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Anti-arrhythmetics
Exam 1-walters
144
Pharmacology
Graduate
09/12/2011

Additional Pharmacology Flashcards

 


 

Cards

Term

Which ion mediates phase 0 of the purkinje cells?

Phase 1

Phase 2

Phase 3

Phase 4

Definition

[image]

Phase 0: Na+ in

Phase 1: K+ out

Phase 2: Ca++ in

Phase 3: K+ out (Ca in)

Phase 4: Na and Ca in, K goes out

Term
What does Class I do as a whole?
Definition

Blocks Fast Na+ channels

Local anesthetic effects

Binds open or inactive state

Term
What is dose dependent and which class is this referring to?
Definition
Dose dependence: if HR increases, Class I can bind easily since more Na channels are in the open or inactivated state (which it binds best to).
Term
How does class I affect Vmax and what does this in turn do to slope of phase 0 in AP of the PK cell?
Definition

Decreases Vmax of depolarization

Decrease the slope of phase 0 of PK AP

Term
What does Class 1a bind to and how does it dissociate?
Definition
Binds to open channels and dissociates slowly
Term
What is the effect of Class 1a on PK and PM cell APs?
Definition

PK cells: Decreases slope of phase 3 (blocking K channels too). This prolongs repolarization


PM cells: Decreases slope phase 4, so threshold for depolarization also increases

[image]

Term
What are the Class 1a drugs?
Definition

Quinidine

Procainamide

Disopyramide

 

(Pretty Darn Quick)

or

(Quit procrastinating in climing the pyramid)

Term
What is Quinidine used for?
Definition
Supraventricular and ventricular arrhythmias
Term
Is it bad to use high doses of quinidine? If so, why?
Definition
YES- can cause fatal arrhythmias, including Torsades de Pointes- prolonged QT interval
Term
What can increase the risk of Torsades de Pointes?
Definition
Hyper or Hypokalemia
Term
What is Chinconism and which drug can cause this?
Definition

Quinidine can cause this

 

blurred vision, tinnitus, HA, disorientation and psychosis (antimuscarinic activity)

 

All these Sx occur after getting wasted at a loud concert (except psychosis maybe..)

 

Term
What is a SE of quinidine that is not cardiac related? What is the worry with this SE?
Definition

Diarrhea

 

Worry is that by having so much diarrhea, you are crapping out all your K and can have hypokalemia and this may induce Torsades de Pointes.

Term
How is procainamide administered?
Definition
IV- 
Term
What is procainamide used for?
Definition
An alternative to quinidine for various ventricular and Supraventricular arrhythmias.
Term
Explain the metabolism of Procainamide and why fast vs slow acetylation is so important.
Definition
Procainamide-> NAPA (class III K+ blocker)-> enhances procainamide's effect on phase 3 repolarization (prolonging it further).
Term
Explain what happens if a patient has renal failure and is taking procainamide. How can you correct this?
Definition

With renal failure, NAPA can accumulate and increase risk of Torsades de Pointes.

 

Give lower dose of Procainamide then

Term
If someone comes into the ER and needs rapid IV administration of Procainamide, what is wrong with this?
Definition
Rapid IV administration can cause hypotension from ganglionic block
Term
What are the SE of procainamide?
Definition

Depression

Hallucination

Psychoses 

Arrhythmias

(PHAD- Procainamide was a "phad" until ppl realized that the crazy SE)

Term
What is disopyramide used for?
Definition
Ventricular and supraventricular arrhtymias
Term
What are the SE of Disopyramide drug?
Definition

Anti-muscarinic activity:

Constipation

Urinary retention

Blurred vision

dry mouth

(Poop, pee, see, salivate)

Term
What does disopyramide do the contractility? What should you be careful about?
Definition
It decreases myocardial cotractility despite having anti-muscarinic activity. This can lead to Heart Failure so beware if pt has pre-existing LV dysfunction.
Term
What is a condition with the eye that patients taking disopyramide should beware of?
Definition

Glaucoma

It narrows the __?__ angle and increases the pressure.

 

(I don't know name..)

Term
A diabetic pt comes into hospital also taking Disopyramide, what is your worry?
Definition
Diabetics taking oral hypoglycemics should beware if on disopyramide bc can decrease blood glucose more because it increases insulin release (blocks sam Katp channels)
Term
What are the main things to worry about if taking Dispyramide (summary)?
Definition

Anti-muscarinic activity (poop, pee, see, salivate)

Heart failure

Glaucoma

Diabetes (hypoglycemia)

 

 

Term
What do class 1b bind to and how do they recover?
Definition

open and inactivated, but prefer inactivated.

Recover rapidly

Term
How are PK cells and PM cells affected in class 1b drugs?
Definition

PK cells: increases slope phase 3, thereby decreasing AP time and decreasing repolarization time

 

PM cells: Same as Class 1a

Decreases phase 4 slope and increases threshold

Term
What is lidocaine used for?
Definition

Ventricular arrhtymias

Also has local anesthetic effect

Term
Why is lidocaine not used for atrial arrhythmias?
Definition

Atrial APs are too short and channels aren't open long enough for lidocaine to penetrate

 

Atrial arrhythmias are usually not in ischemic tissues, which would be partly depolarized (more time spent in inactivated state)- ischemic tissue is ventricles and non-ischemic tissue is atrial

Term
How should lidocaine be administered?
Definition

Slow IV because of extensive 1st pass metabolism.

 

Fast IV causes arrhythmias or seizure**

Term
What are the SE of lidocaine?
Definition

nystagmus

tremors

slurred speech

dysarthria

altered consciousness

Term

What is mexiletine used for?

 

How is it administered?

Definition

Ventricular arrhythmias

 

Orally.

Term
What is phenytoin used for?
Definition

ventricular and digoxin-induced arrhythmias

 

seizures

Term
What channels does phenytoin block?
Definition
Blocks Na+ and some Ca++ influx.
Term
What are the SE of phenytoin?
Definition

Gingival hyperplasia

Enzyme induction- drug interactions

Hirsutism- give eflornithine (inhibits ornithine decarboxylase involved in hair growth)

Term
What does class 1c bind to and how it its recovery?
Definition

Open channels

 

Recover is very slow

Term

What are some effects of class 1c having slow recovery?

 

What is this drug generally used for?

Definition

Makes these Rx more dangerous. Class 1c are associated with excessive mortality or non-fatal cardiac arrest. 

 

Used for life threatening situations

Term
How does Class 1c affect PM and PK cells?
Definition

PK cells: decreases slope of phase 0, increasing time for depolarization

 

PM cells: Same as for Class 1a/1b: decr slope phase 4 and incr threshold

Term
What are the Class 1c drugs?
Definition

Flecainide

Propafenone

 

(Probably Free ;p)

Term
What are the class 1b drugs?
Definition

Lidocaine

Mexiletine

Phenytoin 

(Please Lick Me!)

Term

What is flecainide used for?

 

How administered?

Definition

Paroxysmal A-fib

Paroxysmal SVT

AV reentrant tachy

other SVTs

 

Oral

Term
What does Flecainide block?
Definition

Na+ channels

Ryanodine Ca channels in SR and prevents arrhthmogenic Ca rel from SR.

 

Useful if genetic defect in Ryanodine Ca channels whcih causes CA polymorphic ventr tachy

Term
What does propafenone block?
Definition

Na channels

Produces significant Beta block (Class II activity)

Term
What is propafenone used for and how is it administered?
Definition

A-fib

A-flutter

paroxysmal SVT

other ventricular arrhythmias

 

Oral

Term
How is propafenone metabolized?
Definition

CYP2D6

 

This is absent in 7% pts, so can exaggerate effects and toxicity (mostly GI) if pt doesn't have this

Term
What is Class II?
Definition
Beta blocker
Term
What are the effects of NE on heart?
Definition

1) incr cAMP->activate PKA->phosph a1 subunit of Ca channels->incr Ca++ influx->incr myocardial contractility

 

2)Phosph Troponin-> incr sensitivity of contractile prots to Ca

 

3)Facilitates Ca capture by ryanodine-R on SR-> incr Ca available for release

 

4)Incr Ca entry increases automaticity-> delayed after-depolarizations. Via the Na/Ca exchanger, one Ca moves out for every 3 Na moving in->net influx of 1 charge per exhange.

*Beta blockers inhibit all this*

 

 

 

Term
Beta blocker blocks which receptor that causes the therapeutic effects of antiarrhythmetics?
Definition

B1- receptor that's on the heart 

 

B2- on vasculature and bronchioles and no effect arrhythmias

Term
How does Class II affect PK cells and PM cells?
Definition

PK cells: NO EFFECT


PM cells: Phase 4 slope is decreased, so it takes longer to reach threshold (but threshold doesn't change)

Phase 3 slope is decreased, prolonging repolarization

-AP is wider

[image]

Term
WHat is the main goal of beta blockers?
Definition
Decrease 02 demand on th heart by preventing the effects of endogenous CAs.
Term

What are the non-selective beta blockers?

 

Which are the B1 selective beta blockers?

Definition

Acebutalol

 

Propranolol (non selective) 

 

Esmolol

(APE- ooh ooh ahh ahh)

 

Term
What is propranolol used for?
Definition

It blocks b1 and b2.

 

Supraventricular arrhythmias

 ventricular arrhythmias indcued by CAs

digoxin-induced arrhtymias

Term
What does B1 block do?
Definition

Decreases HR and contractility

This decreases CO and leads to reflex vasoconstriction to maintain BP

Term
What is an undesirable effect of propranolol
Definition
Since it's non-selective, it also blocks B2 and leads to bronchoconstriction and causes resp crisis
Term
What is acebutaolol used for?
Definition
Premature ventricular contractions
Term
Which Beta blocker has intrinsic sympathomimetic activity?
Definition

Acebutalol- limits its use

 

(think Acebutalol is kinda like ASSbutalol and it has ISA which if say fast sounds like an english person saying ASS)

Term
How is esmolol given? WHY?
Definition
IV ONLY bc its rapidly metabolized by plasma esterases
Term
What other beta blockers ares used for arrhythmias but are not FDA approved?
Definition

Metoprolol

Atenolol

Pindolol

 

(MAP)

 

Term
What are Class III?
Definition
K+ channel blockers
Term
What is the effect of blocking K channels?
Definition

Inhibit K outward current and this prolongs the plateau and the AP.

 

This increases the refractory time and decreases risk of reentry, but increases risk of Torsades

Term
How do Class III K blockers affect PK and PM cells?
Definition

PK cells: decreases slope phase 3, prolongs repolarization (similar to class 1a)

 

PM cells: NO EFFECT

Term
What are the Class III drugs?
Definition

Bretylium

Amiodarone

Dronedarone

 

Dofetilide

Sotalol

Ibutilide

(BAD DIS- K)

 

Term
What is the affect of amiodarone?
Definition

Has properties of all 4 classes:

Class I: decr rate firing of pacemaker

Class II: antagonism of beta receptors

Class IV: AV block and bradycardia

Term
Which drug is linked with thyroid hormone?
Definition

Amiodarone

 

It has I and is related to thyroid hormone.

Can cause hyper-hypothyroidism

Term
What is amiodarone's dominant effect?
Definition
Prolongation of the Ap which decreases risk of reentry.
Term
What is Amiodarone's T1/2 and why?
Definition

T1/2=50 days

 

It's lipophilic and accumulates and is slowly eliminated

 

Increases risk of toxicity

Term
What is amiodarone used for?
Definition
Refractory supraventricular and ventri arrhythmias
Term
What is the BBW with Amiodarone?
Definition

Fatal acute pulmonary toxicity

-cough

-dyspnea

-bronchospasms

-infiltrates

-hemoptysis

-alveolar hemorrhage

-resp failure

Term
What are the SE of amiodarone
Definition

hypo/hyperthyroidism

Corneal deposits

Hepatotoxicity

peripheral neuropathies

photodermatitis (blus skin and ears-smurffs)

Term
What does amiodarone inhibit? (enzyme?)
Definition

Cyp3A4

Cyp2C9 

P-glycoprotein

Term
What is dronedarone used for? which drug is it similar to, except for what?
Definition

Used for Afib/Aflutter

Analog of amiodarone but without the I.

Term
Which channels does dronedarone block?
Definition
Properties of all 4 classes
Term
What are the CAUTION and SE of dronedarone
Definition

CAUTION- increases risk of CV events including 2x incr risk of death in pts w/ Afib

 

SE: N,V,D, abdl pain, asthenia (weakness).

Rare, but severe liver injury could require liver transplant

Term
What are the Rx interactions of Dronedarone?
Definition

Cyp3A4 (same as amiodarone)

Cyp2D6

P-glycoprotein (same as amiodarone)

Term
What is Bretylium used for and how is it administered?
Definition
IV for life threatening V-tach, V-fib
Term
What are the effects of bretylium?
Definition

Prolongs AP thru ion channel effects

 

Displaces NE: initially increases NE release and contractility with a transient incr BP and potential ventr arrhythmias. This is followed by decr in BP as NE is depleted

Term
What activity does Sotalol have?
Definition
Class II and II
Term
What activity of sotalol is more apparent in lower doses? at higher doses?
Definition

LOW: Class II- beta block

 

HIGH: effects on AP 

Term
What is sotalol used for?
Definition
Supraventricular and ventr tachyarrhythmias
Term
What is a dangerous cardiac risk with sotalol?
Definition
Torsades de pointes
Term
What is ibutilide and what is its main effect?
Definition

Ikr blocker

 

Actiavtes slow inward Na channels

Term
What is ibutilide used for?
Definition
Afib/Aflutter
Term
What is a cardiac SE of ibutilide?
Definition

Prolongs QT interval

 

monitor carefully

Term
What is dofetilide and what is it used for?
Definition

Pure Ikr blocker (no extracardiac effects)

 

Used to convert Afib/flutter

Term
What should you not give dofetilide with?
Definition

Thiazide Diuretic

 

it will increase dofetilide's level and cause significant prolongation of QT interval

Term
What are Class IV antiarrhythmetics? what do they block?
Definition

Ca channel blockers

 

specifically L-type slow Ca++ channels. 

Term
what state of the channel do the class 4 bind to? what is this helpful in preventing then?
Definition

open channels

 

Thus, are more effective against reentrant SVT

Term
Where do these class IV drugs target best? What part of the heart?
Definition
AV node because slow Ca channels predominate in the AV node causing depolarization??
Term
What is the overall effect of Class IV?
Definition
Slow HR and terminates SVTs by causing partial AV block
Term
What are the effects of Class IV drugs on PK and PM cellS?
Definition

PK cells: NO EFFECT


PM cells: Decreases phase 4, 0 and 3 slope

Prolongs depolarization and repolarization and elongates the AP.

[image]

Term
What are the Class IV drugs?
Definition

Verapamil

Diltiazem

Term
Explain the worry about IV vs Oral administration for verapamil.
Definition

The L racemate is more potent than the D, but L undergoes more 1st pass metabolism.

 

A certain amt given IV prolongs the PR interval more than the same amt given orally so be careful. (bc oral causes 1st pass and metabolism)

Term
What is a major SE (non-cardiac) of verapamil
Definition

CONSTIPATION

more notable with verapamil than other Ca channel blockers bc it has high affinity for GI sm.

 

*Treat this bc if strain to poop (valsalva), can increase o2 consumption of heart and since there is an increase in intrathoracic pressure the volume going back to heart decreases, so could cause an MI

Term

Where does verapamil work?

What about diltiazem?

Definition

More selective for heart

 

Acts on heart and vascular sm

Term
What should you watch for with diltiazem?
Definition

Decreased BP from vasodilitation


Decrease in contractility

Term
Why do the Ca channel blockers not affect Skeletal MM?
Definition
Ca channels affect all ca channels, but skeletal mm gets most of its Ca from the Sarcoplasmic Reticulum, therefore blocking the extracellular Ca channels and decreasing influx of Ca into the skeletal mm cell will not affect its function bc it's getting its Ca from elsewhere.
Term
What are the Miscellaneous antiarrhythmetics?
Definition

Digoxin

Atropine

Aenosine

Magnesium

 

(DAAM- imagine a goat saying Dam..)

Term
What is Digoxin used for?
Definition

Afib

Aflutter

 

Also used for CHF (Rx increases contractility)

Term
What is Digoxin's MOA to prevent arrhythmias?
Definition

its vagomimetic (mimics parasympathetics)

 

a) inhibits stmpathetics

b)vagal stimulation->

incr ACh release->

incr K efflux->

hyperpolarized SAN->

closes Ca++ channels->

Decr Ca influx->

decreased slope 0 in AVN->

and this slows ventricular contraction 

Term

What is Digoxin better at?

Ventricular arrhythmias or Atrial arrhythmias?

Definition

Atrial Arrhthmias=

 

There isn't much parasympathetic activity in ventricles. 

 

BUT by controlling conduction thru the AV node, Digoxin controls the ventricular response to Afib and Aflutter

Term

What can cause increased risk of Digoxin toxicity?

 

What can this toxicity lead to potentially?

Definition

Hypokalemia (low K)

 

Can lead to Torsades de Pointes

Term
How does low K lead to digoxin toxicity?
Definition

In cardiac cells, digoxin binds to phosphorylated form of NA/K ATPase.

 

The problem is that K promotes dephosphorylation of this pump. If there is low K, then dephosphorylation doesn't happen and you get phosphorylaton of the channel.

 

Phosphorylated channel promotes digoxin binding and toxicity.

Term

What should you not mix Digoxin with and why?

 

 

Definition

Diuretic

 

CAuses K+ loss and if low K, will have phosphorylated Na/K pumps and lead to toxicity of digoxin..

Term
How do you treat Digoxin toxicity?
Definition

Digoxin immune Fab (digibind)- an antibody to digoxin that forms a 1:1 complex w/ digoxin and is then rapidly excreted. 

Give IV over 15-30 minutes

 

IV K- this would work bc K causes dephosphorylation of the channel that digoxin binds to. Without this channel, Digoxin has not effects.

Term
How with Ca affect Digoxin toxicity?
Definition

Makes it worse

 

The more Ca you have, the more Na that is brought out of the cell...

 

Actually I don't Know :/

Term

What is the effect of Mg?

 

What if have low Mg?

Definition

It competes with Ca and decreases risk of arrhythmia because basically blocking Ca channels so depolarization doesn't happen like normal.

 

Low Mg causes increased risk for arrhthmia because there will be no competition w/ Ca and so depolarization happens.

 

Term

What is Atropine used for?

 

How is it administered?

 

Why?

Definition

Bradyarrhythmias

IV

 

Atropine is a competitive antagonist of the muscarinic ACh-R, meaning that it blocks the effects of parasympathetics. It makes sense that if it's blocking Parasympathetics, which normally decr HR, it'd lead to an increased HR.

Term
What is Adenosine used for and how is it administered?
Definition
IV for PSVT and reentry.
Term

What is the T1/2 of Adenosine?

 

Why is it good?

Definition

T1/2= 15 seconds!!!!!

 

Easy to control and so decreases risk of significant SE. Yeay!

Term
What is the MOA of adenosine?
Definition

Stimulates P1 purine-R->

activates Ach-sensitive K channels->

K efflux in atria and SA/AV node->

Hyperpolarization->

decreases automaticity and causes a transient AV block

Term

What other channel does Adenosine block?

What is the result?

Definition
Blocks Ca currents and increases the AV node's refractoriness
Term
What are the SE of adenosine
Definition

Transient asystole (lasts less than 5 sec) Scares the shit out of new doctors who have to administer it

 

Facial flushing, chest pain, dyspnea, N, vfib, vtach or bradycardia. Short lived SE bc T1/2 is so short

Term
What does Adenosine interact with?
Definition

Methylxanthine is an antagonizer of adenosine

 

a purine base found in most human body tissues and fluids and in other organisms

 

Methylxanthines affect not only the airways but stimulate heart rate, force of contraction, cardiac arrhythmias at high concentrations. 

Term
Which drugs treat SVT?
Definition

 

Sotalol

Adenosine

Disopyramide

Propranolol

Amiodarone (for refractory)

Procainamide

 

 

 

 

 

 

 

 

Quinidine

Flecainide

(SAD PAP- Quit Fucking)



Term
Which drugs are for V-tach?
Definition

Quinidine

Procainamide

Diopyramide

Lidocaine

Mexilitine

Phenytoin (digoxin induced)

Propafenone

Propranolol (Ca and digoxin induced)

Amiodarone

Bretylium

Sotalol

 

(All the drugs that Tx SVT are here except for Flecainide and Adenosine (Ademir flees). The extra ones are bolded and make

Lick My Butt Pretty Please!

Term
Which drugs are used to treat Afib/Aflutter?
Definition

Flecainide (fib)

Ibutilide

Bretylium (fib-life threatening)

Propafenone

Dronedarone

Dofetilide (converts them)

Digoxin

 

(FIB P-DDD)

Sounds like P-diddy and he "FIB"-ed us with all his name changes)- also Fib for A-fib.. DUH!

Term
What drugs are used to treat reentry?
Definition

Flecainide (AV)

Adenosine

 

(Ademir Flees.. and then reenters)

Term
What drug treats Premature ventricular contractions?
Definition
Acebutalol
Term
Which drug is used for Bradyarrhythmias?
Definition

Atropine

 

Makes sense because Atropine is a blocks ACh-R basically blocking parasympathetics, causing incr in HR.

Term
Which class of anti-arrhythmetics prolongs repolarization in Purkinje cells?
Definition

Class Ia

Class III

 

(Na and K blockers)

Term
Which class of antiarrhythmetics shortens repolarization in Purkinje cells?
Definition

Class 1b

 

(Na blocker- rapid recovery)

Term
Which class of antiarrhythmetics has no effects on Purkinje cells?
Definition

Class II

Class IV

 

(Beta blocker and Ca blockers- affect nodes)

Term
Which Anti-arrhythmetic decreases phase 4 slope of the Pacemaker cells?
Definition
All of them, except for Class III (which has NO EFFECT on PM cells)
Term

Which antiarrhythmetics increase the threshold for firing in Pacemaker cells?

 

Which ones don't affect threshold?

 

Which one has NO EFFECT on Pacemaker cells?

Definition

Class Ia

Class Ib

Class Ic

 

Class II and Class IV

 

Class III 

 

Term
Which antiarrhythmetic affects the slope of all parts of the depolarization graph in the Pacemaker cell?
Definition

Class IV

 

Decr slope of 4, 0, 3

Term
Which antiarrhythmetic class prolongs repolarization in the Pacemaker cells?
Definition

Class II

Class IV

Term
Which antiarrhythmetic Rx can induce Torsades de Pointes?
Definition

Quinidine (in high doses)

Sotalol

Procainamide (if increased NAPA like in renal failure or if pt is a fast acetylator)

Digoxin

Class III- K blockers

Term
Which Antiarrhythmetics can cause psychosis
Definition

Quinidine

Procainamide

Term
Which anti-arrhythmetic can be used to treat CHF?
Definition
Digoxin
Term
Which antiarrythmetic can cause blurred vision?
Definition

Quinidine

Disopyramide

Digoxin

Term
Which antiarrythmetic can cause Hursitism?
Definition

Phenytoin

 

(Penny is a hairy little girl)

Term
Which antiarrythmetics have ISA?
Definition

Acebutalol

amiodarone

 

(ASS-ISA)

Term
Which antiarrythmetic can cause Constipation?
Definition

Disopyramide

Class IV- Ca channel blockers- ESP verapamil

 

(climbing pyramides makes you veray constipated)

 

Term
Which antiarrythmetic can cause GI problems like NVD, HA?
Definition

Dronedarone

Digoxin (NV, HA)

Adenosine (N)

Quinidine (HA)

 

(Dronedarone sounds like Dramamine which you take for sea sickness... so just think about those Sx)

(Ademir makes me nauseous sometimes)

Term
Which antiarrythmetic can cause heart problems?
Definition

Disopyramide (heart failure)

Class 1c (cardiac arrest)

Dronedarone (CV events)

Adenosine (asystole, vfib, vtach, bradycardia)

Term
Which antiarrythmetic can cause toxicity?
Definition

Amiodarone (highly lipophilic and accumulates)

Digoxin (if low K because of phosphorylation of the Na/K pump.. remember?)

Term
Which antiarrythmetic can cause liver problems?
Definition

Amiodarone (hepatotoxicity)

Dronedarone (liver damage)

Term
Which antiarrhythmetics can cause a decrease in BP?
Definition

Procainamide (if rapid IV- ganglionic block)

Digoxin

Term
Which antiarrythmetic can cause hypoglycemia?
Definition

Disopyramide

Beta blockers- right? Blocks the B2 mediated stimulation of glycogenolysis and decrease blood sugar.

Term
Which antiarrythmetic can causes nystagmus?
Definition
Lidocaine
Term
Which antiarrythmetic can causes corneal deposits (halo)?
Definition
Amiodarone
Term
Which antiarrythmetics can cause dyspnea?
Definition

Amiodarone

Adenosine

Term
Which antiarrythmetics have a BBW? What is it?
Definition

Amiodarone:

 Possible fatal acute pulmonary toxicity: cough, dyspnea, bronchospasms, infiltrates, hemoptysis, alveolar hemorrhage, respiratory failure

Term

Which antiarrhythmetic can cause thyroid problems?

 

What can you give instead?

Definition

Amiodarone

Contains Iodine and can cause hyper-hypothyroidism (potentially fatal thyrotoxicosis)

 

Can give dronedarone because it's an analog of amiodarone but without the Iodine

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