Antiarrhythmic Flashcards Preview

T&D III exam 1 > Antiarrhythmic > Flashcards

Flashcards in Antiarrhythmic Deck (63):
1

Class I

Na Channel block (phase 0)

2

Class II

BB (sympathetic input/SA node)

3

Class III

prolong APD (inc ERP/block potassium)

4

Class IV

CCB

5

Class Ia

Moderate dissoc rate

6

Class Ib

Rapid dissoc

7

Class Ic

Slow dissoc

8

Class I is classified on

rate of dissociation from closed channels

9

state-dependent block means

binding to open or inactivated channels

10

association occurs in

systole

11

dissociation occurs in

diastole

12

Block related to depolarization

HR
ischemia
APD

13

what maintains block in normal

slowly dissociating (not rapid)

14

what maintains block in high HR, ischemia, prolonged APD

slow and rapid dissociation

15

Procainamide

Class Ia

16

Avoid in prolonged QT syndrome

Class Ia

(torsades de pointes)

17

Anticholinergic effect

Class Ia

18

Effect on AV node conduction with Class Ia

unpredictable
(direct - decreases, antichol - increases)

19

active metabolite of Procainamide

NAPA

20

ADR Procainamide

+ANA
Lupus like syndrome
Agranulocytosis/leukopenia
Proarrhythmic effect

21

CI for Procainamide

Prolonged QT
hypokalemia
SLE

22

Class Ib

Lidocaine
Mexiletine

23

Indications for Lidocaine

Life threatening V arrhythmias
Digoxin-induced arrhythmias

24

ADR - lidocaine

CNS (disorientation -- seizures)
Hypotension
decrease cardiac contractility

25

CI - Lidocaine

hypersensitivy - amides
severe hepatic dysfunction

history of lidocaine-induced seizures

26

Class Ib

IV vs Oral

IV- lidocaine
Oral - Mexiletine

27

Mexiletine ADR

thrombocytopenia
tremors
CNS
GI

28

Main concern with lidocaine

seizure

29

Class Ic

Flecainide
Propafenone

30

Markedly slow conduction

Class Ic

31

Tx of life threatening v. arrhythmias/Supraventricular arrhythmias in ABSENCE of organic heart disease

Flecainide

32

Effect of FLecainide on mortality post MI

HUGE, don't use if they have pre-existing heart disease

33

Indicated for A flutter, fib and Post MI

BB - Class II

34

Increased insulin induced hypoglycemia

beta blockers

35

Non specific beta blocker

Propranolol

36

Cardioselective beta blocker

Metoprolol
Esmolol

37

Control sinus tachy , short half life

Esmolol

38

Homogenous prolongation of APD

Proarrhythmic

(Class III)

39

Tx of refractory life threatening V arrhythmias

Class III

40

Class III

Amiodarone
Dronedarone
Ibutilide, Dofetilide
Sotolol

41

DOC for acute suppression of V arrhythmias

Amiodarone

42

Kinetics of Amiodarone

highly lipophilic
Very long half life - months

43

ADR - Amiodarone

Pulm fibrosis
Hyper-/Hypothyroidism
Hepatotox
AV block, bradycardia
Proarrhythmic

Corneal microdeposits
Photosensitive
Blue/gray nose and cheeks
drug-durg intrxn

44

Why monitor ptns on amiodarone ?

Pulm fibrosis

45

Class III and non selective BB

Sotolol

46

Prevent recurrence of sx A flutter, A fib

Sotolol

47

Class IV

Verapamil

48

supraventricular arrhythmias and PSVT with AV nodal reentry as indication

Class IV

49

Tx of acute termination of PSVT BUT Avoid in Asthma and COPD

Adenosine

causes bronchoconstriction

50

Terminate PSVT - valsalva, carotid sinus massage

Vagomimetics

51

Tx of bradyarrhthmias (prior to pacemaker transplant)

atropine
Isoproterenol

Inc AV/SA

52

Phase 0 on EKG

QRS

53

Phase 2 and 3 - repolarization on EKG

ST segment and T wave

54

Increased QT interval

Procainamide and Amiodarone

55

increased QRS interval (slowing conduction/slowing depolarization)

Flecainide

(also Procainamide and amiodarone)

56

No effect on EKG intervals

Lidocaine

57

Increased PR interval

Flecainide
Propranolol
Amiodarone
Verapamil

58

class Ic drug with weak beta-blocking activity

propafenone

59

refractory, life threatening V tach

Amiodarone

60

backup drug for amiodarone

Sotolol

61

Verapamil has DI with

Digoxin,
concurrent use of BB

62

How is Adenosine administered

IV

63

Increased PR int, QRS int, and QT interval

Amiadarone