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Details

Cardio
Antiarrthymic Drugs
12
Medical
Graduate
01/22/2011

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Cards

Term
Procainaminde,
Definition
Class 1A, Na channel blocker,
Uses: life-threatening ventricular arrhythmias, i.e. sustained VT. Not a first-line med
Major side effect: agranulosytosis and lupus like syndrome,
Metabolized to NAPA, which is a Class 3 agent, K channel blocker,
NAPA lengthens the QT segment, predisposes to Torsades. Fast acetylators accumulate NAPA, slow acetylators accumulate procainamide
Term
Lidocaine,
Definition
Class 1B, weak Na channel blocker,
Uses: Ventricular arrhythmias only. Excellent drug for VT/VF that is due to ischemia—has NO effect on SA or AV node arrhythmias. On crash cart, used for life-threatening ventricular arrhythmias, such as those occurring post-MI.
Neurological side effects, also GI
Term
Propafenone
Definition
Class 1C, strong Na channel blocker.
Useful for A. Fib and some supraventricular arrhythmias
Contraindicated in patients with structural heart disease.
Term
Amiodarone
Definition
Class 3— Classified as Class 3, but also has Na channel blocker, K channel blocker beta blocker and calcium channel blocker.
Uses: the most effective drug for both atrial and ventricular arrhythmias in patients with abnormal hearts (hearts with structural disease), particularly those with heart failure. Used in patients with defibrillators, patients with ventricular arrhythmias. Not usually used for patients with AV nodal reentry arrhythmias because other, less toxic agents are available
4 major toxicities: liver (monitor with liver function tests); eyes—optic neuritis; lungs—pulmonary fibrosis (symptoms: cough, SOB); thyroid (hypo or hyper—can ppt thyroid storm)
Term
Sotalol
Definition
Class 3, renally excreted drug, (good for patients with compromised liver function) also has beta blocker properties
Uses: approved for atrial and ventricular arrhythmias, AF, AT, SVT, VT, VF
Side effect: prolongs QT interval, predispose to Torsades
Term
Ibutelide (iv form of sotalol)
Definition
Used IV for chemical cardioversion, of A. Tach and A. Fib. short half-life



Used IV for chemical cardioversion, of A. Tach and A. Fib. short half-life
Term
Beta BlockersClass 2.
Use: SV arrhythmias (i.e. AV node reentrant)
Definition
Class 2.
Use: SV arrhythmias (i.e. AV node reentrant)
Term
Verapamil and Diltiazem
Definition
Class 4 agents
Use: SV arrhythmias, such as AV node reentrant arrhythmias, but are generally used only if beta blockers are not well tolerated
Term
Adenosine
Definition
selectively blocks the AV node.
Use: SVTs that are AV node-dependent, i.e. AV node reentrant arrhythmias. Not effective for other atrial or ventricular arrhythmias
15 sec half-life, given IV,
Side effects: flushing, SOB, discomfort for the patient, very short lasting because the drug is so rapidly metabolized. Can also depress the SA node, problematic if the patient goes into VF
Term
Digoxin—
Definition
positive inotrope used in heart failure,
Use: adjunct for AV arrhythmias if beta blockers or calcium channel blockers don’t work
Side Effects_ narrow therapeutic index, can be proarrhythmic in overdose
Term
Difference btwn a reversible and fixed Thalium Test
Definition
A reversible thalium defect implies ischemia, where as a fixed, if this were to remain, it would mean infarct. Thalium defects either mean infarct or ischemia.
Term
What are the common causes of cyanotic congenital heart disease?
Definition
Caues of cyanotic congential Heart Disease:
1) TGA; 2) Truncus arteriosus; 3) Tetralogy of Fallot
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