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Pharmacology Test II Antidysrhythmics
Pharmacology Test II Antidysrhythmics
37
Medical
Graduate
08/22/2015

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Term
[image]Which class of antidysrythmics and what ion is affected?
Definition
[image]
Term
describe class I antiarrythmics
Definition
Class I are Na blockade
1a: prolong repolarization
1b: shorten repolarization
1c: repolarization unchanged
Term
dilantin is what type of antiarrythmic
Definition
class 1b which shortens repolarization
Term
lidocaine is what class of antiarrythmic
Definition
class 1b which shortens repolarization
Term
procainamide is what class of antiarrythmic
Definition
class 1a which prolongs repolarization
Term
which antiarrythmic is a class Ic
Definition
fecainide
Term
which antiarrythmic class is a beta adrenoreceptor antagonist
Definition
class II
Term
1/2 life of adenosine
Definition
12 seconds
Term
adenosine has such a short half life because it is metabolized by
Definition
vascular endothelial cells
Term
adenosine effects can be blocked by
Definition
caffeine
Term
a person on digatlis is having arrythmias you can help treat these by giving
Definition
magnesium (remember digatalis results in increased Ca, so increase Ca can cause arrythmias)
Term
will hypo or hyper kalemia result in digoxin toxicity
Definition
hypokalemia
Term
describe the effects of digitalis on the myocytes and conduction system of the heart in relation to ECG
Definition
1. hyperpolarization 2. prolonged PR interval 3. T wave flattening or inversion 4. Reduced AV conduction
Term
greatest dilatory CCB is
Definition
nicardipine
Term
what is the side effect of verapamil
Definition
major depression of AV node and negative chornotorpy on SA node more than diltazepam
Term
verapamil and dilatizepam are in what CCB classes
Definition
1. Verapamil is a phenylalkylamine
2. diltazepam is a benzothiazepine
Term
class I anti arrythmics are used to treat what three conditions
Definition
1. acute and chrnoic SVT
2. slow atrial rate in AFIB
3. suppress tachydysryhtmis associated iwth WPW
Term
Class II cardiac antidysrhythmics work by
Definition
1. depressing automaticity at nodal tissue
2. decreasing conduction speed of cardiac impulses
Term
digoxin induced cardiac dysrhthmias are best treated wtih what five drugs
Definition
1. lidocaine
2. procainamide
3. dilantin
4. propanolol
5. DC countershock
Term
what drug has shown to be very effective in treating dysrhtymias associated with digoxin toxicity
Definition
dilantin
Term
what antidysrthimc class may also have local anesthetic activity
Definition
Class I anti dysrhtymics
Term
what four drugs should be avoided with a patient on digoxin
Definition
1. sux (increase PNS)
2. Quinidine - increases levels of digoxin
3. Beta agonist (like epi, levo - can cause increase risk of cardiac dysrhtms.)
4. Calcium Cl or Calcium Carrbonate since they may preciptiate arrthym
Term
what is the risk with giving dilantin to a hyperglycemic patient
Definition
dilantin paritally inhibits insulin release and therefore makes hyperglycemia worse.
Term
what cardiac anti-arrhtymias should you consider for a mitral valve prolapse that causes dysrhtymias
Definition
1. esmolol
2. amiodarone
3. lidocaine
Term
3x main effects of digitalis
Definition
1. increase inotoropy
2. decrease heart rate
3. slows propagation through AV node
Term
what phase of the cardiac cycle does digitalis effect
Definition
phase 4. by decreasing automaticity and lowers heart rate. Automaticity is reflected in the slope of phase 4.
Term
signs of digitalis toxicity
Definition
1. atrial or Ventricular dysrhtymias
2. Prolong PR
3. GI disturbances
Term
what three electrolyte disturbances enhance digitalis toxicity
Definition
1. hypokalemia
2. hypercalcemia
3. hypomagnesemia

If those are present than big risk for digitalis toxicity.
Term
how does hypokalemia enhance digitalis toxicity
Definition
hypokalemia allows incrased binidng of digitalis to the Na-K ATPase pump in cardiac cells, resulting ina n excessive drug effect.
Term
why should hyperventilation be avoided during anesthesia for a patient who is taking digitalis
Definition
hyperventilation may cause hypokalemia, and hypokalemia increases likilihood for digitalis toxicity.
Term
plasma concentrations of potassium decreases how much for how much change in PaCO2
Definition
decrease K 0.5 mEq/L for every 10 mmHg decrease in paCO2
Term
what two CCB are good for treating coronary artery vasospasm
Definition
1. nifedipine
2. diltiezpam
Term
How do CCB affect drugs we use in anesthesia
Definition
potentiates the actions of nondepolarizers
Term
verapamil is contraindicated in what six patient groups
Definition
1. WPW
2. Sick sinus syndrome
3. AV block
4. HF
5. Pts on beta blockers (synergistic)
6. pts on digitalis.
Term
why is verapamil a poor choice when treating patients with WPW
Definition
verapamil may increase conduction velocity in the accessory tract and increase heart rate excessively
Term
which is better for peirpheral vasodilatition verapimil or diltizaem
Definition
verapimil.
Term
describe five cardiovascular effects of histamine
Definition
1. relaxes smooth muscles of arterioles and small blood vessels
2. increase capillary permeability causing edema
3. increases contracility of heart
4. increase HR
5. acts on the adrenal medulla to stimulate release epi and norepi. '
6. vasoconstricts bronchial smooth muscle
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