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Pharm- Arrythmias

Pharmacology 9/17/08

QuestionAnswer
Cardiac Action Potential Phase 4 Diastole Cells are polarized and resting
Cardiac Action Potential Phase 0 Depolarization Rapid influx of Na and then slow influx of calcium causes the cell to depolarize. Alteration of the sodim and calcium channels effect the rate of impulse propagation through the heart.
Cardiac Action Potential Phase 1 Na channels close leading to rapid depolarization
Cardiac Action Potential Phase 2 Refractory Period Little Activity
Cardiac Action Potential Phase 3 Refractory Period Outward K flow until cells return to polarized resting state. In this phase the cardiac cell can be stimulated by a strong aberrent impulse.
P wave depolarization of the atria
PR Interval Delay as impulse travels from SA node to AV node
QRS Interval Depolarization of ventricles
T wave Repolarization of ventricles
QT Interval Time from ventricular depolarization through repolarization
Non Drug Treatment for Arrhythmias Ablation Implantable Cardiac Defibrillator (ICD) Elective Cardioversion Emergent Cardioversion
Class I Antiarrhythmic Drugs Direct Membrane Action (Na channel blockade) Divided into Ia, Ib, Ic
Class II Antiarrhythmic Drugs Beta Blockers
Class III Antiarrhythmic Drugs Potassium Blockers (prolon repolarization)
Class IV Antiarrhythmic Drugs Calcium channel blockers
Class Ia Effects Conduction velocity- decreased Refractory period- prolonged Automaticity- decreased Ion blockade- Na EKG effects- Prolonted QRS and QT
Quinaglute, Quinidex, Cardioquin Quinidine Class Ia Antiarrhythmic Ind: A flutter, A fib, SVT, VT, VF
Procan, Procan-SR, Procanbid, Pronestyl Procainamide Class Ia Antiarrhythmic Ind: A flutter, A fib, VT, VF
Norpace, Norpace-CR Disopyramide Class Ia Antiarrhythmic Ind: Ventricular arrhythmias
Class Ib Effects Conduction velocity: neutral or decreased Refractory period: shortened Automaticity: decreased Ion blockade: Na (fast) EKG effects: shorten QT slightly
Xylocaine Lidocaine Class Ib Antiarrhythmic Ind: Ventricular arrhythmia
Mexitil Mexiletine Class Ib Antiarrhythmic Ind: Oral analog of lidocaine for ventricular arrhythmia prevention
Class II Effects Conduction velocity: markedly decreased Refractory period: prolonged Automaticity: decreased Ion blockade: calcium (indirect) EKG effect: prolong PR
Tocainide Class Ib Antiarrhythmic
Class Ic Effects Conduction velocity: markedly decreased Refractory period: no effect Automaticity: decreased Ion blockade: Na (slow) EKG effect: prolonged PR and QRS/QT
Flecainide Class Ic Antiarrhythmic
Moricizine Class Ic Antiarrhythmic
Class III Effects Conduction velocity: No effect Refractory period: markedly prolonged Automaticity: No effect Ion Blockade: Potassium EKG effect: prolonged QT
Coradone, Pacerone Amiodarone Class III Antiarrhythmic ADRs include Blue, Gray skin tint Also blocks Ca, Na, and beta receptors
Bretylol Bretylium Class III Antiarrhythmic Also blocks beta receptors
Betapace Sotalol Class III Antiarrhythmic Also blocks beta receptors
Class IV Effects Conduction velocity: Decreased Refractory period: prolonged Automaticity: decreased EKG effect: Prolonged PR
Calan, Calan SR, Covera-HS, Isoptin-SR Verapamil Class IV Antiarrhythmic Ind: Acute use for supraventricular tachycardias (PSVT), HTN, and angina
Cardizem, Cardizem SR, Cardizem CD, Dilacor XR, Tiazac Diltiazem Class IV Antiarrhythmic Ind: I.V. for A fib, A flutter, paroxysmal ventricular tachycardia
Lanoxin Digoxin Class IV Antiarrhythmic Ind: Rate control in A. fib
Antidote for Digoxin digibind
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Created by: Marywood
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