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Exam 3
Lecture 8
79
Art History
8th Grade
05/04/2013

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Term
which phase is rapid repolarization
what happens during this-3
Definition
phase 1
Na channels close
K leaks
Ca starts to oepn
Term
what phase is the plateua?
what causes this?
Definition
phase 2
balance of Ca channels and K leakage
Term
which phase is reploarization?
what happen here?-2
Definition
3
Ca close
K leaks through delayed rectifier
Term
which phase is the resting phase?
what occurs here?
Definition
4
diastole
Term
which cells have a constant leakage of Na?
Definition
SA
Term
which has a shorter refractory period- ventricles or atria
Definition
atria
Term
beta blockers primarily act by doing what
Definition
decreasing slop of phase 4
Term
Na and Ca channel blockers primarily act by doing what-
Definition
increasing threshold potential
Term
K channel blockers primarily act by doing what
Definition
prolonging action potential
Term
all antiarrythmic drugs work to reduce what?
Definition
number of action potentials
Term
classes of antiarrhythmics-
1
2
3
4
Definition
Na blockers
B-blockers
K blockers
Ca blockers
Term
effects of Na blockers- 2
Definition
reduce slope of phase 0
increase threshold potential
Term
effects of B-blockers-3
Definition
blocks sympathetic activity which reduces slope of phase 4
reduces rate and conduction
Term
effects of K blockers
Definition
delays reploarization (phase 3) which increases action potential and ERP
Term
effects of Ca channel blockers
what phase do they work on
Definition
elevates threshold potential
decreases rate and conduction
-zero
Term
where do Ca blockers work best in?
Definition
SA and AV nodes
Term
which antiarrythmic drug is used for torsades de pointes
Definition
Mg
Term
which class is proarrythmic-
which of these causes torsades de pointes?
which does CAST?
Definition
Class 1-
Ia
Ic
Term
which drug classes have - inotropic
Definition
I and IV
Term
which drug class has all of its drugs that can cause torsades de pointes
Definition
Class III
Term
which classes cause braycardia
Definition
class II and III
Term
which classes cause heart block
Definition
I, II, IV
Term
which class depression left ventriclar function
why?
Definition
II
aderenergic effect
Term
which class is proarrythmic-
which of these causes torsades de pointes?
which does CAST?
Definition
Class 1-
Ia
Ic
Term
which drug classes have - inotropic
Definition
I and IV
Term
which drug class has all of its drugs that can cause torsades de pointes
Definition
Class III
Term
which classes cause braycardia
Definition
class II and III
Term
which classes cause heart block
Definition
I, II, IV
Term
which class depression left ventriclar function
why?
Definition
II
aderenergic effect
Term
class 1 agents do not bind to what channels?
Definition
resting Na channels
Term
which subtype of CLass I is the most potent, which is the least?
which has the fastest recovery, the slowest?
Definition
Ic, Ib
Ib, Ic
Term
Ib has minimal effect on what tissues?
so what are they used on?
Definition
atrial
ventricular arrhythmias
Term
which subtype of I has most potency on Phase 0, which has weakest?
Definition
C
b
Term
which subtype of CLass I has additional effects that includes prolonging repolarizaiton (phase 3)?
which shortens it?
Definition
a
b
Term
which subtype of Class I has additional effects that includes increasing action potential (ERP)? which shortens it?
Definition
Class Ia
class Ib
Term
which subtype of CLass I ahs no effect on replorization or ERP
Definition
Ic
Term
what is the drug of class Ia?
Definition
disopyramide
Term
procainamide is part of what drug class?
Definition
Ia
Term
quinide is part of what drug class?
Definition
Ia
Term
what are the Ic drugs?
Definition
propafenone
flecainide
Term
what are the class Ib drugs
Definition
lidocaine
mediletine
Term
besides Na channels, what other effects does fleicanide have-2
Definition
blocks K
blocks Ca
Term
which drug can really slow down conduction in the His-perkinjie?
how?
what else does this inhibit?
Definition
flecianide
Na blockade
abnormal automaticity
Term
flecainide delays action potentials more at what type of heart rates?
what tohers does it work on?
Definition
faster
normal heart rates
Term
what can flecainide prolong?
Definition
QRS,
some QT
Term
caution use of flecanide in what type of impairment?
Definition
renal and hepatic
Term
felcainide is metabolized by
Definition
2D6
Term
ADEs of flecainide-3
Definition
heachade, blurred vision, worsen HF
Term
caution use of flecainide in-2
Definition
HF, electrolyte imbalance
Term
flecainide is contraindicated in-3
Definition
2nd/3rd degree heart block
CAD
cardio shock
Term
what other effects does propafenone have
Definition
K blockers
b-blocker
Term
which class Ic drug is best at maintaining sinus rhythm (supraventiruclar arrhythmias)?
what does it have modest effiacy in?
Definition
propafenone
ventricular arrythmias
Term
what does propafenone prolong
Definition
PR, QRR
Term
what is propafenone metabolized by?
Definition
2D6
Term
caution use of propafenone in what impairment
Definition
hepatic
Term
caution use of propafenone in-2
Definition
HF
hepatic failure
Term
what ADEs does propafenone have? -3
Definition
worsen HF
ventricle arrythmias
bronchospams
Term
contraindications for propafenone- 4
Definition
bradycardia
sevre hypotension
SA,AV, and ventricular disorders
-cardio shock
Term
disopyramide blocks what channels besides Na?
what are the 3 effects of the drugs and what channel does it?
Definition
Ca
K;
prolong action potential-k
increase threshold- Na
decreased automaticity- Na
Term
blocking of Na channel leads to what-2
Definition
increased threshold potential
decreased automaticity
Term
what CLass 1 drug also has an anticholinergic effect?
what is it?
Definition
dysopyriamide
vagal inihbition
Term
caution use of dysopyramide in what impairment
Definition
renal
heaptic
Term
dispyramide is metabolized by?
Definition
3A4
Term
ADEs of disopyramide
Definition
dry mouth
constipation
glaucoma
hypoglycemia
Term
disopyramide is contraindicated in-
Definition
heart block
congenital QT prolong
Term
the Ib classes have more effects on what tissue? -2
why?
Definition
ischemic/depolarized and fast
bc fast Na recovery
Term
what are the effects of Class Ib-2
Definition
increase threshold potential
reduce slope of pohase 4
Term
which drug doesnt have effect on QRS or PR intervals and may actually shorten QT?
Definition
lidocaine
Term
what is lidocaine metabolized by?
Definition
3A4
Term
which drug crosses the placenta and BBB
Definition
lidocaine
Term
caution use of lidocaine in what impairemnt
Definition
hepatic
Term
ADEs of lidocaine-3
Definition
dysathria (speech disroder)
nystgimus
seizures
Term
what is an early sign of lidocaine toxciity
Definition
nystagmus
Term
which class Ib drug is used for chronic therapy?
why?
Definition
mexiletine
bc oral formulation
Term
why dont you ahve to watch for mexilitine as much in heaptic impairment
Definition
bc less first pass metab
Term
mexilitine is metabolized by
Definition
2D6
Term
what drug should be taken with food to decrease ADEs?
what else cna it be taken with
Definition
mexilitine
antacids
Term
ADEs of mexiletine-3
Definition
tremor
GI
lightheaded
Term
contraindicaitons for mexiletine-2
Definition
2nd/3rd heart blocks
cardio shock
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