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NAPLEX
Arrhythmias
| Question | Answer |
|---|---|
| which class 1a drug has a warning for hemolysis risk? | quinidine |
| which antiarrhythmic has a side effect of DILE? | quinidine |
| what are the symptoms of cinchonism? | tinnitus, hearing loss, blurred vision, headache, delirium |
| what are the boxed warnings for amiodarone? | pulmonary toxicity, hepatotoxicity, proarrhythmic |
| what are the warnings with using amiodarone | Hyper/hypothyroidism, visual impairment, photosensitivity (blue-gray skin discoloration), neurotoxicity, peripheral neuropathy |
| what to monitor when on amiodarone? | ECG, BP, HR, electrolytes |
| what type of filter do you use with amiodarone? | 0.22 micron filter/central line preferable |
| when you start amiodarone and are on digoxin, what do you do with digoxins dose? | decrease by 50% |
| when on warfarin but starting amiodarone, what then | decrease warfarin dose by 30-50% |
| which drug can enhance the bradycardic effect of amiodarone? | sofosbuvir |
| what is the active metabolite called that procainamide produces? | NAPA |
| long term use of procainamide leads to what? | positive ANA which leads to DILE |
| what is the DOC for wolff-parkinson-white syndrome? | procainamide |
| what is the BW to procainamide? | potentially fatal blood dyscrasias |
| what is the CI to using mexiletine? | cardiogenic shock |
| which Class Ic drug has a side effect of metallic taste? | propafenone |
| Propafenone | Rhythmol |
| what is the preferred antiarrhythmic in HF | Dofetilide and amiodarone |
| Dofetilide | Tikosyn |
| what is different between amiodarone and dronedarone? | dronedarone does not contain iodine and has little effect on thyroid function |
| Dronedarone | Multaq |
| what is the boxed warning to using dronedarone? | CI in patients with decompensated HF or permanent AF due to increased risk of death, stroke, and HF |
| which antiarrhythmic can worsen HF? | sotalol |
| what are the warnings to using sotalol? | proarrhythmic, can worsen HF and cause bronchoconstriction |
| what are the toxicity symptoms with digoxin? | N/V, loss of appetite, abdominal pain, blurred/double vision, greenish-yellow halos, confusion, delirium, bradycardia, life-threatening arrhythmias |
| what is the ambulatory ECG device called that records continuously for 24-48 hours that can detect arrhythmias that are intermittent? | holter monitor |
| what is a normal heart rate? | 60-100 |
| which node is the heart's natural pacemaker | SA node |
| what is unique about the myocytes in the SA node (pacemaker) | they have automaticity which means they initiate their own action potential |
| what is the most common cause of arrhythmias | myocardial ischemia or infarction |
| all antiarrhythmic drugs have the potential to what? | induce a proarrhythmia |
| how can the risk of additive proarrhythmia be minimized? | correcting electrolyte abnormalities prior to antiarrhythmic use and throughout treatment |
| what are the boxed warnings for amiodarone | hepatotoxicity and pulmonary toxicity |
| what is more common with amiodarone, hypo or hyperthyroidism? | hypo since amiodarone inhibits peripheral conversion of T4 to T3 |
| with what drug do you see cinchonism? | quinidine |
| in what type of patient population should you avoid quinidine? | G6PD deficiency |
| a patient who is having drug accumulation and toxicity of procainamide, what do they most likely lack | they are slow acetylators |
| what does long term use of procainamide lead to? | antinuclear antibody (ANA) which can result in DILE |
| what is the warning to using flecainide? | avoid use in severe hepatic and renal impairment |
| which class Ic drug has a taste disturbance? | propafenone |
| what is the CrCI cutoff to using dofetilide? | CrCI <20: CI |
| what is the boxed warning for dofetilide? | must be initiated or reinitiated in a setting with continuous ECG monitoring, experienced staff and ability to assess CrCI for a minimum of 3 days |
| what is the half life of adenosine? | <10 seconds |
| with what type of tachycardia do you use adenosine? | used for supraventricular re-entrant tachycardia |
Created by:
KaHerre12