Anti-arrhythmics Flashcards
(37 cards)
General rule about anti-arrhythmics?
They all cause arrhythmias.
Most AAs are negative/positive inotropes
negative
Pacemaker cells have what that allows them to beat on their own?
automaticity
What are most arrhythmias caused by? (2)
- slowed conduction in the pacemaker system leading to re-entry circuits
- altered rate of spontaneous discharge (ectopic pacemakers)
How many classes of AAs are there?
1 -A, B, C
2
3
4
Class 1 are…and how do they work?
sodium channel blockers that slow depolarization and have membrane stabilizing affect (MSA)
Class 1A are _________ na channel blockers. Name 3.
Intermediate
Quinidine
Disopyramidine
Procainamide
Class 1B are ______ na channel blockers. Name 3.
Fast
Lidocaine
Mexiletine
Tocainamide, Phenytoin
Class 1C are ________ na channel blockers. Name 2..
slow
Flecanide
Propafenone
Which class of AAs have a black cloud CAST upon them? Why?
Class 1C
Cardiac Arrhythmia Suppression Trial – found increased mortality in post-MI patients with non-life threatening vent. arr. SO, they are rarely used.
What are the Class 2 AAs? How do they work? Name 3.
Beta blockers
They reduce sympathetic tone…
Propanolol, Sotalol, Esmolol, Metroprolol, Atenolol
What are the Class 3 AAs? Name 3.
Potassium Channel Blockers
Amiodarone
Dofetilide
Sotalol
What are the Class 4 AAs? Name 2.
Calcium Channel Blockers
Diltiazem, Verapamil
Class 1A AAs are highly _________.
Anti-cholinergic.
Which class of AAs are highly anti-cholinergic?
Class 1A
What are some anti-cholinergic S/S? Which class of AA’s are prone to these effects?
Class 1A Anti-cholinergic = sympathetic... increased HR constipation, GI upset dry mouth urinary retention
Which AA causes a Lupus-like syndrome? Which class is it?
Procainamide – Class 1a
Lidocaine and Mexiletine are what class of AA?
Class 1B, Fast Na channel blockers
What is lidocaine most commonly used for? How is it administered?
ventricular arrhythmias and local anesthesia
IV
Why is Mexiletine used?
Oral maintenance for lidocaine.
Which drugs were involved in the CAST?
Class 1C – Flecainide and Propafenone
What is important about esmolol?
Short half life!
How is amiodarone administered?
IV and PO
Why is Amio used a lot?
Used for both ventricular and atrial arrhythmias.
