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How would u tx torsades de points? give MgSO4 2g IV + isopreterenol infusion (B 1&2 agonist)/ or atrial ventricular pacing
What are the class IA? Disopyramide, quinidine, procainamide (double, quarter, pounder)
What are the class IB? mexiletine, lidocaine, tocainide, phenytoin (mayo, lettuce, tomato, pickles)
What are the class IC? moricizine, flecainide, propafenone (more fries please)
What are the class II drugs? esmolol, propranolol
What are the class III drugs? sotalol, amiodarone, dofetilide, ibutilide, bretylium, dronedarone
What are the class IV drugs? verapamil and diltiazem
What is the MOA of class IA? stabilize the membrane channel -> decreasing Na influx during deporlarization
What are some dietary considerations for quinidine? take with food or milk to decrease GI upset
Quinidine is CI in pts taking _____ that prolong QT interval quinolones
What is the most common SE of quinidine? diarrhea (35%)
Quinidine overdose can cause ____, marked by what SEs (5)? cinchonism; SE= HA, tinnitus, hearing loss, nausea, diplopia
______ has an active metabolite called ____ that is renally cleared Procainamide; NAPA (N-acetyl procainamide)
Name 2 BBW for procainamide 1. fatal blood dyscrasias 2. lupus erythematosus like syndrome (20-30% of pts)
Disopyramide has what type of SEs? Anticholinergic effects - xerostomia, constipation, urinary hestitancy
What is the Dig dose adjustment when used with quinidine? decrease by 50%
What is special about the lidocaine metabolism? it inhibits its own metabolism, so its 1/2 life increases after 24-48 hrs
Class IC agents should be avoided with this condition? HF
What is the class III MOA? increase the refractory period; mainly blocking K+ channels
What lab tests are obtained baseline with amiodarone? liver, thyroid, and pulmonary tests
What is the dose of amio? 200-400 mg QD with meal
What are 2 BBW for amio? lung damage and liver damage.
Amio SEs: name 4? hypothyroidism 3X more common than hyperthyroid, photosensitivity, corneal micro-deposits, blue skin discoloration (smurf)
What is the brand name for dronedarone? Multaq
Multaq has less SEs than Amio but more_____ more dangerous in HF (CI); and more N/D
What is the brand name for dofetilide? Tikosyn
Pharmacies must have what to dispense tikosyn? What are the BBW requirements? T.I.P.S. (tikosyn in pharmacy system) Must be initiated (or reinitiated) in a setting with cont ECG monitoring for a minimum of 3 days or 12 hrs after cardioversion, whichever is greater. This is due to possible torsades.
The following meeds must have the doses decreased 30-50% when starting Amio: (4) dig, warfarin, quinidine, procainamide
2 labs that must be done before giving antiarrythmics electrolytes and tox-screen
CCB may be preferred over B-blockers if ____? co-existing COPD/asthma
Adenosine MOA? Is used in what type of arrythmias? decreases conduction via AV node restoring NSR PSVTs (t1/2 <10 sec)
What is the dosing for digoxin? 0.125 - 0.25 mg daily
Dig: what are the first signs of toxicity? What are the severe toxicities? N/V, loss of appetite, decrease HR Halos, dizziness, arrythmias
________ will increase dig levels. Hypokalemia (< 3.5 mEq/ml)
Created by: dcandrade