Antiarrhythmics

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Author:
jaime.davenport
ID:
240329
Filename:
Antiarrhythmics
Updated:
2013-10-13 12:44:02
Tags:
antiarrythmics
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Description:
Pharm Midterm Fall 2013
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  1. What is the only drug used exclusively for arrhythmias?
    Amiodarone - potassium channel blocker

    -can also use BB
  2. Sodium channel blockers act on _______ of the action potential
    depolarization
  3. Which class is amiodarone
    Potassium channel blocker
  4. Indications for antiarrhythmics
    • Paroxysmal SVT
    • A-fib
    • PVC's
  5. Antiarrhythmic drugs MOA
    act to reduce electrical irregularity of the heart
  6. MOA sodium channel blockers (class I drugs)
    • depress rapid depolarization (phase 0) of the action potential. 
    • Slow conduction by lengthening the refractory period of the atrial and ventricle myocardium.
    • BY DEPRESSING THE INWARD FLOW OF SODIUM.
  7. MOA for BB (class II drugs)
    Inhibit sympathetic stimulations (epi and nor-epi)
  8. MOA potassium channel blockers (class III drugs)
    • Prolong phase 3 repolarization (outward flow of potassium) by blocking potassium channels
    • Prolongs QT interval, increases risk of torsades
  9. MOA CCB (class IV drugs)
    Inhibit Calcium influx through slow channels into conductile and contractile myocardial cells and vascular smooth muscle cells.
  10. Prophylaxis of PSVT
    1st line
    2nd line
    digoxin or BB

    Verapamil is 2nd line tx (verapamil will increase dig levels)
  11. Verapamil increases _______ levels
    serum dig
  12. Afib and treatment prevention of thrombemboic events
    Warfarin is treatment of choice especially in patients of 70
  13. Long term amiodarone use increases patient risk of _______?
    Pulmonary fibrosis
  14. What is the main cause of amiodarone associated deaths
    pulmonary toxicity
  15. Goal of treatment with arrhythmias
    to prevent potentially fatal arrhythmias or prevent symptoms

    Total elimination of irregular beats is unrealistic.
  16. Treatment principles of amiodarone
    WATCH FOR PULMONARY TOXICITY

    • Obtain baseline chest xray and PFT's
    • Thyroid panel
    • liver panel 2x a year
    • eye exam yearly
    • DO NOT GIVE WITH BRADYCARDIA OR 2ND OR 3RD DEGREE HEART BLOCKS.
  17. What has occurred in 10-17% of patients on amiodarone at doses of 400 mg/d
    hypersensitivity pneumonitis or interstitial alveolar pneumonitis
  18. PVC treatment
    quinidine, procainamide, BB, amiodarone
  19. Afib/aflutter treatment
    Dig, BB, verapamil, anticoagulants
  20. Teach patient to do what if on anti arrhythmic drugs
    Wear medical alert bracelet indicating they are on an antiarrythmic drug
  21. First sign of dig toxicity
    • anorexia, nv
    • Report any halo around objects, nausea, decreased appetite, and extreme fatigue

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