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39 Cards in this Set
- Front
- Back
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Quinidine
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Quinidex, 200-400 q4-6hr
Diarrhea, GI, QTc prolongation, Torsades, cinchnism |
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Procainamide
has an active metabolite |
Procanbid, Pronestyl
50-100mg/k/day IV 20mg/min LD, 4mg/kg Lupus like syndrome, QTc, Torsades, blurred vision |
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Disopyramide
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Norpace 100-200mg q6-8
Anticholinergic effects, QTc, torsades, hypoglycemia, HF |
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Moricizine
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Proarrhythmia, Bradycardia
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Lidocaine
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CNS toxicity drowsiness, confusion, coma, seizures
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Tocainide
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GI distress, pulmonary fibrosis, seizures
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Mexiletine
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GI distress, CNS tremors, vertigo, nystagmus, vision issues, AV block
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Flecainide
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Proarrhythmia, PR and QRS prolongation
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Propafenone
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Metallic taste, CNS, agranulocytosis
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Bretylium
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Initial HTN then Hypo, GI, hyperthermia
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Amiodarone: Pacerone, Cordorone
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IV: phlebitis
General: corneal deposits, photophobia, LFTs, blue-grey skin, pulmonary fibrosis, hyper/hypothyroidism, polyneuropathy |
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Sotalol
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BB effects, QTC, torsades
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Ibutilide
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QTC, torsades
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Dofetilide
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QTC, Torsades
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Digoxin
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many
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Diltiazem
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Heart block, Hypotension, bradycardia, HF
3A4i, P-gp inhibitor |
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Verapamil
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Hypotension, bradycardia, HF, Constipation*
3A4i , P-gp inhibitor 3A4 and 1A2 substrate |
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Sinus bradycardia
HR<60 ECG normal |
Atropine 0.5-1mg IV
max 3mg |
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AV block
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Pacemaker or intermittent atropine
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Atrial fibrillation and atrial flutter
Fib: No P waves flutter: saw tooth P wave |
1. rate control with digoxin, BB, NDHCCB
2. rhythm control: EC *anticoagulation tx needed |
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recurrent AFIB/Flutter with HTN but no LVH?
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Flecainide, propafenone then type III then 1A
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Recurrent Afib/flutter with HTN and LVH
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Amiodarone
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Recurrent Afib/flutter with CAD?
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Sotolol, then amiodarone / dofetilide then type 1a drugs
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Recurrent Afib/flutter with CHF?
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Amiodarone / dofetilide
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Narrow QRS -- reentry?
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Verapamil, diltiazem or adenosine
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Wide QRS --- reentry
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Adenosine or procainamide
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wide QRS with afib
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Procainamide
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Supraventricular tach all the time
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Verapamil, diltiazem or type 1C
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Tx torsades de pointes
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Stop causing agent
Admin Mag sulfate 2gm over 1 minute IV Use pacemaker Isoproterenol Correct hypo K or Mag |
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Class 1A
Double Quarter Pounder NA blocker, K blocker |
Disopyramide (Norpace) PO
Quinidine (Quinalan) PO/IV Procainamide (Procanbid) PO/IV |
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Class 1B *not for Afib
Lettuce, tomato, Mayo Cleanest agents only NA blocking Only effective for ventricular arrhythmias |
Lidocaine IV in D5W
Tocainamide (Tonocard)PO Mexiletine (Mexitil)PO |
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Class 1C
More, Fries, Please Cleanest for LOW ADR Avoid in HF and IHD |
Moricizine
Flecainide (Tambocor)PO Propafenone (Rythmol)PO |
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Class II Beta-blockers
Slows down ventriculare rate Avoid in asthmatics |
Metoprolol (lopressor, Toprol)
IV/PO Propranolol (Inderal)IV/ PO Esmolol (Brevibloc) IV |
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Class III
Prolongs refractory period by inhibiting refractory period |
Bretylium (Bretylol) IV in D5W
Amiodarone (Cordarone)IV in D5W, PO Sotalol (Betapace) PO Ibutilide (Covert) IV Dofetilide (Tikosyn) PO |
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Class IV CCB
blocks influx of Ca in SA and AV nodal tissue |
Verapamil (Calan, Covera HS) IV / PO
Diltiazem (Cardizem) IV /PO |
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V TACH
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Amio
Lidocaine Procaineamide |
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Pulseles V TACH
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DCC X3, Amio, Lido, Procain
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V fib
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DCC X3, Amio, Lido, Procain
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Acute A Fib
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DCC
BB,CCB,Dig, Amio Heparin, Coumadin or 1A or 1C Never 1B |
