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Flashcards in Anti-arrhythmic drugs Deck (22)
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1

2 class Ic drugs? MOA?

flecainide
propafenone
MOA: block open Na2+ channels

2

predicted actions: markedly slows phase 0 depolarization
uses: rhythm control, paroxysmal a. fib, SVT, ventricular arrhythmias, Wolff-Parkinson-White Syndrome

class Ic drugs: flecainide, propafenone

3

SEs: proarrhythmia, QT prolongation
increases digoxin concentration, increased activity when paired w/haloperidol, cimetidine, fluoxetine

flecainide, a class Ic drug

4

SEs: proarrhythmia in pts w/ischemic heart disease, QT prolongation, 1st or 2nd degree AVN block metallic taste, dizziness
may increase digoxin concentration, decreases warfarin metabolism, C/I in HF NYHA III-IV, liver dz, valvular dz, CAD, or V. tach

propafenone

5

class II drug? MOA?

propranolol
MOA: blocks catecholamines, blocks at the AV node

6

predicted actions: decrease slope of phase 4 depol, prolong repol in AV node= blocks re-entry
uses: rate control, tachyarrhythmia, SV arrhythmias, a. flutter, ventricular arrhythmias
SEs: bradycardia, hypotension, LV failure, AVN block, bronchospasm
C/I w/ sick sinus syndrome, bradycardia or heart block

propranolol, a class II anti-arrhythmic

7

5 class III anti-arrhythmics?

amiodarone
sotalol
ibutilide
dofetilide
dronedarone

8

MOA of class III anti-arrhythmics?

block lKr, K+ channel block

9

distinguishing characteristics: T1/2 of 26-107 days
predicted actions: prolong phase 3 depolarization w/o altering phase 0
uses: rhythm control, SV & ventricular arrhythimas

amiodarine, a class III anti-arrhythmic

10

SEs: corneal microdeposits, peripheral neuropathy, pulmonary fibrosis, disturbed thyroid fxn, photosensitivity w/blue/gray discoloration of skin, may precipitate heart failure

amiodarine, a class III anti-arrhythmic

11

predicted actions: prolong phase 3 depol w/o altering phase 0
uses: Wolf-Parkinson-White Syndrome, rhythm control, ventricular arrhythmias, maintenance of a. flutter
SEs: non-selective beta blockade, torsades

sotalol, a class III anti-arrhythmic

12

C/I w/idoine hypersensitivity, hyperthyroidism, 3rd degree AV heart block, D/I with warfarin (reduce dose by 25%-50%) and re-check INR, with concurrent digoxin use reduce dose by 50%, with concurrent statin use the max dose is 20 mg

amiodarone, a class III anti-arrhythmic

13

3 class IV anti-arrhythmics? MOA?

verapamil (diphenyl alkamine)
diltiazem (benzothiazepine)
amlodipine (dihydropyridine)
MOA: Ca2+ channel blockers

14

MOA: blocks L-type Ca2+ channels, decreases AV node conduction & increases refractory period

class IV anti-arrhythmics, CCBs, diltiazem & verapamil

15

distinguishing characteristics: similar to class II but doesn't block adrenergic system
predicted actions: slows phase 4 depol & slows conduction particularly at the AV node
uses: rate control, prevent recurrence of PSVT, control ventricular rate in a.fib, HTN, angina
SEs: negative inotropic, AVN block, sinus arrest, peripheral vasodilation, constipation, dizziness, flushing, H/A, hypotension, gingival hyperplasia

class IV anti-arrhythmics, CCBs

16

3 "other" anti-arrhythmics?

digoxin
adenosine
atropine

17

MOA: inhibits Na/K ATPase in myocardium

digoxin

18

MOA: acts on certain receptors to decrease adenyl cyclase to decrease cAMP

adenosine

19

MOA: competitive inhibitor of muscarinic acetylcholine receptors

atropine

20

distinguishing characteristics: decreases membrane Na+ gradient, decreases Na-Ca exchange, increases intracellular Ca2+
uses: rate control, a. fib, a. flutter w/RVR, heart failure
SEs: bradycardia, partial or complete heart block, GI, drowsiness, fatigue, visual disturbances
what is it's antidote?

digoxin
antidote is digibind

21

distinguishing characteristics: increases K+ efflux= cell hyperpolarization= transient heart block of AV node
uses: AV re-entrant tachycardia, AV nodal re-rentrant tachycardia, acute paroxysmal supraventricular tachycardias
SEs: transient hypotension & chest pn
recommended as initial drug of choice for PSVT

adenosine

22

use: bradycardia
SEs: blurry vision, dry mouth, tachycardia
ssxs of overdose?
antidote?

atropine
ssxs of overdose: dry as a bone, red as a beet, mad as a hatter, blind as a bat
antidote: neostigmine