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Flashcards in Pharmacology Deck (50):
1

What are class I (A, B and C) drugs

Sodium channel blockers

2

What do class I drugs do

Prolong ventricular action potential

3

What does a prolonged ventricular action potential mean

Shorter AA / VV intervals = less chance for re-entrant tachy provocation

4

What are class II drugs

Beta blockers

5

What are class III drugs

Potassium channel blockers

6

What are class IV drugs

Calcium channel blockers

7

What are class V drugs

Adenosine and digoxin - mechanisms unknown

8

How do class II drugs work

Block beta-adrenergic binding sites in cardiac and vascular cell membranes Limit/Moderate sympathetic activity

9

What are the cardiac effects of class II drugs

Decreased HR Inotropy (contractility) Dromotropy (conduction velocity) Reduced BP Inhibit SA node automaticity - reduced ectopy

10

Two examples of class II drugs

Propanolol Metoprolol

11

How do class III drugs work

Bind and block potassium channels responsible for phase 3 repolarisation

12

What are the effects of class III drugs on the action potential

Increases AP duration and ERP

13

Two examples of class III drugs

Amiodarone - Long half life (25-60days) - Pulmonary fibrosis Sotalol - Also has class II activity

14

What are the cardiac effects of class IV drugs

Negative Inotropy (Decreased contractility) Negative chronotropy (Decreased HR) Negative dromotropy (Decreased conduction velocity)

15

What are the 3 classes of calcium channel blockers

Dihydropyridines Non-Dihydropyridines - Phenylalkylamine class // Benzothiazepine class

16

Examples of Dihydropyridines (Class IV)

Amlodipine Felodipine

17

Example of Phenylalkylamine (Class IV)

Verapamil

18

Example of Benzothiazepine (Class IV

Ditiazem

19

What classes would you give for Sinus Tachy

II, IV - treat underlying cause 1st

20

What classes would you give for AF

IA, IC, II, III, IV V-rate control is important here

21

What classes would you give for PSVT

IA, IC, II, III, IV - Most probably adenosine to block AV node

22

What classes would you give for AVB

Atropine

23

What classes would you give for PVCs

II, IV Most likely benign - no treatment

24

What classes would you give for Digitalis toxicity

IB

25

Metabolic states which increase capture threshold

Acidosis (80%) Alkalosis (80%) Hypercarbia Hyperkalemia Hyperglycaemia Hypoxemia MI // Ischemia Myxoedema Sleep Eating

26

Drugs which increase pacing threshold

IA = Quinidine, Procainamide, Disopyramide

IC = Flecanide, Propafenone

III = Amiodarone

IV = Verapamil

27

Drug which MAYBE increases pacing threshold

IA - Procainamide, Quinidine

Ib = Lidocaine

28

Drugs/Sympathetic agents, which decrease pacing threshold

Atropine Epinephrine Isoproterenol Corticosteroids

29

Drugs which have no effect on threshold

B Blockers Digitalis ACE inhibitors

30

Which 5 drugs increase DFT

IA = Quinidine

IB = Lidocaine Mexiletine

III = Amiodarone

IV = Verapamil

31

Which 3 drugs may decrease DFT

Ic = Flecaide - CONFLICTING ATRIAL ONLY

II = Metoprolol - CONFLICTING

III = Sotalol

32

Renal elimination drugs

Sotalol Digoxin Disopyramide Bretylium Tocainide

33

Hepatic elimination drugs

Lidocaine Flexanied Amiodarone Verapamil Propafenone

34

Drugs which increase digoxin

Flecanide Amoidarone Verapamil

35

Drugs which add to beta blockers effect

Flecanide - additive negative inotropic Amiodarone - additive b blocking effect Verapamil - additive bradycardia Lidocaine = Increase Blocker level

36

What reverses midazolam // Diazepam // Temazepam

Flumazenil

37

What reverses fentanyl // Morphine // Diamorphine

Naloxone

38

Which drug does this to the AP 

Q image thumb

1a = Slow conduction, Prolonged repolarisation 

39

Which drug does this to the AP 

Q image thumb

Class 1b = Shorter repolarisation, no effect on conduction 

40

Which drug class does this to the AP 

Q image thumb

1c = Slow conduction, no effect on repolarisation 

41

Which drug class does this to the AP 

Q image thumb

Class III - Prolonged repolarisation, no effect on conduction 

42

Which class of drugs are pro-arrhyhtmic to torsades and may slow VT 

 

2 examples 

Class Ia

 

Procainamide

Quinidine 

43

Which drugs may cause CNS side effects 

 

2 examples 

Class Ib

 

Lignocaine

Mexiletine 

44

What drugs are proarrhythmia for SCD in LV dysfunction

 

2x examples 

Flecanide 

Propafenone 

45

Which class III drug

 

Increases DFTs

Decreases DFTs

Amiodarone INCREASES

 

Sotalol DECREASES

46

What drug class may cause or exacerbate CHB and HF

 

2x examples 

Class IV - Potentiate Digoxin 

 

Verapamil 

Diltiazem 

47

Which class of drugs are mainly prescribed for SVTs 

Class IV 

48

Which class can't be used post MI (CAST) 

Class I 

Also negatively inotropic so nobody with LV dysfunction

49

3 major dawbacks of Sotalol

Relatively high Torsades rate

 

Non cardioselective 

 

Reverse use dependence 

50

Describe reverse use dependence 

Less effect at higher rates

 

I.e. Good at preventing AF (as HR is low) 

Shit at converting AF once its started (as HR is now high)