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Pharmacology > Cardiovascular 2 Anti-arrhythmics > Flashcards

Cardiovascular 2 Anti-arrhythmics Flashcards

(57 cards)

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1
Q

Drug class for Procainamide

A

class 1A Na channel

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2
Q

MoA for Procainamide

A

Decreases myocardial excitability and conduction velocity and may depress myocardial contractility, by increasing the electrical stimulation threshold of ventricle, His-Purkinje system and through direct cardiac effects (UtD)

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3
Q

Indications for Procainamide

A

life threatening ventricular arrhythmias

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4
Q

SE/ADRs for Procainamide

A

hypotension, N/V/D, SLE sxs, agranulocytosis (w/ prolonged use), QTc prolongation

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5
Q

Contra-indications for Procainamide

A

complete heart block, 2nd deg AV block, SLE, tornadoes de pointes

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6
Q

Dx-Dx interactions for Procainamide

A

other anti-arrhythmics

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7
Q

Monitoring for Procainamide

A

ECG, BP, eGFR, BUN, CBC, ANA titers, liver function, procainamide/NAPA conc (in liver disease)

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8
Q

PG category for Procainamide

A

PG C

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9
Q

Drug class for Lidocaine

A

class 1B Na channel

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10
Q

MoA for Lidocaine

A

blocks both the initiation and conduction of nerve impulses by decreasing the neuronal membrane’s permeability to sodium ions,suppresses automaticity of conduction tissue, by increasing electrical stimulation threshold of ventricle, His-Purkinje system, and spontaneous depolarization of the ventricles during diastole (UtD)

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11
Q

Indications for Lidocaine

A

suppression of existing ventricular arrhythmias

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12
Q

SE/ADRs for Lidocaine

A

arrhythmias, CV collapse, increase defib threshold, edema, heart block, hypotension, agitation, anxiety, metallic, taste, bronchospasm

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13
Q

Contra-indications for Lidocaine

A

severe SA, AV interventricular heart block w/out pacemaker, corn allergy

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14
Q

Dx-Dx interaction for Lidocaine

A

multiple (prolonged use)

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15
Q

Monitoring for Lidocaine

A

liver function, serum concentration, ECG, BP

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16
Q

PG category for Lidocaine

A

PG B

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17
Q

Drug class for Flecainide

A

class 1C Na channel

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18
Q

MoA for Flecainide

A

slows conduction in cardiac tissue by altering transport of ions across cell membranes; causes slight prolongation of refractory periods; increases electrical stimulation threshold of ventricle, His-Purkinje system

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19
Q

Indications for Flecainide

A

ventricular arrhythmias (prevention); PSVT (prevention); paroxysmal A fib/flutter

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20
Q

SE/ADRs for Flecainide

A

dizziness, blurred vision, dyspnea, palpitations, HA, pro-arrhythmic potential

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21
Q

Contra-indications for Flecainide

A

pre-existing 2 or 3 deg heart block, RBBB w/out pacemaker, cardiogenic shock

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22
Q

Dx-Dx interactions for Flecainide

A

multiple

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23
Q

Monitoring for Flecainide

Study These Flashcards
A

ECG, BP, HR, periodic trough serum levels w/ renal or liver impairment

24
Q

PG category for Flecainide

25
Flecainide should not be used for what chronic arrhythmia?
A fibrillation
26
Drug class for Amiodarone
Class 3 Repolarization delay
27
MoA for Amiodarone
inhibits adrenergic stimulation (alpha/beta) affecting Na, K, Ca channels; prolongs action potential & refractory period in cardiac tissues; decrease AV conduction & sinus node function
28
Indications for Amiodarone
life-threatening recurrent VF, unresponsive or unstable VT refractory to other anti-arrhythmic; off label- AF, PSVT, adjunct to ICD to suppress ventricular tacky in otherwise optimally tx patients w/ HF
29
SE/ADRs for Amiodarone
pulm toxicity, exacerbation of arrhythmias, optic neuritis, photosensitivity
30
Contra-indications for Amiodarone
hypersensitivity to iodine, cardiogenic shock, severe sinus node dysfunction, 2nd or 3rd deg HB or severe bradycardia without pacemakers
31
Dx-Dx interactions for Amiodarone
multiple, avoid grapefruit juice
32
Monitoring for Amiodarone
BP, HR, EKG, PE for lethargy, edema, wt loss, pulm toxicity, LFT, electrolytes, thyroid function, eye exams w/ long term use
33
PG category for Amiodarone
PG D
34
Drug class for Adenosine
other
35
MoA for Adenosine
- PSVT: slows conduction time through AV node, interrupting the re-entry pathways & restoring normal sinus rhythm - Stress test: causes coronary vasodilation & increases blood flow in normal coronary arteries w/ little or no increase in stenotic coronary arteries
36
Indications for Adenosine
PSVT, pharmacologic stress testing
37
SE/ADRs for Adenosine
new arrhythmias, chest pain, HA, flushing, dyspnea, bronchospasm
38
Contra-indications for Adenosine
2nd or 3rd deg AV block, sick sinus syndrome, symptomatic brady (except ones w/ pacemaker), known bronchoconstrictive or bronchospastic lung disease, asthma
39
Dx-Dx interactions for Adenosine
agents that have vascular impact (nicotine, caffeine); dipyridamole, carbamazepine, digoxin
40
Monitoring for Adenosine
EKG, HR, BP
41
PG category for Adenosine
PG C
42
Drug class for Digoxin
other: cardiac glycoside
43
MoA for Digoxin
inhibits Na/K ATPase pump in myocardial cells promoting influx Ca leadings to increased contractility; also direct suppressor of AV node which decreases ventricular rate
44
Indications for Digoxin
mild to moderate HF; A fib rate control
45
SE/ADRs for Digoxin
incomplete heart block may proceed to complete block, digoxin toxicity, SSS
46
Contra-indications for Digoxin
V fib, co-existing thyroid disorders, recent MI
47
Dx-Dx interactions for Digoxin
Amiodarone, verapamil; multiple others
48
Monitoring for Digoxin
HR & rhythm, serum dig level, serum K+, eGFR, electrolytes, serum Ca, Mg, K, mental state (confusion, depression)
49
PG category for Digoxin
PG D
50
Drug class for MgSO4
other
51
MoA for MgSO4
unknown
52
Indications for MgSO4
digitalis induced arrhythmias w/ low serum Mg; low Mg induced arrhythmias (VF, VT); off label-torsades (severe exacerbation asthma in kids)
53
SE/ADRs for MgSO4
flushing, hypotension, hypermagnesemia
54
Contra-indications for MgSO4
heart block
55
Dx-Dx interactions for MgSO4
multiple
56
Monitoring for MgSO4
EKG, vital signs, serum Mg, K, Ca; eGFR, SaO2
57
PG category for MgSO4
avoid

Pharmacology (16 decks)

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