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46 Cards in this Set

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What is the DOC for Paroxyxsmal Supraventricular Tachs?
Verapamil
What are uses for AHA's?
Reetrant Supraventricular Tach, & control of rapid ventricular response due to atrial flutter/fibrillation
What occurs as a result of the hypotensive effects of AHA drugs?
A small reflex inc in SA node firing
Which drug has some Na+ channel activity? What can it predispose pt's to?
Bepridil. Torsades de pointes
This drug is not currently approved for antiarrhythmic indications?
Bepridil.
What other effect does bepridil have?
It slows repolarization (prolonged QT interval) - may induce Torsades
AHA's should not be used for these conditions?
(when a sick hippo is shockingly coughing cards)
SSSyndrome, 2nd/3rd degree AV block, hypotension, CHF.
IV verapamil should not be used with what drugs? Why?
B-blockers. The depress cardiac contractility and AV conduction.
What are the AHA drugs?
The Ca+ channel blockers: nefedipine, bepridil, verapamil, and diltiazem. They are Antianginal, AntiHypertensive, and AntiArrhythmic
What is the mechanism of the AHA drugs?
Reduce depolarization by blocking Ca+, neg. inotropy, depressed automaticity, reduced conduction velocity
How do AHA drugs affects the AV node? AV and SA node conduction?
Prolong ERP. Depresses their conduction.
How does AHA work in atrial flutter or fibrillation?
It slows the ventricular rate.
What does they convert?
Supraventricular Tachs to normal sinus rhythm.
What is the action of of AIDS drugs?
They prolong phase 3 repolarization, and lengthen the QT interval
What are the cardiac effects of amiodorone?
Slows sinus rate and AV conduction. Inc. repolarization and refractoriness
What are the extracardiac effects of amiodorone? What is its boxed warning?
Dilitation (peripherally), alpha blockade, & ca+ channel blockade. Pulmonary toxicity
What are the fx's of pulmonary toxicity?
Interstitial pneumonitis, alveolitis, and pulmonary fibrosis
What is another extracardiac effect that involves the cornea, liver, thyroid, and skin
Microcrystals of drug are deposited into all the tissue.
What is amiodarone used for?
Life threatening recurrent ventricular arrhythmias or recurrent unstable ventricular tachycardia
It may be used as a preferred alternative in what other cases?
pulseless ventricular tach, atrial fib, refractory paroxysmal supraventricular tach, multifocal atrial tach, and monomorphic/polymorphic ventricular tach
This drug has beta-blocking activity (nonselective, nonsympathomimetic, low lipid solubility)
Sotalol
Sotalol demonstrates these affects which are seen w/ B-blockers
fatigue, bradycardia, dyspnea
It is potentiated by these drugs?
Class I agents, phenothiazines, and TCA's
Pt's on Sotalol have an increased incidence of this arrhythmia?
torsades de pointes
What is Sotalol used to treat?
Life-threatening ventricular arrhythmias
Sotalol achieves normal sinus rhythm in these 2 arrhythmias?
atrial fibrillation and atrial flutter
Sotalol interferes with what ions and how?
Na+. It delays repolarization by activation of a slow inward current.
What is the half life of Amiodarone? Ibutilide?
1 month; 6 hours
What is ibutilide used for? What is its action?
Recent onset of atrial fibrillation/flutter. Converts to normal sinus rhythm.
What is the boxed warning for Ibutilide?
Life-threatening arrhythmias (polymorphic ventricular tachycardia)
This drug blocks the rapid component of the delayed rectifier potassium
Dofetilide
What is a serious side affect of dofetilide?
Torsades!
What is Dofetilide used for?
Atrial fib/flutter conversion to normal sinus rhythm.
Why is the affect on the SA node and AV nodes by Verapamil important?
They depend on Ca+ current for activation
Why does Bepridil predispose pt's to torsades?
It slows repolarization (prolongs QT)
What is the therapeutic use of Ca+ channel blockers?
for Reeentrant supraventricular tachycardia
This drugs has indirect vagomimetic actions?
digitalis
How does digitalis work? What 2 phases does it affect and how?
It depresses the Na+ pump and produces arrhythmias. Phase O is diminished. Phase 4 depolarization is increased.
What are two uses for digitalis?
CHF, and atrial tachycardias
This drugs produces a bradycardia that is resistant to atropine?
Adenosine
What are the two activities of adenosine?
Reduces SA node automaticity and depresses AV nodal conduction
What are the 3 electrophysiology mechanisms of Adenosine?
Inc K+ conductance, reduces c-AMP slow Ca+ channel conduction, antagonizes catecholamines
What is the half life of Adenosine?
10 seconds
What are the main side effects of Adenosine?
dyspnea, flushing, retrosternal chest pain, and transient asystole
What does Adenosine treat?
Paroxysmal Supraventricular Tach to normal sinus rhythm
What to drugs interact with Adenosine and how?
Dipyridamole; potentiation.
Methylxanthines; are adenosine receptor antagonist and affect its effects in the AV node