Antiarrhythmic Drugs - Moa, Clinical Use, Side Effects

Front 1

What effect does digoxin have on the AV node

Back 1

slows it down

Hint 1

enhances vagal effects

Front 2

Effect of blocking Na channels on conduction velocity and effective refractory period in fast response tissue

Back 2

decreases conduction velocity
no effect on ERP

Front 3

Effect of blocking Na channels on conduction velocity and effective refractory period in nodal tissue

Back 3

no effect on conduction velocity
no effect on ERP

Front 4

Effect of blocking K channels on conduction velocity and effective refractory period in fast response tissue

Back 4

no effect on conduction velocity
prolongs ERP

Front 5

Diltiazem does which of the following for Afib?
rate control or rhythm control

Back 5

rate control

Hint 5

Diltiazem is a Non-DHP CCB

Front 6

Blocking which channels will cardiovert Afib to NSR?

Back 6

Na or K channels

Front 7

MOA - quinidine

Back 7

blocks Na channels (intermediate recovery)
blocks K channels
increases AV conductance (inhibits vagus)

Front 8

MOA - procainamide

Back 8

blocks Na channels (intermedicate recovery)
blocks K channels

Front 9

MOA - lidocaine

Back 9

blocks Na channels (fast recovery)

Front 10

MOA - flecainide

Back 10

blocks Na channels (slow recovery)

Front 11

MOA - amiodarone

Back 11

blocks Na, K, Ca channels
blocks beta receptors

Front 12

MOA - sotalol

Back 12

blocks K channels
blocks beta receptors

Front 13

MOA - ibutilide

Back 13

blocks K channels

Front 14

MOA - dofetilide

Back 14

blocks K channels

Front 15

MOA - adenosine

Back 15

blocks AV node

Front 16

what causes torsades de pointes

Back 16

blocking K channels and increasing the ERP

Front 17

Which antiarrhythmics are used IV only

Back 17

procainamide
lidocaine
ibutilide
adenosine

Front 18

Which channels do you want to block to treat Vfib or Vtach

Back 18

Na or K channels

Front 19

Which channels do you want to block to treat AVNRT?

Back 19

Na or K channels
or AV nodal blockers

Front 20

Which of the following agents has a higher proarrhythmic effect because it has a higher chance of affecting normal tissue?
lidocaine or flecainide

Back 20

flecainide

Front 21

What effect does quinidine have on the AV node?

Back 21

inhibits vagal activity
increases AV conduction

Front 22

What effect does amiodarone have on the AV node?

Back 22

Blocks Ca channels and beta receptors
decreases AV conduction

Front 23

Side effect - Cinchonism

Back 23

quinidine

Front 24

Blocking which channel prolongs the QT interval on an ECG?

Back 24

K channels

Front 25

Side effect - lupus like syndromes

Back 25

procainamide with prolonged use

Front 26

Which of the following should be avoided in heart failure patients because of their negative inotropic effect?
flecainide, amiodarone, sotalol, dofetilide, ibutilide, beta blockers, and/or calcium channel blockers

Back 26

flecainide, sotalol, beta blockers (unless used to treat the HF), and calcium channel blockers

Front 27

lidocaine can treat which of the following arrhythmias?
atrial fibrillation
WPW
AVNRT
ventricular fibrillation

Back 27

ventricular fibrillation

Front 28

Side effect - paresthesia, tremor, nausea, hearing disturbances, slurred speech, convulsions

Back 28

lidocaine

Hint 28

'anesthetize the brain'

Front 29

Which of the following would you use to treat an arrhythmia in a patient with previous MI?
amiodarone or flecainide

Back 29

amiodarone

Front 30

What is the main contraindication for use of flecainide?

Back 30

CV disease (besides the arrhythmia)

Front 31

Side effect - blue skin, photosensitivity

Back 31

amiodarone

Front 32

Side effect - Pneumonitis and pulmonary fibrosis, peripheral neuropathy

Back 32

amiodarone

Front 33

Side effect - Fatigue, sinus bradycardia, dyspnea

Back 33

beta blockers, including sotalol

Front 34

What effect will diltiazem have on Vtach?

Back 34

May cause hypotension, reflex sympathetic stimulation of heart and Vfib

Front 35

Diltiazem will cardiovert which of the following arrhythmias?
AVNRT or Afib

Back 35

AVNRT

Front 36

What is the half life of amiodarone?

Back 36

many days (13-103 days)

Front 37

What is the half life of adenosine?

Back 37

10 seconds

Front 38

Adenosine will cardiovert which of the following arrhythmias?
AVNRT, Afib, Vfib

Back 38

AVNRT

Front 39

Side effect - transient asystole

Back 39

adenosine

Front 40

Best prevention for arrhythmia in patient with long QT syndrome?

Back 40

beta blocker

Hint 40

sympathetic stimulation can precipitate the arrhythmia

Front 41

Which of the following should you avoid in a patient with long QT syndrome?
quinidine, flecainide, verapamil

Back 41

quinidine

Front 42

What are two situations where you can use propranolol for Afib?

Back 42

Slow the AV node and ventricular rate
Prevent the arrhythmia if it is triggered by physical or emotional stress

Front 43

Will verapamil cardiovert atrial flutter?

Back 43

No