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Antiarrhythmic: miscellaneous group; parenteral only. Hyperpolarizes A V nodal tissue, blocks conduction for 10– 15 s. Used for nodal reentry arrhythmias. Tox: hypotension, flushing, chest pain
Miscellaneous Group Antiarrhythmic: Hyperpolarizes AV nodal tissue, blocks conduction for 10–15 s. Used for nodal reentry arrhythmias. Parenteral only. Tox: hypotension, flushing, chest pain
Class I A (and other classes) antiarrhythmic: broad spectrum; blocks sodium, potassium, calcium channels, beta receptors. High efficacy and very long half-life (weeks to months). Tox: deposits in tissues; blueish skin coloration; hypo- or hyperthyroidism; pulmonary fibrosis; optic neuritis
Calcium channel blocker: Oral, parenteral administration. Intermediate in selectivity for cardiac vs vascular smooth muscle voltage-gated calcium channels. Used as a Group IV antiarrhythmic and for HTN and angina. See verapamil as prototype.Diltiazem, has more depressant effect on heart than dihydropyridines (eg, nifedipine) but has more effect on the vessels compared to verapamil.
Class IC antiarrhythmic prototype: blocks Na channels; no effect on myocyte action potential duration. Used in ventricular tachycardia and rapid atrial arrhythmias with Wolff-Parkinson-White syndrome. Tox: arrhythmogenic, CNS excitation. do not use as prophylaxis.
Group III antiarrhythmic: See amiodarone and sotalol. Available only for parenteral administration. Dofetilide is similar though only available for oral administration.
- Highly selective use-dependent group IB antiarrhythmic; blocks Na channels; shortens action potential duration in myocytes. IV only for acute post-MI ischemic ventricular arrhythmias. Tox: CNS excitation. Mexiletine: like lidocaine, but orally active antiarrhythmic.
- Amide local anesthetic, medium-duration amide prototype: used for nerve block
Miscellaneous Group antiarrhythmic: Poorly understood mechanism of action. Used parenterally for torsades de pointes arrhythmia and severe hypomagnesemia
Miscellaneous Group Antiarrhythmic: Increase in all K+ currents; decreased automaticity; decreased ventricular conduction
Group IA antiarrhythmic drug: Inhibits Na channels and prolongs myocyte action potential duration through K channel block. short half-life, metabolized by N- acetyltransferase. Similar to quinidine but more cardiodepressant and may cause a lupus-like syndrome esp. in slow acetylators.
Nonselective beta blocker prototype: Used in arrhythmias (Group 2), HTN, angina, migraine, hyperthyroidism, tremor. Tox: asthma, AV block, HF. Metoprolol is beta-1 selective beta blocker
- Group IA antiarrhythmic: used (rarely) in atrial and ventricular arrhythmias. Used intravenously in acute, severe malaria. Tox: cinchonism, GI upset, thrombocytopenic purpura, arrhythmogenic (torsades de pointes).
- Group III antiarrhythmic: blocks IK channels and β receptors. Used for atrial and ventricular arrhythmias. Tox: torsades de pointes arrhythmias. Others in group: amiodarone, ibutilide, dofetilide.
- Calcium channel blocker prototype: blocks L-type channels; cardiac depressant and vasodilator; used in HTN, angina, and arrhythmias (Group 4). Tox: AV block, HF, constipation, edema
- Diltiazem, like verapamil but diltiazem has more effect on vascular resistance
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