker)

Question 20

What are the indications for verapamil (and other Ca channel blockers

Answer 20

atrial dysrhythmias, like A-fib

Question 21

What is the MOA of Verapamil

Answer 21

Calcium channel blockade causes a slowing of phase 4 depolarization, resulting in slowed AV conduction.

Question 22

What is adenosine used for

Answer 22

Adenosine is recommended as the initial drug of choice for PSVT (paroxysmal supraventricular tachycardias)

Question 23

What is the MOA of adenosine

Answer 23

acts directly on sinus pacemaker cells and vagal nerve terminals. right at that SA node! Within seconds decreases rate and force of contraction

Question 24

How is adenosine administered

Answer 24

Available for IV administration only

Question 25

How long does the action of adenosine last

Answer 25

15 seconds

Question 26

What are the side effects of adenosine

Answer 26

Low toxicity but often causes transient hypotension and chest pain

Question 27

What class is atropine

Answer 27

anti-arrythmic

Question 28

what are the indications of atropine

Answer 28

to treat bradycardia

Question 29

what is the MOA of atropine

Answer 29

Anticholinergic agent - Atropine is a competitive inhibitor of the muscarinic acetylcholine receptors thus it can be thought of as a parasympatholytic

Question 30

What are the side effects of atropine

Answer 30

dry mouth, dry eyes, dilated pupils, blurred vision

Question 31

How is atropine delivered

Answer 31

IV, PO, and endotracheal tube

Question 32

When is it appropriate to use atropine

Answer 32

In an emergency setting when there is life threading bradycardia and hypotension

Question 33

What is atropine an antidote for

Answer 33

organophosphate poisoning from pesticides or nerve gas

Question 34

What is the antidote to atropine

Answer 34

physostigmine

Question 35

What are signs of atropine toxicity

Answer 35

decreased secretions; flushed, dry, warm skin, visual changes and delirium with hallucinations. “Dry as a bone, red as a beet, hot as a hare, blind as a bat, mad as a hatter."

Question 36

What drug class is Digoxin

Answer 36

Cardiac glycoside

Question 37

What is the difference between digoxin and digitoxin

Answer 37

Compared to digoxin, digitoxin has longer half life (~ 7 days), is absorbed more readily, is more highly protein bound and is more extensively metabolized before excretion.

Question 38

What effect does digoxin have on the heart

Answer 38

It slows the rate yet increases the contractility by inhibiting the Na/K ATPase pump

Question 39

What are the indications of digoxin

Answer 39

CHF, failing other heart drugs

Question 40

What are the signs of digitalis intoxication

Answer 40

Halos around light, flickers, dots, blurred vision, N/V, diarrhea, bradycardia, heart block,

Question 41

What increases the risk of digitalis intoxication

Answer 41

low potassium esp in those on potassium wasting diuretic

Question 42

What is the antidote to digitalis intoxication

Answer 42

administering specific immune antibodies, known as Digoxin immune Fabs