Naplex Review Chapter 34 Antiarrhythmics

Front 1

phases of myocardial AP
phase 0

Back 1

resting potential
-90 mV
Na + channels open, Na rushes in

Front 2

phases of myocardial AP
phase 1

Back 2

depolarization phase
this is peak potential (+10mV)
Na channels close

Front 3

phases of myocardial AP
phase 2

Back 3

Plateau, refractory period
Ca channel opens, rushes in
K channel opens, rushes out

Front 4

phases of myocardial AP
phase 3

Back 4

refractory period, repolarization

Ca channel closes

Front 5

avoid which antidepressant in patients at risk for QT prolongation

Back 5

citalopram

Front 6

before starting meds for non-life threatening arrhythmia, check what

Back 6

check electrolytes and run a tox screen

Front 7

class 1a antiarrhythmic meds

Back 7

quinidine, procainamide, disopyramide

Front 8

class 1b antiarrhythmic meds

Back 8

lidocaine, mexilentine, phenytoin

Front 9

class 1c antiarrhythmic meds

Back 9

flecainide, propafenone

Front 10

class II antiarrhythmic meds

Back 10

BB, esmolol and propanolol

Front 11

class iii antiarrhythmic meds

Back 11

amiodarone, dofetilide, dronedarone, ibutilide, sotalol

Front 12

class iv antiarrhythmic meds

Back 12

diltiazem and verapamil

Front 13

class I antiarrhytmics work by..

Back 13

blocking Na+ channels, the sub classes determine length of blocking
1a - intermediate
1b- fast blockers
1c- long na channel blockers

Front 14

quinidine
class?
BBW
SE

Back 14

1a
BBW- may increase mortality
SE- LOTS of diarrhea, stomach cramping, tinnitus (cinchonism)
strong anti-cholinergic

Front 15

procainamide
class
metabolite?
BBW
SE

Back 15

1a
active metabolite- N-acetyl procainamide (NAPA)
BBW- fatal blood dyscrasias (agranulocytosis)
may cause drug induced lupus
SE- hypotension, NVD, lupus

Front 16

disopyramide
SE

Back 16

strong anti-cholinergic
xerostomia, constipation

Front 17

disopyramide interacts with

Back 17

digoxin (decrease dig by 50%) and grapefruit juice

Front 18

what arrhythmias are class 1b used for

Back 18

ventricular arrhythmias, no supra ventricular (A.Fib)

Front 19

class ii antiarrhythmics used to tx
and how

Back 19

they block beta and indirectly block Ca channels in SA and AV nodes

used to slow ventricular rates in supraventricular tachycardias

Front 20

class iii antiarrthymic - ihate this word- meds

how do they work

Back 20

block K channels

Front 21

amiodarone
BBW
SE
dosing longer than 2 hours, must be administered in..
t1/2

Back 21

BBW- Liver tox, and can cause arrhythmia
SE- hypotension, hypo/hyperthyroidism, optic neuritis, ataxa, pulmonary fibrosis

must be admin in non PVC container-glass or polyolefin
t1/2=55 days!!

Front 22

dronaderone
brand?
SE

Back 22

dronaderone
like amiodarone- hepatic failure, renal failure, pulmonary fibrosis, increased SCr

hypoK, hypoMg

Front 23

Sotalol
Monitor

Back 23

SCr, BUN, K

CI- in <40ml/min and K <4

Front 24

AGENTS not in the Vaughan-Williams classification for arrthymias

Back 24

adenosine

digoxin (lanoxin)
a. fib therapeutic rang 0.8-2 ng/ml
antidote- digibind or digifab