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2013-01-23 21:04:24

Pharmacology - Antiarrhythmic drugs
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  1. What medication has the potential to cause a possibly fatal lupus-like syndrome that starts as a rash with mild arthralgia?

    What class does this medication belong to?
    procainamide (Pronestyl)

    Class IA Sodium Channel Blockers
  2. This medication is commonly associated with diarrhea, cinchonism, hypotension, syncope, and GI problems.
    What is quinidine (Quinidex)?
  3. This Class IA sodium channel blocker is approved for chronic treatment of atrial flutter, atrial fibrillation, ventricular fibrillation, and ventricular tachycardia.  It commonly causes anticholinergic side effects and can sometimes worsen heart failure.
    What is disopyramide (Norpace)?
  4. A patient taking lidocaine may experience common adverse events such as _____ and _____.  What class does lidocaine belong to?
    • CNS: seizures
    • Tinnitus

    Class B Sodium Channel Blockers
  5. Name a class IB sodium channel blocker (other than lidocaine) than often causes tremor and nausea and can cause severe interactions with other anti-arrhythmic drugs.
    mexiletine (Mexitil)
  6. This anti-arrhythmic drug is associated with life-threatening CAST proarrhythmia in patients with MI.  It is _____. 

    What class does it belong to?
    flecainide (Tambocor)

    Class IC sodium channel blocker
  7. This class IC sodium channel blocker is often associated with beta-adrenergic blocking effects (worsening of heart failure and bronchospasm).  
    What is propafenone (Rythmol)
  8. Propafenone (which is a _____) may increase frequency or severity of _____ _____.
    Class IC sodium channel blocker

    ventricular tachycardias
  9. Name 3 Class II beta-adrenergic antagonists.
    • propranolol (Inderal)
    • sotalol (Betapace)
    • esmolol (Brevibloc)
  10. To achieve rate control in atrial fibrillation and chronic treatment of torsades de pointes, one would use this class of drug.
    What is Class II beta-adrenergic antagonists?
  11. This class II beta-adrenergic antagonist is associated with torsades de pointes and Long QT.
    What is sotalol?
  12. Due to its short half-life, this drugs beta-adrenergic adverse events quickly dissipate after discontinuation.
    What is esmolol?
  13. Amiodarone, dronedarone, sotalol, dofetilide, and ibutilide belong to this class of medication.
    What is class III?  [they increase the refractory period]
  14. This medication has a half-life of several months and is used for acute and chronic treatment of ventricular tachycardia and ventricular fibrillation, as well as chronic treatment of atrial fibrillation.
    What is amiodarone?
  15. Name 3 unique and very counsel-able talking points of amiodarone?
    • Pulmonary fibrosis with chronic therapy which can be fatal (requires periodic monitoring of lung function)
    • Corneal microdeposits
    • Hepatotoxicity
    • Neuropathies
    • Photosensitivity
    • Thyroid dysfunction
    • Half-life of several months
  16. This Class III drug causes fewer GI problems than amiodarone, but may increase mortality in patients with severe heart failure.
    What is dronedarone?
  17. These 3 class III drugs are all associated with Long QT syndrome.
    What are sotalol, dofetilide, and ibutilide?
  18. Dofetilide is approved for _____ AF, while ibutilide is approved for _____ AF.
    • Chronic
    • Acute
  19. Class IV Calcium channel blockers inhibit these, while prolonging the PR interval.
    What are the SA and AV nodes?
  20. Digoxin inhibits this transporter while increasing vagal tone.
    What is the Na+/K+/ATP-ase?
  21. To counteract severe toxicities of digoxin, one would administer this agent.
    What is digibind?
  22. Although its mechanism is unknown, magnesium sulfate's clinical use is this.
    Acute treatment of torsades de pointes.
  23. _____ has a very short half-life (<5 sec) and can result in brief episodes of asystole and dyspnea.  

    What class does this agent belong to?
    Adenosine (Adenocard)

    Miscellaneous: adenosine receptor agonist
  24. Adenosine is clinically used for this purpose.
    What is acute treatment of AV nodal reentry?
  25. Name 3 adverse events associated with digoxin.
    • GI problems
    • Vision problems
    • Cognitive dysfunction
    • Arrhythmias
    • Sinus bradycardia and AV block
  26. 40% of patients taking this drug discontinue therapy within the first 6 months because of side effects such as hypotension and nausea.
    What is procainide?