Anti-Arrhythmic Drugs

Front 1

Type Ia Drugs?

Back 1

Type Ia Drugs:

Procainamide, Quinidine, Disopyramide

Front 2

Type Ib Drugs?

Back 2

Type Ib Drugs:

Lidocaine, Mexiletine

Front 3

Type Ic Drugs?

Back 3

Type Ic Drugs:

Flecainide, Propafenone

Front 4

Type II Drugs?

Back 4

Type II Drugs:

Propranolol, Metoprolol, Esmolol

Front 5

Type III Drugs?

Back 5

Type III Drugs:

Amiodarone, Dronedarone, Sotalol, Dofetilide, Ibutilide

Front 6

Type IV Drugs?

Back 6

Type IV Drugs:

Verapamil, Diltiazem

Front 7

Other Anti-Arrhythmic Drugs (2)?

Back 7

Other Anti-Arrhythmic Drugs:

Adenosine, Digitalis

Front 8

Dihydropyridine Calcium Channel Blockers?

Back 8

Dihydropyridine Calcium Channel Blockers"

Nifedipine, Nicardipine

Front 9

ACE Inhibitors?

Back 9

ACE Inhibitors:

Captopril, Enalapril, Benazepril

Front 10

Angiotensin Receptor Blockers?

Back 10

Angiotensin Receptor Blockers:

Losartan, Candesartan, Valsartan

Front 11

Renin Inhibitor?

Back 11

Renin Inhibitor:

Aliskiren

Front 12

Nitrates?

Back 12

Nitrates:

Nitroglycerin, Isosorbide Dinitrate, Isosorbide Mononitrate, Sodium Nitroprusside

Front 13

Direct Vasodilators?

Back 13

Direct Vasodilators:

Nitrates, Hydralazine, Minoxidil, Diazoxide, Fenoldopam

Front 14

Procainamide drug class?

Back 14

Procainamide is a Type Ia Medium Affinity Sodium Channel Blocker

Front 15

Procainamide ADR?

Back 15

Procainamide can cause lupus erythematosus

Front 16

Major ADRs of Type 1a Sodium Channel Blockers?

Back 16

QT prolongation and induction of Torsade de Pointes are the major ADRs of Type 1a Sodium Channel Blockers

Front 17

Lidocaine drug class?

Back 17

Lidocain is a Type Ib Low Affinity Sodium Channel Blocker

Front 18

Mexiletine drug class?

Back 18

Mexiletine is a Type Ib Low Affinity Sodium Channel Blocker

Front 19

Clinical use of Type Ib Sodium Channel Blockers?

Back 19

Type Ib Sodium Channel Blockers are used to treat ventricular arrhythmias

Front 20

Flecainide drug class?

Back 20

Felcainide is a Type Ic High Affinity Sodium Channel Blocker

Front 21

Propafenone drug class?

Back 21

Propafenone is a Type Ic High Affinity Sodium Channel Blocker

Front 22

ADR to Lidocaine?

Back 22

Lidocaine has mainly CNS adverse side effects (paresthesias, tremor, nausea of central origin, lightheadedness, tinnitus, slurred speech, convulsions)

Front 23

Clinical use of Type Ic Sodium Channel Blockers?

Back 23

Type Ic Sodium Channel Blockers are used to treat supraventricular arrhythmias; chronically treat PSVT

Front 24

Contraindication for use of Type Ic Sodium Channel Blockers?

Back 24

Do not use Type Ic Sodium Channel Blockers in patients with congestive heart failure or myocardial ischemia

Front 25

Propranolol drug class?

Back 25

Propranolol is a Type II nonselective beta antagonist

Front 26

Metoprolol drug class?

Back 26

Metoprolol is a Type II selective beta-1 antagonist

Front 27

Esmolol drug class?

Back 27

Esmolol is a Type II, short-acting selective beta-1 antagonist

Front 28

Clinical use of Type II Beta Adrenergic Receptor Blockers?

Back 28

Type II Beta Adrenergic Receptor Blockers inhibit ventricular response in atrial tachycardia; treat PSVT

Front 29

Clinical uses (2) of Metoprolol?

Back 29

Metoprolol is used to treat ventricular arrhythmias (ectopic pacemaker) and atrial arrhythmias

Front 30

Clinical use of Esmolol?

Back 30

Esmolol is used to treat atrial arrhythmias

Front 31

Mechanism of action of Type III drugs?

Back 31

Type III drugs block delayed rectifier potassium channels (Ikr)

Front 32

ADR of Type III drugs?

Back 32

Type III Delayed Rectifier Potassium Channel Blockers can cause EADs and prolong the QT interval

Front 33

Amiodarone drug class?

Back 33

Amiodarone is a Type III Delayed Rectifier Potassium Channel Blocker

Front 34

Dronedarone drug class?

Back 34

Dronedarone is a Type III Delayed Rectifier Potassium Channel Blocker

Front 35

Sotalol drug class?

Back 35

Sotalol is a Type III Delayed Rectifier Potassium Channel Blocker

Front 36

Dofetilide drug class?

Back 36

Dofetilide is a Type III Delayed Rectifier Potassium Channel Blocker

Front 37

Ibutilide drug class?

Back 37

Ibutilide is a Type III Delayed Rectifier Potassium Channel Blocker

Front 38

Clinical use of Amiodarone?

Back 38

Amiodarone is used to treat ventricular arrhythmias and supraventricular arrhythmias

Front 39

ADRs (4) of Amiodarone?

Back 39

Amiodarone can cause: pulmonary fibrosis, photodermatitis and gray-blue skin discoloration, corneal microdeposits, block T4-->T3 conversion

Front 40

Clinical use of Dronedarone?

Back 40

Dronedarone is used to treat atrial fibrillation

Front 41

Contraindication for use of Dronedarone?

Back 41

Dronedarone cannot be used in patients with severe or decompensated heart failure

Front 42

Clinical use of Sotalol?

Back 42

Sotalol can be used to treat ventricular tachyarrhythmias and atrial fibrillation or flutter; chronically treat PSVT

Front 43

ADRs (2) of Sotalol?

Back 43

Sotalol can cause EADs and Torsades de Pointes

Front 44

Mechanism of action of Dofetilide?

Back 44

Dofetilide inhibits delayed rectifier potassium channel (Ikr) with NO EFFECTS on sodium channel

Front 45

ADR of Dofetilide?

Back 45

Dofetilitde can cause Torsades de Pointes

Front 46

Mechanism of action of Ibutilide?

Back 46

Ibutilide inhibits Ikr and ACTIVATES sodium channels

Front 47

Clinical use of Ibutilide?

Back 47

Ibutilide is an I.V. treatment for atrial flutter/fibrillation

Front 48

ADRs (2) of Ibutilide?

Back 48

Ibutilide can cause prolonged QT interval and Torsades de Pointes

Front 49

Mechanism of action of Type IV Drugs?

Back 49

Type IV L-Type Calcium Channel Blockers (Non-Dihydropyridine) reduce rate of phase 4 depolarization and block L-type calcium channels

Front 50

What phenomenon does NOT occur with Type IV drugs?

Back 50

Type IV L-Type Calcium Channel Blockers don't induce reflex sympathetic compensation

Front 51

Verapamil drug class?

Back 51

Verapamil is a Type IV L-Type Calcium Channel Blocker

Front 52

Diltiazem drug class?

Back 52

Diltiazem is a Type IV L-Type Calcium Channel Blocker

Front 53

Clinical use of Verapamil?

Back 53

Verapamil is used to treat supraventricular tachycardia; treat PSVT

Front 54

Clinical use of Diltiazem?

Back 54

Diltiazem is used to treat supraventricular tachycardia; treat PSVT

Front 55

ADR of Verapamil?

Back 55

Verapamil can cause peripheral vasodilation

Front 56

Clinical use of Adenosine?

Back 56

Adenosine is an I.V. drug used to treat reentry supraventricular arrhythmias; treat PSVT

Front 57

Mechanism of action of Adenosine?

Back 57

Adenosine blocks IkAch and IkAdo

Front 58

Clinical uses (2) of Digitalis?

Back 58

Digitalis is used to treat reentry arrhythmias in AV node and atrial fibrillation

Front 59

ADRs (4) of Digitalis?

Back 59

Digitalis can cause: arrhythmias, nausea, cognition disturbance, blurred or yellow vision

Front 60

Contraindication for use of Verapamil?

Back 60

Do NOT use Verapamil in patients taking a beta blocker

Front 61

Contraindication for use of Diltiazem?

Back 61

Do NOT use Diltiazem in a patient taking a beta blocker

Front 62

Nifedipine drug class?

Back 62

Nifedipine is a Dihydropyridine Calcium Channel Blocker

Front 63

Nicardipine drug class?

Back 63

Nicardipine is a Dihydropyridine Calcium Channel Blocker

Front 64

Mechanism of action of Dihydropyridines?

Back 64

Dihydropyridines block L-Type calcium channels to produce relaxation in arterial smooth muscle

NO EFFECT on heart or venous smooth muscle

Front 65

ADRs (2) of Nifedipine?

Back 65

Nifedipine can cause hypotension and headaches

Front 66

ADRs (2) of Nicardipine?

Back 66

Nicardipine can cause hypotension and headaches

Front 67

Captopril drug class?

Back 67

Captopril is an ACE Inhibitor

Front 68

Enalapril drug class?

Back 68

Enalapril is an ACE Inhibitor

Front 69

Benazepril drug class?

Back 69

Benazepril is an ACE Inhibitor

Front 70

ADRs (4) of Captopril?

Back 70

Captopril can cause: hypotension, dry cough, angioedema, hyperkalemia

Front 71

ADRs (4) of Enalapril?

Back 71

Enalapril can cause: hypotension, dry cough, angioedema, hyperkalemia

Front 72

ADRs (4) of Benazepril?

Back 72

Benazepril can cause: hypotension, dry cough, angioedema, hyperkalemia

Front 73

Losartan drug class?

Back 73

Losartan is an Angiotensin Receptor Blocker

Front 74

Candesartan drug class?

Back 74

Candesartan is an Angiotensin Receptor Blocker

Front 75

Valsartan drug class?

Back 75

Valsartan is an Angiotensin Receptor Blocker

Front 76

Benefit of Angiotensin Receptor Blocker over ACE Inhibitor?

Back 76

Angiotensin Receptor Blocker doesn't have the problem of dry cough

Front 77

ADRs (3) of Losartan?

Back 77

Losartan can cause: hypotension, angioedema, hyperkalemia

Front 78

ADRs (3) of Candesartan?

Back 78

Candesartan can cause: hypotension, angioedema, hyperkalemia

Front 79

ADRs (3) of Valsartan?

Back 79

Valsartan can cause: hypotension, angioedema, hyperkalemia

Front 80

Aliskiren drug class?

Back 80

Aliskiren is a Renin Inhibitor

Front 81

ADRs (3) of Aliskiren?

Back 81

Aliskiren can cause: hypotension, angioedema, hyperkalemia

Front 82

Clnical use of Sodium Nitroprusside?

Back 82

Sodium Nitroprusside is an I.V. drug used to treat hypertensive emergencies

Front 83

ADRs (3) of Sodium Nitroprusside?

Back 83

Sodium Nitroprusside can cause: hypotension, orthostatic hypotension, cyanide poisoning

Front 84

Drawback to use of Nitrates?

Back 84

Develop tolerance quickly to nitrates

Front 85

Contraindication for use of Nitrates?

Back 85

Do NOT use Nitrates for a patient taking Phosphodiesterase 5 Inhibitor (ex. Sildenafil)

Front 86

ADRs (2) of Nitroglycerin?

Back 86

Nitroglycerin can cause hypotension and orthostatic hypotension

Front 87

ADRs (2) of Isosorbide Dinitrate?

Back 87

Isosorbide Dinitrate can cause hypotension and orthostatic hypotension

Front 88

ADRs (2) of Isosorbide Mononitrate?

Back 88

Isosorbide Mononitrate can cause hypotension and orthostatic hypotension

Front 89

Nitroglycerin drug class?

Back 89

Nitroglycerin is a Nitrate (Direct Vasodilator)

Front 90

Isosorbide Dinitrate drug class?

Back 90

Isosorbide Dinitrate is a Nitrate (Direct Vasodilator)

Front 91

Isosorbide Mononitrate drug class?

Back 91

Isosorbide Mononitrate is a Nitrate (Direct Vasodilator)

Front 92

Sodium Nitroprusside drug class?

Back 92

Sodium Nitroprusside is a Nitrate (Direct Vasodilator)

Front 93

Mechanism of action of Hydralazine?

Back 93

Hydralazine causes release of NO from endothelium

Front 94

ADRs (3) of Hydralazine?

Back 94

Hydralazine can cause: compensatory salt and water reabsorption, angina or arrhythmias in patients with ischemic heart disease, lupus erythematosus

Front 95

Drawback to use of Hydralazine?

Back 95

Rapid tachyphylaxis with Hydralazine use

Front 96

Mechanism of action of Minoxidil?

Back 96

Minoxidil opens potassium channels in vascular smooth muscle (dilates arterioles)

Front 97

Clinical uses of Minoxidil

Back 97

Minoxidil (oral): treat hypertension not responsive to Hydralazine or in patients with renal failure

Minoxidil (topical): Rogaine

Front 98

ADRs (3) of Minoxidil?

Back 98

Minoxidil can cause: compensatory water and salt reabsorption, compensatory increase in sympathetic outflow (MUST co-administer beta blocker and loop diuretic), hypertrichosis

Front 99

Mechanism of action of Diazoxide?

Back 99

Diazoxide opens potassium channels in vascular smooth muscle

Front 100

Clinical uses of Diazoxide?

Back 100

Diazoxide (parenteral): treat hypertensive emergencies

Diazoxide (oral): treat hyperinsulinism

Front 101

ADRs (3) of Diazoxide?

Back 101

Diazoxide can cause: excessive hypotension (leading to stroke or MI), compensatory tachycardia and increased CO (leading to angina, cardiac ischemia, cardiac failure in patients with ischemic heart disease), inhibits insulin release from pancreas

Front 102

Mechanism of action of Fenoldopam?

Back 102

Fenoldopam stimulates dopamine D1 receptors (arteriolar dilation and natiuresis)

Front 103

Clinical use of Fenoldopam?

Back 103

Fenoldopam is used I.V. to treat hypertensive emergencies and postoperative hypertension

Front 104

ADRs (2) of Fenoldopam?

Back 104

Fenoldopam can cause reflex tachycardia and increased interocular pressure