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Anti Arrhythmic Drugs
Cardio Module
62
Medical
Graduate
08/27/2009

Additional Medical Flashcards

 


 

Cards

Term
What are the drugs in the class IA group?
Definition

quinadine

procainamide

disopyramide

Term
What is the general mechanism of class I anti-arrhythmics?
Definition
they block the Na activation/inactivation channel therfore reducing condution velocity and reducing the phase 0
Term
Which class I subclass also has activty against the Kr and Ks channels?
Definition
1A
Term
What are the major side effects of quinidine? (3)
Definition

Long QT-->Torsade de Pointes-->Quinidine Syncope

Increased level of digoxin b/c it displaces it

Cinchonism

 

Term
What drug will decrease the metabloism of quinidine and cause increased serum levels?
Definition
cimetidine
Term
What are the signs/symptoms of cinchonism?
Definition

flushed skin

ringing in the ears

blurred vision

Term
Which arrhythmias in general are the IA and IB drugs used for?
Definition
atrial and ventricular arrythmias
Term
What arrhthmias are the class 1C drugs used for?
Definition
ventricular arrhythmias
Term
What is the common class IB drug?
Definition
lidocaine
Term
What is true of lidocaines half life?
Definition
short
Term
What is the drug in class 1C that was presented?
Definition
flecainide
Term
What is Procainamide converted to in the body?
Definition
NAPA
Term
What disease symptoms can one present with procainamide treatment?
Definition
LUPUS
Term
What are the adverse effects of procainamide? (2)
Definition
lupus symptoms, agranulocytosis
Term
What medication can be responsible for lupus like symptoms?
Definition
procainamide
Term
What is the use of Procainamide?
Definition
ventricular and atrial arrhythmias
Term
What are two side effects with disopyramide?
Definition

strong negative inotrope --> CHF

anticholenergic systemically (constipation, urine retention, etc.)

Term
What medication can lead  to a strong negative inotrope --> CHF?
Definition
disopyramide
Term
What is the relative dissociation length of times for class IB and IC?
Definition

IB- fast

IC- slow

Term
What does class IB do to the conduction cells in addition to blocking the fast Na channels when it acts?  What does this result in?
Definition

also blocks the slow Na channels responsible for phase II.

 

results in an increased refractory period

Term
What type of tissue does lidocaine prevent reentry in?
Definition
ischemic tissue
Term
What is the main adverse effect in the use of lidocaine?
Definition
CNS effects in the elderly
Term
What drug causes CNS effects especially in the elderly?
Definition
Lidocaine
Term
What are the side effects of flecainide? (2)
Definition

negative inotropic

sudden death

Term
What is the mechanism of flecainide?
Definition
blocks fast Na channels to decrease conduction velocity
Term
What is true about the gates that flecainide effect?
Definition
both inactive and active Na gates
Term
What cardiac tissue does flecainide effect?
Definition
all cardiac tissue
Term
What is the mechanism of class II antiarrhythmics?
Definition
block B1 adernergic receptor
Term
What do class II antiarrhythmics end in?
Definition
olol
Term
What does blocking the B1 adernergic receptor do to the cell?
Definition
decrease I(funny) and I(Ca)
Term
Which cardiac anti-arrhythmic drugs are AV blockers? (4)
Definition

Calcium channel blockers

Beta blockers

Adenosine

Digoxin

Term
What conditions are Beta blockers good for? (6)
Definition

afib

aflutter

AVNRT

APB

PVC

ischemic V. tach

 

Term
What are the adverse effects of Beta blockers? (5)
Definition

bronchospasm

heart block

CNS hallucinations nightmares depression impotence

 

lose of sensitivity to hypoglycemia

Term
Which drug can cause impotence?
Definition
beta blockers
Term
Which drug makes a diabetic less sensitive to changes in blood sugar levels?
Definition
beta blockers
Term
What is the mechanism of action of the class III antiarrhythmic drugs?
Definition
block Kr and Ks channels
Term
What are the 4 drugs in class III?
Definition

amiodarone

sobatol

ibutilide

dofetilide

 

Term
Which two class III drugs are great for getting a patient out of A.fib or A.flutter?
Definition
ibutimide or dofetilide
Term
What are the two class IV antiarrhythmics?
Definition

verapamil

diltiazem

Term
What is the half life of Amiodarone?
Definition
25-60 days
Term
What are the side effects of amiodarone? (6)
Definition

blue skin

hepatotoxicity

long QT--> Torsades de pointe

Pulmonary fibrosus

hyper/hypothyroid

corenal deposits

Term
What three tests must you perform regularly to monitor a patient on amiodarone for its toxic effects?
Definition

EKG

liver function

hypo/hyper thyroid

Term
What two classes does sotalol fit under?
Definition

class III (Kr,Ks blocker)

Beta blocker

Term
What is the general adverse effect of sotalol, Ibutilide, and Dofetilide?
Definition
long QT
Term
What is the mechanism of action of the class four anti-arrhythmics?
Definition
block Ca L-type channels
Term
What type of arrhythmias are verapamil/diltiazem used for?
Definition

a fib/flutter

AVNRT

Term
What are three adverse effects of class IV antiarryhthmics?
Definition

negative inotropy

AV block

hypotension

Term
What channels do acetylcholine open at pharmalogical doses?
Definition
K(ach)
Term
What does acetylcholine do to the cell?
Definition
opens the K ach channel causing a hyperpolarized state in the SA node
Term
What type of cardiac drug is digoxin?
Definition
cardiac glycoside
Term
What drug blocks the Na/K pump in the cardiac cell?
Definition
Digoxin
Term
What will digoxin do to a muscle cell?
Definition
increase contractility
Term
What is the mechanism of action for atropine?
Definition
blocks the K(ach) channel so they are partially depolarized in SA node
Term
Where will atropine work and why?
Definition
SA node b/c works on K (ach)
Term
What is true of the half life of atropine?
Definition
short (10 seconds)
Term
Why is adenosine not that useful in treating A fib and flutter however is useful in diagnosising it?
Definition
becuase of its short half life
Term

What substaince can cause adenosine not to work as well?

 

What drug will do the same?

Definition

caffine

 

theophylline

Term
What is the mechanism of action of adenosine?
Definition
Increases outward K (ach) channel, decreases inward Calcium and funny current
Term
What arrhythmia is adenosine useful in?
Definition
AVNRT
Term
In the presence of theophylline, what must you do the dose of adenosine and why?
Definition
you must increase the does because theophylline competes for the same receptor
Term
What are four side effects of adenosine?
Definition

chest pain

AV block

flushing

bronchoconstriction

Term
What is unique about Ibutilide being the the Class III classification?
Definition

it does not block the Kr and Ks

 

instead it enhances sodium slow inward current

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