Anti-Arrhythmic Drugs

Front 1

Quinidine
class?/moa?
uses?
adverse?
contra?

Back 1

-Class 1a, Na channel blocker (high doses blocks Ca and a1)
-2nd choice in: V ectopic beats, A flutter/fib, recurrent supra/V tachy, malaria, RLS
-torsades de pointes, cinchonism, diarrhea, arterial embolism, allergic rxns (prevalence ~15-30%)
<OD tx: Na-lactate>
-complete heart block, BBB, V arr w/ long QT, increased QRS complex

Front 2

Procainamide
class?/MOA?
uses?
adverse?

Back 2

-Class 1a, blocks Na and K channels (main active metabolism= N-acetylprocainamide)
-acute arr (WPW), acute tx/prevention of supra/V arr
<OD tx: Na-lactate>
-diarrhea, hypotension, CNS, thrombocytopenia, lupoid syndrome (30%)= higher incidence in slow acetylators

Front 3

Lidocaine
class?/MOA?
uses?
adverse?
contra?

Back 3

-Class 1b, blocks Na channels
-acute tx of V arr in ICU, digitalis induced arr, prevents V arr/fib in MI, WPW
<given IV only>
-least cardiotoxic drug, heart block, hypotension, coma, allergies
-2nd/3rd degree heart block, sick sinus syndrome, A-fib, liver dz, over 70yrs

Front 4

Mexiletine
class?
pk?
uses?

Back 4

-Class 1b
-lidocaine analog; oral
-Ventricular tachycardia, analgesic in neuropathic pain

Front 5

Phenytoin
class?
MOA?
uses?

Back 5

-anti-convulsant, Class 1b
-blocks inactivated Na in heart and brain
-digitalis induced arrhythmia

Front 6

Flecainide
class?
uses?
adverse?
contra?

Back 6

-Class 1c; blocks activated Na and K channels
-rhythm control in A-fib/flutt, chronic control of supraventricular arr
-new V-arr, worsening congestive HF, visual, dizzy
-any structural heart dz

Front 7

Amiodarone
class/moa?
uses?
adverse?
contra?

Back 7

-class III= blocks K, inactivated Na, slightly Ca, noncompetitive a/b
-most effective most prescribed, A-fib/flutt, supra/V tachy, 1st choice V-fib prophylaxis, hypertrophic cardiomyopathy
-common ~70%, high Iodide content, constipation, torsades de pointes, pulm fibrosis, inhibits CYP450
-preggos (D), congential long QT, sinus bradycardia, SA/AV block, pulm dz

Front 8

Sotalol
class?/moa?
uses?
adverse?

Back 8

-Class III= nonselective B blocker, blocks K
-supraventricular + ventricular arrhythmias
-prolonged repolarization could cause torsades de pointes

Front 9

Ibutilide
class/moa?
uses?
adverse?
contra?

Back 9

-Class III, blocks K and activates inward Na current (prolongs AP duration)
-Atrial flutter and fibrillation ONLY
-AV block, BBB, V-tachy, torsades de pointes
-long QT interval & V-tachycardia

Front 10

Verapamil/Diltiazem
class?
uses?
contra?

Back 10

-Class IV- Ca channel blockers
-acute tx of supraV tachy, acute/chronic tx of atrial flutt/fibrill
-WPW and long QRS complex

Front 11

Adenosine
class?/moa?
use?
adverse?

Back 11

-miscellaneous- natural occuring nucleoside; activates ach K and inhibits cAMP induced Ca influx; short 1/2 life given IV
-flushing, dyspnea, chest pain, hypotension, asystole
-paroxysmal supraventricular tachycardia

Front 12

Magnesium
class?
uses?

Back 12

-miscellaneous; given IV MgSO4
-prevents recurrent episodes of torsades de pointes, tx digitalis induced arr

Front 13

Digitalis glycosides
useful in patients with?

Back 13

-atrial flutter or fibrillation with cardiac failure
(abolishes AV nodal reentrant tachycardia)