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Pharm Ch18

Cardiac Rhythym

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
Created by: fmuralid



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