Antiarrhythimics

Question 1

Decreased automaticity
Restoration of conduction (restore depressed conduction and reverse re-entry) 
Decreased conduction (Covert 1-way to 2-way block and block re-entry) 
Decreased/Increased ERPs (reverse or block re-entry)
Homogeneity of ERPs

Answer 1

Antiarrhythmics

Question 2

Most arrhythmias caused by

Answer 2

Abnormal conduction pathway

Question 3

Class ___ drugs good at increasing ERP

Answer 3

3

Question 4

Class _____ drugs good at decreasing conduction velocity

Answer 4

1

Question 5

Na channel blockers - slow conduction

Answer 5

Class 1

Question 6

Beta-receptor blockers

Inhibit sympathetic input to AV node

Answer 6

Class 2

Question 7

Prolong APD

Increase ERP

Answer 7

Class 3

Question 8

Ca channel block

Answer 8

Class 4 drugs

Question 9

Class one drugs bind to Na channels in their ______ state and dissociate in their _____ closed

Answer 9

Open

Closed

Question 10

Class 1A
Class 1B
Class 1C

Answer 10

Moderate dissociation
Fast dissociation
Slow dissociation

Question 11

Good for tachycardia, hypoxia, ischemia

Answer 11

Class 1B

Question 12

A lot of drug stays bound from one AP to next. Most profound effect on slowing conduction

Answer 12

Class 1C

Question 13

Associate during

Dissociation during

Answer 13

Systole

Diastole

Question 14

Procainamide is a class _____ drug

Answer 14

1A

Question 15

Decrease automaticity
Decrease conduction velocity
Increase APD and ERP

Answer 15

Procainamide

Question 16

Has some Anticholinergic effects

Answer 16

Procainamide

Question 17

Has unpredictable effects on the AV node

Answer 17

Class 1A

Procainamide

Question 18

Directly will decrease AV node conduction
Anticholinergic effects increase AV node conduction
Increase/Decrease AV node conduction

Answer 18

Procainamide

Class 1A

Question 19

Avoid in prolonged QT syndrome because can cause torsades de pointes

Answer 19

Procainamide

Question 20

Used for life threatening ventricular arrhythmias
Orally and IV
Hepatic and renal metabolism

Answer 20

Procainamide

Class 1A

Question 21

Has active metabolite NAPA

Answer 21

Procainamide

Question 22

Causes ANA formation and a lupus like syndrome

Answer 22

Procainamide (Class 1A)

Hydralazine

Question 23

Causes agranulocytosis and leukopenia early in treatment

Answer 23

Procainamide

Question 24

Has proarrhythmic effects

Answer 24

Procainamide

Question 25

Avoid in prolonged QT, lupus, and hypokalemia

Answer 25

Procainamide (Class 1A)

Question 26

Lidocaine and mixiletine

Answer 26

Class 1B drugs

Question 27

Have minimal effects in normal myocardium, and class 1A like action in diseased myocardium

Answer 27

Class 1B drugs

Question 28

Use in life threatening ventricular arrhythmias and digoxin-induced arrhythmias

Answer 28

Lidocaine

Question 29

Hepatic metabolism- first pass elimination IV only Must decrease dose in liver disease & CHF

Answer 29

Lidocaine

Question 30

Can cause seizures with CNS

Answer 30

Lidocaine

Question 31

Has hypersensitivity to other amides, causes severe hepatic dysfunction

Answer 31

Lidocaine

Question 32

Similar to lidocaine Orally effective Causes GI, CNS, tremors, and thrombocytopenia

Answer 32

Mexiletene (Class 1B)

Question 33

Flecainide and Propafenone

Answer 33

Class 1C drugs

Question 34

Markedly slow conduction, decrease automaticity

Answer 34

Flecainide and Propafenone

Question 35

Used in life threatening ventricular arrhythmias and disabling supra ventricular arrhythmias IN the ABSENCE of organic heart disease

Answer 35

Flecainide (Class 1C)

Question 36

Increases mortality post MI | Avoid in pre-existing heart probes

Answer 36

Flecainide (Class 1C)

Question 37

Conduction block

Answer 37

Flecainide

Question 38

Similar to Flecainide

Answer 38

Propafenone

Question 39

Inhibit sympathetic input (Decreases automaticity and conduction velocity, increases refractories) Prominent effects in SA and AV nodes Decrease contractility

Answer 39

Class 2 beta blockers

Question 40

Used in supraventricular arrhythmias, a flutter and a fib, symptomatic PVCs, post MI, and CHF

Answer 40

Class 2 (beta blockers)

Question 41

Can cause bronchoconstriction, CHF, AV block, cold extremities Increase insulin-induced hypoglycemia b/c they block the reflexive increase in HR

Answer 41

Class 2 beta blockers

Question 42

Propanolol is

Answer 42

Nonspecific beta blocker

Question 43

Metoprolol is

Answer 43

Cardioselective beta blocker

Question 44

Esmolol is

Answer 44

Cardio selective beta blocker

Question 45

Short half life (mins). Control ventricle rate in Afib and a flutter. Control sinus tachycardia

Answer 45

Esmolol

Question 46

Homogenous prolongation of APD (proarrhythmic).

Answer 46

Class 3

Question 47

Treat refractory life threatening ventricular arrhythmias

Answer 47

Class 3

Question 48

Increased automaticity Conduction block or slowing Decreased/Increased ERPs Heterogeneity of ERPs

Answer 48

Proarrhythmics