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Pharm I Fall 2016 NUNM Jensen > Arrhythmia > Flashcards

Flashcards in Arrhythmia Deck (60)
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1

How do anti-arrhythmic drugs generally work?

By affecting either specialized ion channels or sympathetic tone

2

What are the three main I-a class drugs? (Double Quarter Pounder)

Disopyramide
Quinidine
Procainamide

3

What is the MOA of class I-a drugs?

Moderate block of both open Na+ and K+ channels
-slow phase 0 depolarization
-prolong action potential and slow conduction

4

What conditions do class I-a drugs treat?

Ventricular tachyarrhythmias
Paroxysmal recurrent afib
Wolff-Parkinson-White syn. (procainamide)

5

What are the three I-b drugs? (Lettuce Pickles Mayo)

Lidocaine
Phenytoin
Mexiletine

6

What is the MOA for class I-b drugs?

Mild blocking or inactivating Na+ channels
-shorten phase 3 repolarization
-decrease the duration of the action potential

7

What conditions do class I-b drugs treat?

Ventricular tachycardias

8

What are the two I-c drugs? (Fries Please)

Flecainide
Propafenone

9

What is the MOA for class I-c drugs?

Block open Na+ channels
-markedly slow phase 0 depolarization

10

What conditions do class I-c drugs treat?

Paroxysmal atrial fibrilation

11

What is the class II drug?

Propranolol

12

What is the MOA of Propranolol (II)?

Block catecholamines at the AV node
-decrease slope of phase 4 depolarization
-prolong repolarization in AV node > block reentry

13

What conditions does Propranolol (II) treat?

Tachyarrhythmia
Supraventricular

14

What are the five class III drugs?

Amiodarone
Sotalol
Ibutilide
Dofetilide
Dronedarone

15

What is the MOA of Class III drugs?

Blocking IKr (rapid K+ delayed reaction, outflow)
-prolong phase 3 repolarization without altering phase 0

16

What conditions do class III drugs treat?

Wolff-Parkingons-White syn. (sotalol)
Ventricular arrhythmias
Atrial tachyarrhythmias

17

What makes Amiodarone different from other Class III drugs?

It blocks like other classes
Has a two month half-life
Treats atrial flutter, afib, vtach, vflutter, SVT

18

What are the class IV drugs?

Non-dihydropyridine CCBs
Verapamil
Diltiazem

19

What is the MOA of class IV drugs?

Block L-type Ca++ channels, decrease AV node conduction and increase refractory period
-similar to class II but does not block the adrenergic system

20

What conditions do the class IV drugs treat?

Prevent recurrence of paroxysmal supraventricular tachycardias
Control ventricular rate in afib

21

What treatments control rate?

Class II, IV, digoxin

22

What treatments control rhythm?

Class I-a, I-c, III

23

What are two nonpharmacologic treatments for rate and rhythm control?

Ablation and pacing

24

What are the drug interactions or contraindications for Quinidine?

Warfarin and digoxin

25

What are the drug interactions or contraindications for Disopyramide?

Glaucoma

26

What are the drug interactions or contraindications for Mexiletine?

3rd degree AV block

27

What are the drug interactions or contraindications for Propafenone?

Heart failure, liver disease, valvular disease, CAD, Vtach
May increase digoxin concentrations
May decrease warfarin metabolism, BB properties

28

What are the drug interactions or contraindications for Flecainide?

Increase digoxin
Increased by haloperidol, cimetidine, fluoxetine

29

What are the drug interactions or contraindications for beta blockers?

Severe sinus bradycardia or heart block

30

What are the drug interactions or contraindications for Class III drugs?

Iodine hypersensitivity, hyperthyroidism, 3rd degree AV heart block
Warfarin, reduce 25-50%, recheck INR. Digoxin, reduce 50%. Statin (max 20mg).