Antiarrythmics

Question 1

Even though it’s Class 3, ____ is also a non-selective Betablocker that can block K+.

Answer 1

Sotalol

Question 2

______ is the most effect Anti-AR drug likely because it can block Na, Ca, K, and Beta-Adrenoceptors

Answer 2

Amiodarone

Question 3

Calcium channel blockers greatly decrease phase ____ slope

Answer 3

4

Question 4

Mnemonic for Class 3 Antiarrhythmics?

Answer 4

“Is Bad”

Question 5

Adenosine does what 3 things to cause Negative Hyperpolarization and suppression of calcium-dependent APs?

Answer 5

1. Activate Inward rectifier K+ current to boot out potassium
2. Inhibit Calcium Channel
3. Inhibit Funny Current

Question 6

Beta blockers are contraindicated in patients with ________

Answer 6

Wolf-Parkinson-White Syndrome

Question 7

Anything that blocks Potassium (such as Type 1) can cause which key adverse effect?

Answer 7

Torsade De Pointes

Conduction gets slowed too much

Question 8

How is Esmolol different than propranolo.?

Answer 8

• Selective B1 antagonist

- Ultra Rapid half-life of 9 minutes!

Question 9

Class 1C Anti-AR drugs 2 facts about mech of action?

Answer 9

1. Minimal APD effect

2. Slows upstroke conduction

Question 10

2 main Toxicities of Class 1B Anti-ARs, also what is NOT a risk?

Answer 10

• Mainly Paresthesia and tremors

- NOT Torsades!

Question 11

Beta Blockers dual mech of action?

Answer 11

Lower cAMP to reduce both Na and Ca currents.

Question 12

Main usage of Class 1C Anti-AR drugs?

Answer 12

Supraventricular Arrhythmias
(1B can't do these)

Question 13

Class 1B Anti-AR drugs Mechanism of action?

Answer 13

Shorten APD by targeting either activated or inactivated sodium channels

Question 14

Magnesium as an Anti-AR drug is most effective against _______

Answer 14

Torsades

Question 15

Class 2 Anti-AR drugs are mainly ____ _____ Blocking Drugs

Answer 15

Beta Adrenoreceptor

Question 16

In patients who have late-stage heart failure, they were given IVABRADINE, because unlike the Beta-blockers, it blocks the ____ current while preserving the heart’s contractility.

Answer 16

Funny

Question 17

2 Indications for Class 3 Anti-ARs

Answer 17

1. Most Vent. Arrhythmias

2. Maintain Sinus in A-fib

Question 18

Donedarone is similar to ______ but WITHOUT iodine to avoid thryoid problems. Vernakalant and Ranolzine are also similar to this drug.

Answer 18

Amiodarone

Question 19

Digoxin is used as an adjunctive agent to help Ventricular response during which two heart probs by slowing AV conduction?

Answer 19

1. Atrial Fib/Flutter

2. Supravent. Arrhytmia

Question 20

4 Main uses of Beta blockers?

Answer 20

1. A-fib/Flutter
2. PVCs
3. Prevent night SupraVent Tachy
4. Treat Catecholamine excess

Question 21

Class 4 Anti-AR drug Mechanism (3 facts)

Answer 21

• Block both activated and Inactivated L-type calcium channel
• INCREASE refractory period
• DECREASE Conduction Velocity

Question 22

Aside from never mixing with Beta Blockers, Main toxic event of Class 4 Anti-ARs?

Answer 22

AV block!

Question 23

_____ is the Drug of choice for the prompt conversion of paroxysmal supraventricular tachycardia to Sinus.

Answer 23

Adenosine

Question 24

Adenosine primarily inhibits ____ nodal conduction

Answer 24

AV

Question 25

Ibutilide, Sotalol, Bretylium, Amiodarone, Dofetilide are all Class ______ Anti-AR drugs that mainly block ______ channels.

Answer 25

3, K+

Question 26

Out of the Class 3 Anti-ARs ____ and ____ are experts at treating Atrial Flutter and Atrial Fibrillation

Answer 26

- Ibultilide | - Dofetilide

Question 27

Aside from AV block, 3 common side effects of Class 4 Anti-ARs?

Answer 27

- Hypotension - Constipation - Edema

Question 28

Beta blockers decrease phase ____ slopes

Answer 28

4

Question 29

3 Contraindications of Type 1B Anti-ARs

Answer 29

1. A-fib 2. A-Flutter 3. Supraventricular Tachy

Question 30

What is the double Mechanism of Action of Class 1A Anti-AR drugs?

Answer 30

Moderate Na+ AND K+ block to PROLONG APD and slow upstroke | Misleading bc they're considered mainly Na blockers

Question 31

Flecainide, propafenone, moricizine are all _____ _____ _____ drugs

Answer 31

Class 1C Anti-AR

Question 32

3 Main uses of Type 1B Anti-ARs

Answer 32

1. MI Arrhythmias 2. V-tach 3. Cure Digitalis Arrhythmia

Question 33

Most class 3 drugs, except ______ are reverse use-dependent; whereby unfortunately AP prolongation happens the least in areas with super fast-rates (where it is desirable).

Answer 33

Amiodarone

Question 34

3 Adverse effects of Class 3 Anti-ARs

Answer 34

1. Long QT 2. Torsades 3. Bradycardia

Question 35

Which Type 1 Anti-AR drug causes a Lupus-like syndrome as a side-effect?

Answer 35

Procainamide

Question 36

5 Class 3 Anti-AR drugs

Answer 36

1. Ibultilide 2. Sotalol 3. Bretylium 4. Amiodarone 5. Dofetiliide

Question 37

Class 3 Anti-AR mechanism

Answer 37

Block phase 2 K+ to prolong APD.

Question 38

Flecainide is the prototypical drug for Class _____ Anti-AR drugs and mainly blocks ____ channels

Answer 38

1C, Sodium

Question 39

Procainamide, Quinidine, and Disopyramide are all ______ _____ ______ drugs

Answer 39

Class 1A Antiarrhythmic

Question 40

Main toxicity of Class 1C Anti-AR drugs?

Answer 40

Lethal Arrhythmias.

Question 41

Although Amiodarone is super effective it has 4 Terrible Side-effects

Answer 41

1. Pulmonary Fibrosis 2. Microcrystalline deposits in eye/skin 3. Thyroid Probs 4. Warfarin/Digoxin Itneractions

Question 42

Class ____ Anti-AR drugs are the only ones that do not help during Ventricular Arrhytmias out of classes 1-4.

Answer 42

4

Question 43

Class ____ Anti-AR drugs are key for WPW-related arrhtymias

Answer 43

1C

Question 44

Procainamide is a prototypical class ______ antiarrhytmic drug blocking mainly _____ channels

Answer 44

1A, Sodium

Question 45

Lidocaine and Mexiletine are both _____ _____ ______ Drugs

Answer 45

Class 1B Anti-AR

Question 46

Verapamil and Diltiazem are both Class _____ Anti-AR drugs that block ____ channels

Answer 46

4, Calcium

Question 47

Name the 2 Class 4 Anti-AR drugs (Calcium Blockers)

Answer 47

1. Verapamil | 2. Diltiazem

Question 48

Mg is thought to treat arrhythmias by antagonizing ____ channels

Answer 48

Calcium

Question 49

Lidocaine is the prototypical drug of Class ______ Anti-AR drugs blocking mainly _____ channels

Answer 49

1B, Sodium