Antiarrhythmic Drugs Flashcards Preview

Cardio 2 > Antiarrhythmic Drugs > Flashcards

Flashcards in Antiarrhythmic Drugs Deck (26):
1

Different Channel Expression

Different regions have different expression, so drugs affect them differently

2

Class I Drugs General Action

Block Na channels

3

Class II Drugs

Beta blockers, mainly act on phase IV

4

Class III Drugs

Block K channels: prolong AP and refractory period (suppress re-entry) (prolong QT interval)

5

Class IV Drugs

Ca channel antagonists - impair impulse propagation in nodal and damaged areas

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Subclass IA Drugs (potency, graphical action, 3 examples)

High/intermediate potency prolong depol and repol (prolong QT interval): quinidine, procainamide, disopyramide

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Subclass IB (potency, graph action, 2 examples)

Lowest potency, shorten repol and thus QT interval. Lidocaine and mexiletine

8

Subclass IC (potency, graph action, 2 examples)

Most potent so prolong depol/QRS no effect on repol/QT. Fecainide, propafenone

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Use of 1A (3 points)

AF or VT, NOT SVT. Can't use w/ CHF. Quinidine dangerous so use rarely, cautionary w/ CAD

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Use of 1B (2)

VT, can use w/ CAD or CHF

11

Use of 1C (2)

AF or SVT, but not with CAD or CHF. Cause sudden death w/ ischemia so use in populations not at risk for that

12

Use of Disopyramide

Occasionally pts w/ vagal Afib

13

Use of Lidocaine

Acute IV use in VT/VF

14

Class III Graph Effect and Important Monitoring

Slightly prolong depol and repol - monitor bc don't want QT too long

15

4 Class 3 Drugs

Amiodarone
Sotalol (? - or class II?)
Dofetilide
Dronedarone

16

Amiodarone

Multichannel blocker, all 4 classes that can be used for pretty much any life threatening arrhythmia, even w/ CHF and CAD. But has crazy half life and horrible side effects

17

Sotalol

Good for arrhythmias, but can't use in CHF bc BB

18

Torsades

Polymorphic proarrhythmia associated w/ drugs that prolong QT (IA, III)

19

2 Drug Choice for Premature Atrial/Nodal/Vent Depol

None, maybe BB is symptomatic

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4 Drug Choice for Afib/flutter/PSVT

AV nodal blockers to control vent response: Adenosine, class II, IV, digoxin (except for WPW)

21

3 Drug Choice for VT

Amiodarone, III, I

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4 Drug Choice for VF

Amiodarone, Lidocaine, III, I

23

2 Acute Drug Choice for Tosades

Mg, Isoproterenol

24

CYP3A4

Necessary to clear Class IV (Ca channel blockers like verapamil), inhibited by grapefruit juice

25

Digoxin ANS Mech

Increases vagal tone, inhibiting AV nodal conduction

26

Adenosine

Acutely treats paroxysmal supraventricular tachycardia