Antiarrhythmics Word Scramble

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Question	Answer
Mnemonic to remember the antiarrhythmics	NaB the Long Cab: I=Na blockers, II=Beta blockers, III=Long refractory period and QT interval - K+ block, IV=Ca2+ channel blockers
General information about Class I Antiarrhythmics	Local antesthetics. Slow or block conduction (especially in depolarized cells). Decrease the slope of phase 4 depolarization and increase threshold for firing in abnormal pacemaker cells.
Drugs of Class IA	Quinidine, Amiodarone, Procainamide, Disopyramide (Queen Amy Proclaims Diso's pyramid)
General Mech of Class IA	Slow phase 0. Affect whole heart. Increase AP duration, Increase effective refractory period (ERP), and increase QT interval.
Indications for Class IA	Affect both atrial and ventricular arrhythmias, especially reentrant and ectopic supraventricular and ventricular tachycardia.
Causes cinchonism, thrombocytopenia, and torsades des pointes	Quinidine
Cinchonism is?	Headache, tinnitus and dizziness
What drug reduces the renal elimination of digoxin?	Quinidine
N-acetylprocainamide is an active metabolite	Procainamide
Can cause a reversible SLE-like syndrome	Procainamide
SE common to all Class IA	Ventricular arrhythmias, AV block (increased PR), increased QRT/QT intervals
Drugs of Class IB	Mexiletine, Lidocaine, Tocainide (Mitra Loves Tom)
General mechanism of Class IB drugs	Shorten phase 3, Affect ventricles. Unlike class 1A - these decrease AP duration (and thus ERP). Affect ischemic or depolarized Purkinje and ventricular tissue.
General use of Class IB	Acute ventricular arrhythmias (esp post MI) and in digitalis-induced arrhythmias
General side effects of Class IB	Local anesthetics - cause CNS stimulation/depression, cardiovascular depression
Drugs of Class IC	Flecainide, encainide, propafenone (Follwing Eating Poop)
General actions of Class IC	Markedly slow phase 0 (as all class 1 antiarrhythmics do). Affects atria. Has NO effect on AP duration
General use of Class IC	Useful in V-tachs that progress to VF and in intractable SVT. Also DOC for WPW.
Toxicity of Class IC	Proarrhythmic - especially post-MI (contraindicated). Significantly prolongs refractory period in AV node
Affect both atrial and ventricular arrhythmias especially reentrant and ectopic supraventricular and ventricular tachycardia	Class IA antiarrhythmics
Useful in acute ventricular arrhythmias (especially post MI) and in digitalis-induced arrhythmias	Class IB antiarrhythmics
Useful in V-tachs that progress to VF and in intractable SVT	Class IC antiarrhythmics
AP duration in Class I antiarrhythmics	Class IA = Increase AP duration. Class IB = Decrease AP duration, Class IC = don't effect AP duration
Area of heart affected by Class I antiarrhythmics	Class IA affect whole heart, Class IB affect ventricles, Class IC affect atria
Class II antiarrhythmics	Beta blockers
General actions of Class II	Reduces the effects of the sympathetic nervous system. Decreased Phase 4 depolarization, decrease excitability, and increase the EFP of the AV node
Indications for Class II	Sympathetic induced tachyarrhythmias, PSVT (b/c Bblockers reduce reentry at the AV node), Atrial flutter and fibrillation (b/c Bblockers slow AV conduction)
Side efx of Beta-blockers	Impotence, exacerbate asthma, AV block, may mask signs of hypoglycemia
CI of Beta blockers	Asthma, Prinzmetal's angina
How to remember class III antiarrhythmics	"A Bodygouar is Strong" (Amiodarone, Bretylium, Ibutilide, Sotalol)
General action of Class III	Prolong Phase 3 w/o affecting Phase 0. Increase AP duration, Increase ERP, Increase QT interval. Use these when other antiarrhythmics fail
SE: Torsades des pointes, excessive B-block	Sotalol
General SE of Class III	All can cause torsades des pointes (b/c inc QT interval)
SE of Amiodarone:	Pulmonary fibrosis, hepatotoxicity, Hypo/Hyperthyroidism. Amiodarone inhibits CYP3A4 (so don't use w/warfarin)
Used in prevention of nodal arrhythmias	Calcium channel blockers
General mech of Class IV	Ca2+ channel blockers. Primarily affect AV nodal cells, decrease conduction velocity. Increase ERP and PR.
General SE of Class IV	Flushing, Constipation, Edema. Can also cause heart block, or torsades de pointes.
Drug of choice in diagnosing/abolishing AV nodal arrhythmias (SVT)	Adenosine
Depresses ectopic pacemakers, especially in digoxin toxicity	K+
Effective in torsades de pointes and digoxin toxicity	Mg+

Created by: tommyparisi