Antiarrythmics

Front 1

How many beats per minute is considered to be Bradycardia?

Back 1

60bpm

Front 2

How many bpm is considered tachycardia?

Back 2

100bpm

Front 3

Whats the most common etyology for arrythmias?

Back 3

the process of reentry

Front 4

How do Class 1 agents work in general?

Back 4

they block voltage sensitive Na+ channels decreasing excitability and conduction velocity

they more efficiently block open or inactivated channels in areas of frequent depolarization

Front 5

What are class 1 agents used for:

Back 5

Refractory arythmias

atrial

atrioventricular

junctional

ventricular

Front 6

How does Class 1a work?

Back 6

slows the rate of the rise of Phase 0 increasing the effective refractory period (ventricular

Front 7

Name the Class 1a agents: (3)

Back 7

Quinidine - the prototype

Procainamide

Disopiramide

Front 8

This Class 1a agent can cause cardiotoxicity due to hyperkalemia

Back 8

Quinidine

also causes cinchonism

Front 9

This class 1a agent can increase digoxin concentrations by displacing it from its binding sites

Back 9

Quinidine

Front 10

Class 1a drug is a derivate of procaine

Back 10

Procainamide

Front 11

This class 1a drug produces a butterfly rash in the face (lupus like syndrome in 25-30 of pts)

Back 11

Procainamide

Front 12

This Class 1a agent may produce hallucinations and when metabolized it produces NAPA

Back 12

Procainamide

Front 13

Class 1a agent that is an alternative to Quinidine and Procainamide

Back 13

Disopiramide

Front 14

Side effects of Disopiramide (class 1a) are

Back 14

anticholinergic like reactions

xerostomia

urinary retention

constipation

blurred vision

Front 15

This class is the choice for cardiac arythmias

Back 15

Class 1b

Front 16

How does Class 1b work?

Back 16

decreases the duration of the action potential by shortening depolarization

Front 17

This class 1b agent is the CHOICE for cardiac arrythmias in emergency situations

Back 17

Lidocaine

used IV

also useful in ventricular arythmias

Front 18

Name the class 1b agents (3)

Back 18

Lidocaine

Mexiletine

tocainide

the last 2 are used PO

Front 19

This class 1b agent is used for the chronic treatment of ventricular arrythmias associated with previous myocardial infarction

Back 19

Mexiletine

Front 20

Tocainide (class 1b) has lead to

Back 20

pulmonary fibrosis

Front 21

How does Class 1c work?

Back 21

they depress the rate of rise of the membrane action potential by slowing conduction without affecting duration

Front 22

Name the Class 1c agents (2)

Back 22

Felcainide

Propafenone

Front 23

What does Felcainide (class 1c) do?

Back 23

Depress phase 0 upstroke, slowing conduction in all cardiac tissues.

automaticity is reduced by increased threshold potential

Front 24

This drug is used in refractory arrythmias particularly PVC's and has a negative inotropic effect so it can agravate CHF

Back 24

Felcainide

Front 25

Felcainide (class 1c) may induce

Back 25

threatening ventricular tachycardia resistant to treatment

Front 26

This class 1c is a broad spectrum antiarrythmic agent

Back 26

Propafenone

Front 27

How does Class II work?

Back 27

Diminish phase 4 depolarization depressing atomaticity with prolongation of av conduction, decreasing heart rate as well as contractility.

useful in tachycardia increased by sympathetic activity

Front 28

Name the Class II agents (4)

Back 28

Propanolol

Metoprolol

Pindolol

Esnolol

Front 29

This Class II agent reduces incidence of sudden cardiac death after MI

Back 29

Propanolol

Front 30

This Class II agent is a B1 specificl blocker, used to decrease the risk of bronchoconstriction

Back 30

Metoprolol

Front 31

This Class II agent decreases the frequency of cardiac failure

Back 31

Pindolol

Front 32

This Class II agent is used IV in arrythmias during surgery and emergency conditions

Back 32

Esnolol

Front 33

This class of agents prolong duration of action potential without altering phase 0 of depolarization or resting membrane potential and prolong the effective refractory period

block K channels diminishing activated K current of depolarization

Back 33

Class III

Front 34

Name the Class III agents (3)

Back 34

Amiodarone

Sotalol

Dofetilide

Front 35

Amiodarone (class III) is effective in :

Back 35

Severe refractory supraventricular tachycardia

ventricular tacharrythmia

full effect takes 6 weeks

Front 36

with this Class III agent more than 50% of pts develop severe s.e and have to discontinue the drug

Back 36

Amiodarone

Front 37

This Class III agent causes blue skin

Back 37

Amiodarone

also causes

interstitial fibrosis

thyroid abnormalities

Front 38

This Class III agent prolongs QT interval

Back 38

Sotalol

Front 39

This class III is the 1st line agent for persistent atrial fibrillation and heart failure

Back 39

Dofelitide

Front 40

Name the Class IV agents

Back 40

Verapamil

Diltiazem

Ca++ channel blockers

Front 41

These agents are better for atrial than ventricular arrythmias

Back 41

Verapamil

diltiazem

they are also useful in reentry supraventricular tachycardia, angina, hypertension

but contraindicated for CHF

Front 42

Drug of choice to abolish SVT is:

Back 42

Adenosine

at high doses decreases conduction velocity prolongs refractory period, decreases automaticity in AV node.

Front 43

this class of agents have the capacity to PROVOKE ARRYTHMIAS

Back 43

Class III

Front 44

Drugs that can cause lung fibrosis :

Back 44

Tocainide

Amiodarone