Rhythm control

Question 1

Class I anti-arrhythmics

Answer 1

interfere with sodium channel

Question 2

Class II anti-arrhythmics

Answer 2

Anti-sympathetic nervous system - blocks adrenaline effects, reduces HR, contractility LV and BP

Question 3

Class III anti-arrhythmics

Answer 3

Interfere with potassium channel

Question 4

Class IV anti-arrhythmics

Answer 4

Interfere with calcium channels and AV node

Question 5

Class v anti-arrhythmics

Answer 5

Other/unknown mechanisms

Question 6

Disopyramide, quinidine, procainamide drug class

Answer 6

Ia anti-arrhythmics

Question 7

Ia anti-arrhythmics MOA

Answer 7

Lengthens AP

Question 8

Ia anti-arrhythmics clinical use

Answer 8

SVT/VT

Question 9

Adenosine, digoxin drug class

Answer 9

V anti-arrhythmics

Question 10

Atenolol, bisoprolol drug class

Answer 10

II anti-arrhythmics (mainly beta-blockers)

Question 11

II anti-arrhythmics MOA

Answer 11

Block beta adrenoreceptor slowing SA node and AV node conduction

Question 12

Lidocaine drug class

Answer 12

Ib anti-arrhythmics

Question 13

Ib anti-arrhythmics MOA

Answer 13

Shorten AP

Question 14

Ib anti-arrhythmics clinical use

Answer 14

VT

Question 15

II anti-arrhythmics clinical use

Answer 15

SVT

Question 16

Verapamil, diltiazem drug class

Answer 16

IV anti-arrhythmics

Question 17

IV anti-arrhythmics MOA

Answer 17

Calcium channel blocker slows SA and AV conduction

Question 18

IV anti-arrhythmics clinical use

Answer 18

SVT

Question 19

Flecanide drug class

Answer 19

Ic anti-arrhythmics

Question 20

Amiodarone, sotalol drug class

Answer 20

III anti-arrhythmics

Question 21

III anti-arrhythmics MOA

Answer 21

K+ channel blcoker, prolongs AP

Question 22

Adenosine MOA

Answer 22

K+ channel activation sows pacemaker activity, slowed AV conduction (hyperpolarises)

Question 23

Digoxin MOA

Answer 23

Inhibits Na+K+ATPase membrane pump causing increased intracellular Na+ and decreased intracellular K+, causes positive ionotropic effect from na/ca exchanger trying to extrude sodium and pumping in more calcium

Question 24

Digoxin clinical use

Answer 24

AF, atrial flutter

Question 25

Magnesium MOA

Answer 25

? Ca+ channel blocker

Question 26

Mg clinical use

Answer 26

VF, digoxin toxicity

Question 27

Atropine MOA

Answer 27

Antimuscarinic, vagal, increase firing of SAN and AV conduction

Question 28

Atropine clinical use

Answer 28

Bradycardia

Question 29

B-blockers contrindications

Answer 29

Asthma, cardiogenic shock, hypotension, AV block, untreated pheocytochroma side effects

Question 30

Most important class Ib anti-arrhythmic drug

Answer 30

lidocaine

Question 31

lidocaine used when

Answer 31

VT when amiodarone is contraindicated

Question 32

b-blockers side effects

Answer 32

fatigue, cold extremities, bronchospasm, nightmares, impotence

Question 33

amiodarone side effects

Answer 33

abnorml cardiac rhythm, corneal microdeposits, hypo/hyperthyroidism (contains iodine), photosensitivity reactions, blue-grey skin discolouration, abnormal LFTs, lung fibrosis

Question 34

Calcium channel blockers uses

Answer 34

hypertension, angina, arrhythmias

Question 35

ca channel blocker contraindications

Answer 35

pregnancy, cardiogenic shock, severe bradycardia, moderate to severe heart failue

Question 36

ca channel blocker side effects

Answer 36

lightheadedness, low bp, slower hr, drowsiness, flushing, ankle oedema, increased apetite, GORD

Question 37

Digoxin side effects

Answer 37

abnormal cardiac rhythms, GI effects, visua effects, gynaecomastomia, CNS effects, interacts with diuretics

Question 38

Treatment of AF

Answer 38

ABCDE:
anticoagulants
B-blockers
Ca channel blockers
Digoxin
Electrocardioversion