Antiarrhythmic pharmacotherapy Flashcards Preview

Year 2 Cardiovascular > Antiarrhythmic pharmacotherapy > Flashcards

Flashcards in Antiarrhythmic pharmacotherapy Deck (42):
1

class I antiarrhythmics block what channel?

sodium

2

class II antiarrhythmics block what channel?

beta

3

class III antiarrhythmics block what channel?

potassium

4

class IV antiarrhythmics block what channel?

calcium

5

class Ia antiarrhythmics have what effect on sodium levels

moderate sodium blockage

6

class Ib antiarrhythmics have what effect on sodium levels

mild sodium blockage

7

class Ic antiarrhythmics have what effect on sodium levels

marked sodium blockage

dcreasing conduction velocity, no effect on repol

8

what must be used first before quinidine in aF?

digoxin

9

where is quinidine metabolized?

liver

10

what is the main cardiac adverse effect of quinidine?

prolonged QT interval (torsade de pointes)

11

what is the main metabolite of procainamide?

NAPA

12

what are the main adverse effects of procainamide?

QT prolongation
drug induced lupus

13

where is disopyramide cleared?

kidney

14

what are the adverse effects of disopyramide?

potent anticholinergic (dryness)

15

what type of local anesthetic is lidocaine?

amide

16

what is a benefit of lidocaine?

minimal effect of QT or QRS

17

lidocaine is only effective for what type of arrhythmia?

ventricular

18

flecainide is only effective for what type of arrhythmia? what is their first line use?

atrial (SVTs with normal heart function)

atrial fibrillation only

19

class Ic antiarrhythmics are contraindicated in what population?

anyone with structural heart disease (CHF)

20

what is the indication for propafenone?

without sig CHF that have aF or sustained VT/VF

torsades, AV block, CHF

21

MOA of beta blockers

prolongs AP and slows HR

22

what is the only class of antiarrhythmics found to reduce mortality in arrhythmia patients?

beta blockers

23

what kind of drug is sotolol

beta blocking agent with class III properties

(also blocks potassium channels)

24

what are the indications for sotolol?

AF and sustained VT/VF

25

what is the main side effect of sotolol?

torsades de pointes

potent QT prolongation

26

what class of drug is amiodarone? what are its effects on channels?

class III

has effects in all four Vaughn-WIlliams classes (all channels)

27

what is the principal MOA of amiodarone?

delayed repolarization by prolonging APD and ERP

28

what are the indications for amiodarone?

all types of arrhythmias, increasingly for VF

29

why does amiodarone have such potent side effects?

huge volume of distribution
long tissue half life
short peripheral half life

30

what are the cardiac and pulmonary side effects of amiodarone?

cardiac - torsades
pulmonary - fibrosis

31

amiodarone is only one of two antiarrhythmics safe to use in what condition?

CHF

32

what are the thyroid and ocular side effects of amiodarone?

thyroid - hypo or hyperthyroidism
ocular - corneal deposits, halos, photophobia, retinopathy

33

what are the neuro and derm side effects of amiodarone?

neuro - tremor, ataxia, peripheral neuropathy, seizure
derm - photosensitivity, blue-gray discoloration

34

what are the hepatic and GI side effects of amiodarone?

hepatic - elevated transaminases
GI - loss of taste

35

what kind of drug is dronaderone? what is its clinical use?

derivative of amiodarone

AF

36

dronaderone is contraindicated in what population?

CHF

37

what are the indications for dofetilide?

acute conversion of AF to NSR and for maintenance of NSR

38

what is the main adverse effect of dofetilide?

HIGH incidence of torsades de pointes

39

treatment for AF with no other heart disease?

flecainide or propafenone

40

treatment for AF with history of CAD, but normal EF?

sotolol

41

treatment for AF with CHF?

amiodarone, dofetilide

42

what are the rate control drugs for atrial arrhythmias?

beta blockers
diltiazem
digoxin