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Flashcards in Antiarrhythmics Deck (40):
1

Class 1 antiarrhythmics block what channels? Result in what overall effect to the AP

Voltage gated sodium channels.

Prolongs the phase 0 upstroke and slows the cardiac AP.

2

Do class 1 antiarrhythmics block open, closed, or inactivated Na+ channels?

Open or Inactivated

3

What type of cardiac tissues do Class 1 antiarrhythmics have an effect on?

Rapidly depolarizing cells

4

Class 1 antiarrhythmics have what effect on an ECG?

Increased QRS duration and prolonged AP

5

Name the Class 1a antiarrhythmics

Quinidine
Procainamide
Disopyramide

6

Binding affinity of Class 1a, b, and c?

a - Intermediate
b - Low
c - High

7

Class 1a MOA?

Inhibit Na+ and K+ voltage gated channels. This slows down Phase 0, 2, and 3 and increases the refractory period.

8

Class 1a treats?

Supraventricular and ventricular arrhythmias
WPW

9

Class 1a adverse effects?

Cinchonism
Thrombocytopenia
Lupus like syndrome
Exacerbate HF
Precipitate torsades

10

Name the class 1b medications?

Lidocaine
Mexiletine
Phenytoin

11

Class 1b MOA?

Inhibit Na+ and moderately slow phase 0 upstroke. Decreased phase 2 and 3 leading to a decreased refractory period

12

Class 1b treats?

Ventricular arrhythmias

13

Class 1b adverse effects?

Neurological issues

14

Name the class 1c medications

Flecainidine
Propafenone

15

Class 1c MOA?

Inhibit Na+ channels strongly and prolong the phase 0 upstroke. There is NO effect on AP duration.

16

Class 1c treats?

Supraventricular and ventricular arrhythmias

A-fib

17

Class 1c contraindication?

Ischemic heart disease

18

Name the class 2 antiarrhythmics

Beta-blockers

19

Class 2 MOA?

Blocking sympathetic input to the SA and AV nodes. Decrease cAMP. Closure of Calcium channels. Overall prolongation of phase 4. Decreased AV conduction

20

Class 2 treats?

Supraventricular arrhythmias

A-fib, flutter

Rate control

21

Class 2 effects on the ECG?

Prolonged PR interval

22

Class 3 MOA?

Block K+ channels and prolong phase 2 and 3. Prolonged refractory period

23

What is special about Amiodarone?

Shares properties of class 1, 2, 3 and 4 antiarrhythmics

24

Name the class 3 antiarrhythmics

Amiodarone
Dofetilide
Ibutilide
Sotalol

25

Class 3 treats?

Supraventricular and ventricular arrhythmias
A-fib

26

Amiodarone side-effects

Neurologic
Gray corneal deposits
Thyroid issues
Pulmonary fibrosis
Heart block
HF
Hepatitis
Skin discoloration
Photodermatitis
Inhibits CYP-450

27

Can class 3 antiarrhythmics induce torsades?

YES

28

What are class 4 antiarrhythmics?

NDHP CCBs

29

Name the class 4 antiarrhythmics

Verapamil
Diltiazem

30

Class 4 MOA

Block Calcium current in the SA and AV nodes. Prolong phase 4, decreased pacemaker, prolonged conduction and prolonged refractory period.

Prolonged PR interval

31

NDHP treat?

Supraventricular arrhythmias
A-fib
Rate control

32

NDHP adverse?

Cause heart block

33

Digoxin MOA

Stimulation of the vagus nerve and AV nodal inhibition

34

Digoxin treats?

Prevents rapid ventricular response in A-fib

35

Magnesium treats?

Arrhythmias such as torsades

36

Adenosine MOA

Activates inhibitory A1 receptors on the myocardium at the SA and AV nodes. Suppresses inward Ca++ current and increases outward current of K+. Overall decreased AV conduction and prolonged refractory period

37

Adenosine treatment?

Acute supraventricular arrhythmias such as PSVT

38

Adenosine effect on A2 receptors?

Coronary dilation

39

Adenosine adverse effects?

Cutaneous flushing
SOB, chest pain, feeling of impending doom
Headache
Hypotension

40

Adenosine effects are inhibited by?

Caffeine and Theophylline