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Questions and Answers
What is the primary action of Class I anti-dysrhythmic drugs?
Amiodarone is only approved for life-threatening __________ dysrhythmias.
ventricular
What is a common side effect of Quinidine?
Cinchonism
Class II agents include sodium channel blockers.
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Which drug can double digoxin levels?
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What is the treatment of choice for ventricular dysrhythmias?
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Which of the following are indications for the use of Mexiletine?
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Calcium channel blockers are used for atrial fibrillation.
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What are common side effects of Class II beta blockers?
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Digoxin decreases conduction in the AV node and prolongs the __________ interval.
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Which medication is used for cardioversion that can be administered IV?
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Study Notes
Anti-Dysrhythmic Drugs
Class I: Sodium Channel Blockers
- Divided into three subcategories: IA, IB, and IC
- IA: Quinidine, slows impulse conduction in atria, ventricles, and Purkinje fibers
- IA: Quinidine, delays repolarization, suppresses dysrhythmias, widens QRS and prolongs QT interval
- IA: Quinidine, active against supraventricular and ventricular dysrhythmias, indicated for long-term suppression
- IA: Quinidine, adverse effects include cinchonism, cardiotoxicity, and can double digoxin levels
- IB: Mexiletine, oral analogue of lidocaine, used for symptomatic ventricular dysrhythmias
- IB: Mexiletine, eliminated by hepatic metabolism, prolonged effects in liver patients, adverse effects include GI, neurologic, and can exacerbate HF
- IC: Flecainide and propafenone
Class II: Beta Blockers (BB)
- Examples include propranolol, acebutolol, esmolol, and sotalol
- Prolong QT, decrease Ca entry, and can cause HF, AV block, sinus arrest, hypotension, and bronchospasm
Class III: Potassium Channel Blockers
- Example: Amiodarone, used for life-threatening ventricular dysrhythmias, atrial and ventricular dysrhythmias
- Amiodarone, toxicity can continue for weeks-months after discontinuation, requires medication guide
- Amiodarone, adverse effects include pulmonary toxicity, liver toxicity, thyroid toxicity, and requires regular monitoring of CXR, TSH, and LFTs
- Amiodarone, widens QRS and prolongs QT and PR
Class IV: Calcium Channel Blockers (CCB)
- Examples include verapamil and diltiazem
- Used for afib or flutter, and SVT, adverse effects include bradycardia, AV block, HF, hypotension, peripheral edema, and constipation
- Elevate digoxin levels, can cause bradycardia, AV block, and HF when given with BB
Others
- Adenosine, digoxin, and ibutilide
- Digoxin, decreases conduction in AV, prolongs PR interval, and decreases automaticity in SA
- Digoxin, used only for supraventricular dysrhythmias, risk increased with hypokalemia
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Description
This quiz covers Class I anti-dysrhythmic drugs, specifically sodium channel blockers, including quinidine and its effects on the heart. Topics include impulse conduction, repolarization, and dysrhythmia suppression.
