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Antiarrhythmicss
| Question | Answer |
|---|---|
| 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
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