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Pharm Ch18
Cardiac Rhythym
Question | Answer |
---|---|
MOA of Quinidine, Procainamide, Disopyramide | Class IA Antiarrhythmic Agents (Na+ & K+channel blockers) |
MOA of Lidocaine, Mexiletine, Phenytoin | Class IB: bind to both open & inactivated Na+ channels, use-dependent block |
MOA of Flecainide, Encainide, Moricizine, Propafenone | Class IC: the most potent Na+ channel blockers (long half-life, but can also cause arrhythmia-CI w/ history of MI) |
Class IA antiarrhythmic that is vagolytic and increases levels of digoxin | Quinidine |
Class IA antiarrhythmic that can cause lupus-like syndrome | Procainamide |
Class IA antiarrhythmic that is CI in obstructive uropathy, glaucoma, AV block, sinus node dys, uncomp HF | Disopyramide |
Class IB antiarrhythmic that has short half-life & does not prolong QT | Lidocaine |
Class IB antiarrhythmic that does not prolong QT, is used in combo w/ amiodarone for ICD, VT, also combo w/ quinidine or sotalol ADR: nausea, tremor (less if taken w/ food) | Mexiletine |
Class IB antiarrhythmic that is also an antiepileptic; used to treat VT in young children & congenital prolong QT; also inducer of P450 | Phenytoin |
MOA of "-olol", "-ilol" and "-alol" | Class II Antiarrhythmic Agents (B-adrenergic Antagonists) |
nonselective, does not prolong QT, first-gen, Tx: VT, ADR: bronchospasm, cold extremities, impotence | Propranolol |
selective B1, second gen; ADR: excessive negative inotrope, heart block, bradycardia | Atenolol Metoprolol Acebutolol Bisoprolol |
selective B1, third-gen, cause vasodilation by blocking a-adrenergic-R vasoconstriction | Labetalol Carvedilol |
selective B1, third-gen, cause vasodilation by being partial agonist at B2-adrenergic-R | Pindolol |
MOA of Ibutilide, Dofetilide, Sotalol, Bretylium, Amiodarone | Class III Antiarrhythmic Agents (Inhibitors of Repolarization by blocking K+ channel) |
Class III antiarrhythmics that can cause torsades de pointes | Ibutilide Dofetilide Sotalol Bretylium |
Class III antiarrhythmic that is mixed class II/III | Sotalol |
Class III antiarrhythmic that is used for anti-HTN and is antiarrhythmic at Purkinje fibers (no effect on atria) | Bretylium |
Class III antiarrhythmic that can also act as class I, II & IV by altering lipid membrane where ion channels & receptors are located, and resembles thyroxine (must monitor lung, thyroid, LFTs!) | Amiodarone |
Class III antiarrhythmic that can cause hypotension, pneumonitis & pulmonary fibrosis | Amiodarone |
MOA of Nifedipine, Verapamil, Diltiazem | Class IV Antiarrhythmic Agents (Ca2+ channel blockers at SA/AV node) |
Class IV antiarrhythmic that treats Prinzmetal angina | Verapamil |
Class IV antiarrhythmics that increase digoxin levels and affects cardiac tissue | Verapamil Diltiazem |
Inhibits Ca2+ channel at AV node, short half-life, used to treat narrow-complex PSVT, ADRs: HA, flushing, chest pain, bronchoconstriction, transient new arrhythmia | Adenosine |
Correction of what ion imbalance can terminate some arrhythmias? | Potassium (hypo or hyperkalemia) |
Improves exercise capacity, Tx: chronic stable angina, ADRs: Nausea, constipation, dizziness, prolongs QT | Ranolazine |