Nplex 2 Pharmacotherapeutic Agents - Antiarrhythmics

Front 1

Atenolol - class II

Back 1

I: Tachyarrhythmias such as A-flutter, A-fib, atrioventricular and ventricular arrhythmias, paroxysmal supraventricular tachycardias (PSVT), hypertension, angina.
S/E: Bradycardia, hypotension, dizziness. Bronchoconstriction is possible but occurs less frequently in selective beta blockers. Depression, fatigue, impotency.
MOA: Beta 1 blockade reduces sympathetic effects on myocardium. Reduced phase 4 depolarization and decreased automaticity in the SA node, AV node and the Purkinje fibers.
UQ: PO, IV.

Front 2

Amiodorone - Class III

Back 2

I: Ventricular arryhthmias.
S/E: Dizziness and light headedness. Pulmonary fibrosis possible. BLUE GREY COLORING OF SKIN can occur as a result of iodine deposition.
MOA: Potassium channel blockade. Prolongs phase III.
UQ: PO, IV. Amiodarone contains high level of iodine.

Front 3

Atropine

Back 3

I: Cardiac use is in treatment of bradycardia. blocks action of acetylcholine, atropine antidotes poisoning by organophosphate .
S/E: Blurred vision, dilated pupils, dry mouth and tachycardia. confined to emergency treatment of life threatening bradycardia with hypotension. “Dry as a bone, red as a beet, hot as a hare, blind as a bat, mad as a hatter.”
The specific antidote for atropine toxicity (or tropane alkaloid toxicity) is physostigmine, a reversible acetylcholinesterase inhibitor
MOA: Anticholinergic agent - competitive inhibitor of muscarinic acetylcholine receptors = parasympatholytic.
UQ: IV. PO. Can be also given via an endotracheal tube. Additional uses of atropine include:
-cycloplegic to temporarily paralyze accommodation and as a mydriatic to dilate the pupils.
- diarrhea as it decreases secretions and slows peristalsis.
- decreases bronchial and salivary secretions preoperatively.

Front 4

Digoxin - cardiac glycoside

Back 4

I: CHF. Slows ventricular response to atrial fibrillation and atrial flutter.
S/E: Digitalis intoxication – observed more frequently in hypokalemia. Cardiac signs: arrhythmias, including bradycardia, partial or complete heart block.
GI: nausea, vomiting, anorexia and diarrhea.
CNS: drowsiness and fatigue.
Visual disturbances:
MOA: Inhibits the Na+/K+ ATPase pump which serves to increase inward current of sodium followed by a greater influx of calcium. Cardiac contraction is enhanced by the increased concentration of intracellular calcium.
UQ: PO, 36 hour half life, may cause characteristic flattening or even inversion of the T wave on EKG.