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35 Cards in this Set

  • Front
  • Back
Class 1b drugs?
1) lidocaine (Xylocaine)
2) Mexilitine (Mexitil)
3) Tocainide (TOnocard)
4) Phenytoin (Dilantin)
compare to calss 1a drugs, Class 1b agents exhibit?
rapid association adn dissociation from the Na channels (like temp. plug)
(1a: more permanent)
Lidocaine requires IV administration because of?
extensive first-pass effect
Lidocaine doses need to be decreased with?
1) CHF
2) liver failure
3) pts with cimetidine, propranolol
Lidocaine is mainly metabolyzed in?
the liver
(some active metabolite formed)
compare to Quinidine, Lidocaine blocks?
both activated and inactivated Na channels
(Quinidine blocks only activated Na channels)
during diastole (resting potential), Lidocaine rapidly?
dissociates from teh channel
(low affinity for the channel resting state)
Lidocaine decreases automaticity by?
1) reducing the phase 4 slope
2) increasing threshold
Lidocaine is used for?
1) Vent. arrythmias (limited effect on SVT)
2) reentry-type rhythm disorders (PVC, V-tac)
3) V-fib after MI
overdosage of Lidocaine will result in?
1) vasodilation
2) derect cardiac depression
3) decreased cardiac conduction
major Neuro. side effect of Lidocaine?
1) seizure
2) CNS depression
3) apnea
amine analog of Lidocaine is?
1) Mexiletine (Mexitil): class 1b
2) Tocainide (Tonocard): class 1b
difference between Lidocaine and Mexiletine (Mexitil)?
1) Mexiletine: reduced first-pass metabolism
2) suitable for oral admi.
Mexiletine (Mexitil) is used for?
chronic suppression of Vent. tacchyarrythmias
Tocainide (Tonocard) is similar to?
Mexiletine (Mexitil)
Tocainaide is rarely used due to possibly?
1) fatal bone marrow aplasia
2) pulmonary fibrosis
Phenytoin (Dilantin), class 1b is effective in suppression of vent. arrythmias associated with?
digitalis toxicity
drugs that lower phenytoin levels?
(metabolizing enzyme induction)
drugs that increase phenytoin levels?
1) warfarin
2) phenylbutazone
3) isoniazid
(inhibit metabolism)
Side effects of phenytoin?
1) CNS disturbance
2) ataxia
3) vertigo
4) slurred speech
5) sedation
6) nystagmus
7) confusion
8) partial inhibition of insulin secretion
Flecainide (Tambocor): class 1c blocks?
Na and K channels
Flecainide is fluorinated local anesthetic analog of?
Flecainide (Tambocor) is used for?
1) V-tac
2) PVCs
3) arterial tachycardia
4) WPW
chronic Flecainide tx following MI is not recommended because of?
increased incidence of sudden death
most common side effects of Flecainide?
1) vertigo
2) difficulty in visual accommodation
most serious adverse effect of Flecainide is induction of?
potentially lethal arrythmias
(reentrant vent. tachyarrhythmias)
class 2 drugs block?
class 2 drugs?
1) propranolol
2) Esmolol (Brevibloc)
3) Sotalol (Betapace) - class 2&3
beta-adrenoceptor blockers?
1) decrease the slope of phase 4
2) depresses automaticity
beta-blockers increase?
1) AV node conduction time
2) AV nodal refractoriness
increased sympathetic tone increase?
1) phase 4 depo. (> HR)
2) DAD (delayed afterdepo.)
3) EAD (early afterdepo.)
mediated arrythmias
(*beta-blockers block these effect)
Esmolol (Brevibloc): class 2
1) very short acitng
2) cardioselective
3) used for A-fib
Sotalol (Betapace): class 2 & 3
1) non-selective beta blocker
2) blocks cardiac muscle K channels
use of Sotalol may lead to HTN and vasospasm due to?
alpha override
beta blocker should not be used together with Ca channel abtagonists because?
it may lead to AV block