Antiarrhythmicss
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| How would u tx torsades de points? | give MgSO4 2g IV + isopreterenol infusion (B 1&2 agonist)/ or atrial ventricular pacing
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| What are the class IA? | Disopyramide, quinidine, procainamide (double, quarter, pounder)
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| What are the class IB? | mexiletine, lidocaine, tocainide, phenytoin (mayo, lettuce, tomato, pickles)
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| What are the class IC? | moricizine, flecainide, propafenone (more fries please)
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| What are the class II drugs? | esmolol, propranolol
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| What are the class III drugs? | sotalol, amiodarone, dofetilide, ibutilide, bretylium, dronedarone
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| What are the class IV drugs? | verapamil and diltiazem
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| What is the MOA of class IA? | stabilize the membrane channel -> decreasing Na influx during deporlarization
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| What are some dietary considerations for quinidine? | take with food or milk to decrease GI upset
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| Quinidine is CI in pts taking _____ that prolong QT interval | quinolones
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| What is the most common SE of quinidine? | diarrhea (35%)
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| Quinidine overdose can cause ____, marked by what SEs (5)? | cinchonism; SE= HA, tinnitus, hearing loss, nausea, diplopia
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| ______ has an active metabolite called ____ that is renally cleared | Procainamide; NAPA (N-acetyl procainamide)
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| Name 2 BBW for procainamide | 1. fatal blood dyscrasias
2. lupus erythematosus like syndrome (20-30% of pts)
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| Disopyramide has what type of SEs? | Anticholinergic effects - xerostomia, constipation, urinary hestitancy
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| What is the Dig dose adjustment when used with quinidine? | decrease by 50%
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| What is special about the lidocaine metabolism? | it inhibits its own metabolism, so its 1/2 life increases after 24-48 hrs
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| Class IC agents should be avoided with this condition? | HF
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| What is the class III MOA? | increase the refractory period; mainly blocking K+ channels
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| What lab tests are obtained baseline with amiodarone? | liver, thyroid, and pulmonary tests
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| What is the dose of amio? | 200-400 mg QD with meal
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| What are 2 BBW for amio? | lung damage and liver damage.
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| Amio SEs: name 4? | hypothyroidism 3X more common than hyperthyroid, photosensitivity, corneal micro-deposits, blue skin discoloration (smurf)
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| What is the brand name for dronedarone? | Multaq
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| Multaq has less SEs than Amio but more_____ | more dangerous in HF (CI); and more N/D
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| What is the brand name for dofetilide? | Tikosyn
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| 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.
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| The following meeds must have the doses decreased 30-50% when starting Amio: (4) | dig, warfarin, quinidine, procainamide
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| 2 labs that must be done before giving antiarrythmics | electrolytes and tox-screen
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| CCB may be preferred over B-blockers if ____? | co-existing COPD/asthma
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| Adenosine MOA? Is used in what type of arrythmias? | decreases conduction via AV node restoring NSR
PSVTs (t1/2 <10 sec)
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| What is the dosing for digoxin? | 0.125 - 0.25 mg daily
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| Dig: what are the first signs of toxicity? What are the severe toxicities? | N/V, loss of appetite, decrease HR
Halos, dizziness, arrythmias
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| ________ will increase dig levels. | Hypokalemia (< 3.5 mEq/ml)
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Created by:
dcandrade
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