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Antiarrhythmatics rhythm Flashcards

(56 cards)

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1
Q

Disopyramide, Quinidine, and Procainamide belong to which class of antiarrhythmatics?

A

Class 1A

Double Quarter Pounder

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2
Q

What are the Class 1B drugs?

A

Lidocaine and Mexilitine

Lettuce and Mayo

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3
Q

Flecainide and Propafenone belong to which class of antiarrhythmatics?

A

Class 1C

Fries Please

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4
Q

What is the direct effect of Class 1A drugs?

A

Delay opening of the fast sodium gates

Slow both the rate of activation and reactivation

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5
Q

What is the direct effect of Lidocaine and Mexilitine?

A 
Delay opening of the fast sodium gates
Enhance reactivation (dissociate quickly)
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6
Q

What is the direct effect of Class 1C drugs?

A

Delay opening of the fast sodium gates

Slow the rate of activation of the sodium gates

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7
Q

What are the indirect effects of Quinidine?

A

Strongly vagolytic
Moderate α-adrenergic block
(Reflex β1 stimulation)

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8
Q

What is the indirect effect of Procainemide and Disopyramide?

A

Weakly vagolytic

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9
Q

What is the overall effect of Quinidine?

A

Variable effects on sinus rate and PR interval
Widen QRS complex
Prolong QT interval

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10
Q

What causes the variable effects of Quinidine?

A

The vagolytic activity…can increase HR

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11
Q

What is the overall effect of Procainemide and Disopyramide?

A

Consistent slight slowing of pacemaker and slight prolonging PR interval
Widen QRS complex
Prolong QT interval

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12
Q

Why are Procainemide and Disopyramide more consistent?

A

Less vagolytic activity

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13
Q

Which Class 1A antiarrhythmatic is eliminated primarily by the liver?

A

Quinidine

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14
Q

Which Class 1A drug should not be given to patients with renal failure?

A

Procainemide

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15
Q

Where is Disopyramide eliminated?

A

Liver and kidney (50/50)

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16
Q

What arrhythmias can Quinidine and Procainemide be used to treat?

A

Atrial flutter and A fib
PVCs
Sustained VT

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17
Q

What Class 1A drug can be used to treat ONLY sustained VT?

A

Disopyramide

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18
Q

Which Class 1A drug is most likely to cause severe diarrhea?

A

Quinidine…“the quinidine shits”

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19
Q

Which Class 1A drug is most likely to cause SLE-like symptoms?

A

Procainemide

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20
Q

What does Disopyramide adversely effect? How?

A

CNS

Anti-ACh

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21
Q

What effect do Class 1B drugs have on ECGs?

A

Slight shortening of the QT interval

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22
Q

Which Class 1B drug has a higher oral bioavailability?

A

Mexilitine

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23
Q

Where are Lidocaine and Mexilitine eliminated?

24
Q

What are the adverse effects of Lidocaine?

Study These Flashcards
A

CNS-confusion

Disorientation

25
What are the adverse effects of Mexilitine?
Neurological
26
What are the effects of Class 1C drugs on ECGs?
Slightly prolong PR interval | Widen QRS complex
27
What did CAST studies of Class 1C drugs determine?
Higher mortality rate
28
What are Flecainide and Propafenone used for?
Long-term management of recurrent VT that is unresponsive to other drug therapies
29
Which Class 1C drug has a higher oral bioavailability?
Flecainide
30
Which Class 1C drug should not be given to hepatitis patients?
Propafenone
31
Which drug may cause sinus slowing and/or an AV block?
Flecainide
32
What are the adverse side effects of Propafenone?
VT Heart failure AV block
33
What do beta-blockers end in?
-alol
34
What are the significant effects of beta-blockers?
Slow sinus rate | Prolong PR interval
35
What arrhythmias are beta-blockers used for?
Supraventricular tachyarrhythmias | Exercise-induced ventricular tachyarrhythmias
36
Where are beta-blockers eliminated?
Liver
37
What are the adverse effects of beta-blockers?
Sinus bradycardia AV conduction block Contractile failure
38
What are Class 3 anti-arrhythmatics?
Inhibit closing (phase 4) and re-opening (phase 3) of potassium channels
39
What are the effects of the potassium blockers?
Slow the sinus rate Prolong the PR interval Widen the QRS Prolong the QT interval
40
What are the Class 3 anti-arrhythmatics?
Amiodarone Ibutilide Dofetilide
41
Which Class 3 drug is used for life-threatening VT and for supraventricular arrhythmias?
Amiodarone
42
What are ibutilide and dofetilide used for?
Atrial flutter | A fib
43
What is the most worried about adverse effect of Class 3 anti-arrhythmatics?
Torsades de Pointes
44
Nodes?
Calcium blockers!!
45
What are the calcium channel blockers?
Verapamil | Dilitazem
46
What is verapamil used for?
Supraventricular arrhythmias
47
Where are calcium blockers eliminated?
Liver
48
What are the adverse effects of calcium blockers?
Hypotension Sinus bradycardia AV conduction block Ventricular failure
49
What does adenosine do?
2 mechanisms. Inhibits cAMP-induced calcium influx and increases potassium permeability to hyperpolarize cells.
50
What is adenosine used for?
Converts life-threatening PSVT to normal sinus rhythm
51
What does digitalis do?
Supraventricular tachyarrhythmias | Converts PSVT to normal sinus rhythm
52
What are the risks of digitalis?
``` AV block Sinus bradycardia (give atropine to block ACh receptors) Can increase PVC's...raise RMP closer to threshold ```
53
How should Atrial Flutter be treated?
Class III antiarrhythmia | Ibutelide, Dofetilide
54
How should A Fib be treated? With heart disease?
Beta blocker + Calcium blocker (Diltiazem, Verapamil) | Amiodarione
55
How should Multifocal Atrial Tachycardia be treated?
Verapamil + beta blocker (metoprolol)
56
How should Supraventricular Tachycardia be treated?
Joules/Adenosine | Verapamil

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