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
|
|
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
|
|
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
|
|
Term
| What is the common class IB drug? |
|
Definition
|
|
Term
| What is true of lidocaines half life? |
|
Definition
|
|
Term
| What is the drug in class 1C that was presented? |
|
Definition
|
|
Term
| What is Procainamide converted to in the body? |
|
Definition
|
|
Term
| What disease symptoms can one present with procainamide treatment? |
|
Definition
|
|
Term
| What are the adverse effects of procainamide? (2) |
|
Definition
| lupus symptoms, agranulocytosis |
|
|
Term
| What medication can be responsible for lupus like symptoms? |
|
Definition
|
|
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
|
|
Term
| What is the relative dissociation length of times for class IB and IC? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
Term
| What is the mechanism of class II antiarrhythmics? |
|
Definition
| block B1 adernergic receptor |
|
|
Term
| What do class II antiarrhythmics end in? |
|
Definition
|
|
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
|
|
Term
| Which drug makes a diabetic less sensitive to changes in blood sugar levels? |
|
Definition
|
|
Term
| What is the mechanism of action of the class III antiarrhythmic drugs? |
|
Definition
|
|
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
|
|
Term
| What are the two class IV antiarrhythmics? |
|
Definition
|
|
Term
| What is the half life of Amiodarone? |
|
Definition
|
|
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
|
|
Term
| What is the mechanism of action of the class four anti-arrhythmics? |
|
Definition
|
|
Term
| What type of arrhythmias are verapamil/diltiazem used for? |
|
Definition
|
|
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
|
|
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
|
|
Term
| What drug blocks the Na/K pump in the cardiac cell? |
|
Definition
|
|
Term
| What will digoxin do to a muscle cell? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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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|
