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Flashcards in Antiarrhythmic Drugs Deck (12):
1

Often induced by antiarrhythmics and other drugs that change the shape of the action potential and prolong the QT interval.
Seen in the ECG as polymorphic ventricular tachycardia, often displaying waxing ang waning QRS amplitude.

Torsades de pointes

2

Class I antiarrhythmics act on phase _____ of cardiac action potential.
Examples: (3)
For WPW: (2)

0 (zero)

I am the Queen who Proclaimed Diso's pyramid
Quinidine
Procainamide
Disopyramide

Procainamide, Amiodarone (Group III anthyarrhthmic with class 1A activity.)

3

Treatment of Class 1A overdose
- ______________ to reverse drug-induced arrhythmias
- ______________ to reverse drug-induced hypotension if indicated

Sodium lactate
Pressor sympathomimetics

4

Examples of Class 1B antiarrhythmics: (4)

Lidocaine (DOC for ventricular arrhythmias post-MI, digoxin-induced arrhythmias)
Phenytoin (alternative to lidocaine)
Mexiletine
Tocainide

NOTE: 1B is best post-MI, atrial arrhythmias due to digitalis

5

What are the drugs (not necessarily antiarrhythmics) that can cause agranulocytosis? (8)

Agranulocytosis! CCCAPPIT!
Clozapine
Co-trimoxazole
Colchicine
Aminopyrine
Phenylbutazone
PTU
Indomethacin
Tocainide

6

Examples of Class 1 antiarrhythmics which have no effect on the action potential but increases the QRS duration and are reserved for refractory arrhythmias: (4)

Flecainide
Encainide
Propafenone
Moricizine

NOTE: 1C is contraindicated post-MI.

7

Class 2 antiarrhythmics: Beta-blockers
The AV node is particularly sensitive to these so the PR interval is usually _____________.
Act on Phase _____.

Partial agonists: (2)
Lacking local anesthetic effect: (2)
Low lipid solubility:
Shortest-acting:
Longest-acting:
Combined alpha and beta blockade: (2)

Class 3 antiarrhythmics which also have Class 2 effects: (2)

prolonged
4

Partial agonists: pindolol, acebutolol
Lacking local anesthetic effect: timolol, betaxolol
Low lipid solubility: atenolol
Shortest-acting: esmolol
Longest-acting: nadolol
Combined alpha and beta blockade: carvedilol, labetalol


Amiodarone and sotalol

8

Class 3 antiarrhythmics act on phase ____.
Hallmark is the _________________ of the action potential duration.
ECG morphology shows increase in _____ interval.
Examples: (4)

3
prolongation
QT

AIDS:
Amiodarone (SimD: Dronedaron, Vernakalant)
Ibutilide
Dofetilide
Sotalol

9

The most efficacious of all antiarrhythmics.
Reserved for refractory arrhythmias due to many side effects (microcrystalline deposits in the cornea and skin, thyroid dysfunction -- hyper- or hypo- --, paresthesias, tremor, pulmonary fibrosis)
Has a long half-life of 3-10 weeks.

Amiodarone

10

Class 4 antiarrhythmics
ECG shows a PR interval which is consistently _________________.
Examples: (2)

prolonged

Verapamil (DOC for SVTs)
Diltiazem

11

A miscellaneous antiarrhythmic with a short half-life (15 seconds) which is the drug of choice for paroxysmal supraventricular tachycardia

Adenosine

12

Miscellaneous antiarrhythmic which is effective in some cases of torsades de pointes

Magnesium ion

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