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60 Cards in this Set

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  • Back
classification of drugs is based on ________ properties
electrophysiologic
The classes of antiarrhythmia drugs are
class I (Ia, Ib, Ic); class II, class III, class IV and miscellaneous
class Ia drugs are
sodium channel blockers
examples of Class Ia drugs are
Quinidin; Procainamide; Disopyramide
examples of quinidine meds
quinidine sulfate; quinidine gluconate (Quinaglutge); quinidine polygalacturonate (Cardioquin)
side effects of quinidine meds
GI (n/d) (dehydration leads to electrolyte imbalance leads to arrhythmia); hypotension (alpha blocker); anticholinergic (increased heart rate)
drug interactions with quinidine
digoxin (enhances AV conduction makes atrial arrhythmia go to ventricle); warfarin (displaces both from protein binding site)
procainamide (procan, pronestyl) is available by what routes
PO (immediate and sustained release), IV
side effects of procainamide
GI (n/v/c), rare serum sickness-like rxn (fever; adenopathy), lupus like sx (altered labs (ANA) as well, will resolve with dc of med)
disopyramide (norpace) is has the most negative _____ effect of all the Class I
inotropic
Class Ib meds have a local _____ effect
anesthetic
examples of Class Ib meds are
lidocaine; tocainide; mexiletine
lidocaine's route of admin
IV only (secondary to first pass effect)
half life of lidocaine
approx 1 hour
lidocaine dosing
bolus followed by maintenance infusion
SE of lidocaine
mainly CNS (mild paresthesia, to tremor, to sz)
tocainide (Tonocard) adn mexiletine (Mexitil) route of admin
po
Class Ic meds
Flecainide (Tambocor), propafenone (Rhythmol), Moricizine (Ethmozine)
side effects of Class Ic meds
increased QT prolongation (esp Rhythmol), increased chance of ventr. arr.
Class Ic drugs are used to treat ____________ arrh
atrial
Class II meds are
beta blockers
Examples of Class II meds are
propranolol, atenolol, metoprolol, esmolol
propranolol is ________
non-specific
esmolol is used mostly in __________ to tx __________ induced arrhyth
OR; anesthesia
Class III prolong effective _______ period
refractory
examples of Class III meds
amiodarone (Cordarone), bretylium (Bretylol), sotalol (betapace), ibutilide (Covert), dofetilide (Tykosyn)
amiodarone SE include
pulmonary fibrosis; hypothyroidism; cutaneous rxn (blue/gray pigmentation, rashes); occular deposits (crystals) and visual disturbance
the half-life of amiodarone is
60 days
the dosing strategy for amiodarone is
give a loading dose over 2 week period, then reduce to maintenance
bretylium's route of admin is
IV only (slow push) if too fast pt will vomit
Bretylium causes an initial ______ of ____________
release of norepinephrine
bretylium has subsequent ___________ action
sympatholytic
SE of bretylium are
n/v, hypotension
sotalol (Betapace) is used to tx mostly
atrial fib/ atrial flutter
SE of sotalol are consistent with
beta blockade (bradycardia, CHF, syncope)
do not give sotalol to
asthmatics
sotalol can cause ST segment ___________ and
prolongation; ventricular arrhythmias
Ibutilide (Corvert) is given _________ to tx _______ onset of a-fib/flutter
IV only; recent
SE of Ibutilide are
bradycardia; htn; hypotension; negative inotropy; heart block (dec AV conduction) proarrhythmic
Dofetilide (Tykosyn) is used as a ________ resort
last
it is used to tx _______
atrial fib/flutter
SE are
QT seg prolongation; n/d, dyspnea, CP, proarrhy
Class IV meds are
CCB/ NOT dihydropyridines
examples of Class IV meds are
Verapamil; diltiazem
SE of Class IV meds
hypotension
Class IV meds are administered via
slow IV push
Class IV meds must be avoided in pts with
WPW
nifedipine has less ______ blocking effect, but should only be used when ______
AV; all else fails
meds of the other group
adenosine; magnesium sulfate
adenosine is administered via
rapid IV push 6mg, 12mg, 12mg every 2 minutes
adenosine will treat only ____ and is not effective in treating _______
paroxysymal SVT;atrial flutter/fib
the half life of adenosine is
9 sec
magnesium sulfate if indicated in the tx of _____
v-fib
magnesium is administered via
slow IV push 1-2mg (to decrease drop in BP)
SE of adenosine
flushing, non-cardiac CP, SOB (probably secondary to anxiety from flushing)
one will see _________ on monitor after admin of adenosine
cardia pause
tx of PVST is
adenosine, CCB, BB, digoxin
PVC tx
only when sx; lidocaine and procanide
vtach tx
Class IIb or amiodorone
tx vfib
amiodorone, defib