Shared Flashcard Set

Details

Antiarrhythmics
IUSM
14
Pharmacology
Professional
01/20/2015

Additional Pharmacology Flashcards

 


 

Cards

Term
quinidine
Definition
Class: anti-arrhythmic, Class IA

Mechanism: block Fast Na+ channels, increase AP duration and effective refractory period (blocks K+ channels), anticholinergic effects (increase AV conduction speed); intermediate dissocation rate from channels

Indication: terminate re-entrant arrhythmia, prevent supra-ventricular and ventricular tachyarrhythmias; best at moderately high HR; combine with B-block or CCB for atrial fib/flutter (to counter anticholinergic effects on AV node)

Adverse effects: N, V, D, depress cardiac contractility, hypotension (alpha blockade), thrombocytopenia, allergic rxn, cinchonism, SYNCOPE (PROLONGS QT, tachycardia, decrease CO)

Drug interaction: DOUBLES DIGOXIN PLASMA LEVEL
Term
procainamide
Definition
Class: anti-arrhythmic, Class IA

Mechanism: block Fast Na+ channels, increase AP duration and effective refractory period (blocks K+ channels), anticholinergic effects (increase AV conduction speed); intermediate dissocation rate from channels

Indication: terminate re-entrant arrhythmia, prevent supra-ventricular and ventricular tachyarrhythmias; best at moderately high HR; combine with B-block or CCB for atrial fib/flutter (to counter anticholinergic effects on AV node)

Adverse effects: N, V, allergic rxn, LUPUS-LIKE AUTOIMMUNE syndrome, proarrhythmia TORSADE DEPOINTES (caused by metabolite NAPA which blocks K+ channels)
Term
lidocaine
Definition
Class: anti-arrhythmic, Class IB

Mechanism: block Fast Na+ channels, IV ONLY; rapidly dissociate from channels

Indication: short-term management of life-threatening ventricular arrhythmia; best at high HR

Adverse effects: drowsiness, tremors, convulsions
Term
flecainide
Definition
Class: anti-arrhythmic, Class IC

Mechanism: block Fast Na+ channels, blocks K+ current involved in repolarization, prolongs AP duration in ventricles; very slowly dissociate from channels

Indication: treatment of life-threatening ventricular arrhythmias and atrial fibrillation; effective at normal and low HRs

Contraindications: PATIENTS WITH PREVIOUS MI --> INCREASED MORTALITY
Term
proranolol (antiarrhythmic)
Definition
Class: anti-arrhythmic, Class II

Mechanism: NONSELECTIVE block Beta-R; decrease rate of Phase 4 depolarization in automatic cells (dec. HR and ectopic automaticity), slow AV conduction (enhance AV blocks), reduce myocardial contractility and oxygen demand; (dec. cAMP --> less phosphorylation of Ca++ channels --> decreased Ca++ influx)

Indication: supraventricular tachycardias, atrial and ventricular arrhythmias, prevents SCD in post-MI pts
Term
esmolol (antiarrhythmic)
Definition
Class: anti-arrhythmic, Class II

Mechanism: beta1 SELECTIVE block Beta-R; decrease rate of Phase 4 depolarization in automatic cells (dec. HR and ectopic automaticity), slow AV conduction (enhance AV blocks), reduce myocardial contractility and oxygen demand; (dec. cAMP --> less phosphorylation of Ca++ channels --> decreased Ca++ influx)

Indication: rapid control of ventricular rate in atrial fib/flutter in emergent circumstances where short-term control of ventricular is desirable
Term
amiodarone
Definition
Class: anti-arrhythmic, Class III

Mechanism: block K+ channels and prolong repolarization, prolongs AP duration and refractory period; also blocks Ca++ ch. and Na+ ch.; some non-competitive alpha and beta block;

Indication: supraventricular and ventricular tachycardia, maintenance of sinus rhythm in afib pts

Adverse effects: long term --> fatal PULMONARY FIBROSIS w/ high dose, photosensitivity, corneal deposits, hypo/hyperthyroidism; PROLONG QT
Term
diltiazem
Definition
Class: anti-arrhythmic, Class IV

Mechanism: block Ca++ channels

Indication: supraventricular tachyarrhtyhmia that use the AV node as reentrant pathway (slows AV conduction and prevent reentry), atrial fibrillation (reduce rate of ventricular response)

Contraindication: CHF

Adverse effects: decreased cardiac contractility, relax arterial SMC (dec arterial pressure and barorceptor response --> increase HR)
Term
digoxin
Definition
Class: anti-arrhythmic, other

Mechanism: inhibit Na+/K+ ATPase, vagal stimulation; changes Ca++ handling; INCREASE ARRHYTYHMOGENICITY OF HEART MUSCLE, INTERFERE WITH CA++ HANDLING --> DELAYED AFTER DEPOLARIZATIONS
Term
adenosine
Definition
Class: anti-arrhythmic, other

Mechanism: binds ligand-gated K+ channel, hyperpolarization of AV nodal cells, decreases AV node excitability, decreases AV node condution, interrupts AV reentry tachycardia

Indication: IV ONLY; 1st choice drug for termination of supra-ventricular tachycardia involving AV node in re-entry pathway; reduction of ventricular response during atrial flutter/fibrillation

Adverse effects: flushing, dyspnea, transient bradycardia, AV block
Term
sotalol
Definition
Class III antiarrhythmic
supraventricular and ventricular tachyarrhytmias
Term
ibutilide
Definition
class III antiarrhythmic
acute termination of atrial flutter and fibrillation
Term
dofetilide
Definition
class III antiarrhythmic
maintenance of sinus rhythm after conversion of atrial flutter and fibrillation
Term
dronedarone
Definition
Class III antiarrhythmic
treatment of atrial fibrillation/flutter
Supporting users have an ad free experience!