BMS 204 Pharmacology: Dyrrhythmia Drug Therapy
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Questions and Answers

What are the four classes of anti-arrhythmic drugs according to Vaughan-Williams classification?

  • Class Ia, Class Ib, Class Ic, Class II
  • Class I, Class II, Class IV, Class V
  • Class I, Class IIA, Class IIB, Class III
  • Class I, Class II, Class III, Class IV (correct)

What is the term for the rapid influx of calcium ions during the action potential in calcium-dependent cells?

Depolarization

What does the term 'automaticity' refer to in the context of cardiac cells?

The ability of cardiac cells to generate electrical impulses on their own

Class Ia antiarrhythmic drugs have a minimal effect on conduction.

<p>False (B)</p> Signup and view all the answers

Which of the following is NOT a class Ia antiarrhythmic drug?

<p>Lidocaine (C)</p> Signup and view all the answers

What is the primary adverse effect associated with Procainamide?

<p>Lupus-like syndrome</p> Signup and view all the answers

Which class of antiarrhythmic drugs is known for blocking beta-adrenergic receptors?

<p>Class II (A)</p> Signup and view all the answers

What ECG findings are characteristic of Class Ia agents?

<p>Prolonged QRS interval (C), Prolonged PR interval (D)</p> Signup and view all the answers

What is the primary clinical use of Lidocaine?

<p>Treatment of ventricular arrhythmias</p> Signup and view all the answers

Lidocaine is the most cardiotoxic antiarrhythmic drug.

<p>False (B)</p> Signup and view all the answers

Class Ic antiarrhythmic drugs have a marked effect on conduction.

<p>True (A)</p> Signup and view all the answers

What is the primary adverse effect associated with Propafenone?

<p>Bronchospasm</p> Signup and view all the answers

What effect do Class IV antiarrhythmic drugs have on the heart?

<p>Block calcium channels (B)</p> Signup and view all the answers

What is the most common class of antiarrhythmic drugs used for maintenance in patients with atrial fibrillation?

<p>Class III</p> Signup and view all the answers

Amiodarone is a cumulative drug with a short half-life.

<p>False (B)</p> Signup and view all the answers

What is one of the most notable adverse effects associated with Amiodarone?

<p>Pulmonary toxicity</p> Signup and view all the answers

Adenosine is a short-acting antiarrhythmic drug with a half-life of approximately 15 seconds.

<p>True (A)</p> Signup and view all the answers

What is the primary mechanism by which Adenosine exerts its antiarrhythmic effects?

<p>Hyperpolarization</p> Signup and view all the answers

Adenosine is contraindicated in patients with asthma.

<p>True (A)</p> Signup and view all the answers

Digoxin is an effective antiarrhythmic for both atrial and ventricular arrhythmias.

<p>False (B)</p> Signup and view all the answers

In the setting of atrial fibrillation, which class of antiarrhythmics are commonly used for rate control?

<p>Class III (A)</p> Signup and view all the answers

Beta-blockers are contraindicated in patients with heart failure.

<p>False (B)</p> Signup and view all the answers

Class Ib antiarrhythmic drugs are effective for both atrial and ventricular arrhythmias.

<p>False (B)</p> Signup and view all the answers

Prolonged QT interval is associated with an increased risk of Torsades de Pointes.

<p>True (A)</p> Signup and view all the answers

Which of the following antiarrhythmic drugs has the highest risk of Torsades de Pointes?

<p>Sotalol (A)</p> Signup and view all the answers

What is the term for the delay between the initiation of an action potential and the time when the cell can be re-excited?

<p>Effective refractory period (ERP)</p> Signup and view all the answers

What is the term for the time it takes for a cell to return to its resting membrane potential after an action potential?

<p>Action potential duration (APD)</p> Signup and view all the answers

Flashcards

Bradyarrhythmia

Heart rhythm abnormality characterized by a heart rate below 60 beats per minute.

Tachyarrhythmia

Heart rhythm abnormality characterized by a heart rate above 90 beats per minute.

Antiarrhythmic drugs

Drugs used to treat abnormal heart rhythms.

Class I antiarrhythmics

Antiarrhythmic drugs that block sodium channels.

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Class Ia antiarrhythmics

Antiarrhythmic drugs that moderately block sodium channels, affecting conduction and prolonging action potential duration.

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Class Ib antiarrhythmics

Antiarrhythmic drugs that minimally block sodium channels, and have minimal effects on action potential duration.

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Class Ic antiarrhythmics

Antiarrhythmic drugs that markedly block sodium channels while having minimal effect on action potential duration. Also, they have marked effects on conduction.

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Class II antiarrhythmics

Antiarrhythmic drugs that are beta-blockers.

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Class III antiarrhythmics

Antiarrhythmic drugs that block potassium channels, prolonging action potential duration.

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Class IV antiarrhythmics

Antiarrhythmic drugs that block calcium channels.

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Digoxin

A drug that can be used in atrial fibrillation treatment.

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Lidocaine

A drug used specifically in ventricular arrhythmias.

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Vaughan Williams classification

A system for classifying antiarrhythmic drugs based on their electrophysiological effects.

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Study Notes

Vaughan-Williams Classification of Antiarrhythmic Drugs

  • Class Ia: Sodium channel blockers with intermediate effects on conduction and repolarization
  • Class Ib: Sodium channel blockers with short-acting, minimal effects on conduction and repolarization
  • Class Ic: Sodium channel blockers with marked effects on conduction, prolonging repolarization
  • Class II: Beta-adrenergic receptor blockers
  • Class III: Potassium channel blockers that prolong repolarization
  • Class IV: Calcium channel blockers

Calcium Influx

  • The term “calcium influx” refers to the rapid influx of calcium ions (Ca++) during the action potential in calcium-dependent cells. This calcium influx plays a crucial role in the contraction of heart muscle cells.

Automaticity

  • Automaticity refers to the inherent ability of cardiac cells to generate their own electrical impulses. This property allows the heart to beat spontaneously and rhythmically.
  • In the context of cardiac cells, automaticity relates to their ability to self-depolarize and fire action potentials without external stimulation.

Class Ia Antiarrhythmics

  • Have minimal effect on conduction
  • Examples: Quinidine, Procainamide, Disopyramide

Procainamide

  • Primary adverse effect: Lupus-like syndrome

Beta-Blockers

  • Class II antiarrhythmics are known for blocking beta-adrenergic receptors.
  • Examples: Propranolol, metoprolol, atenolol

ECG Findings of Class Ia Agents

  • Prolonged QT interval
  • Widened QRS complex
  • Reduced heart rate

Lidocaine

  • It's used primarily for the treatment of ventricular arrhythmias.
  • It's the most cardiotoxic antiarrhythmic drug.

Class Ic Antiarrhythmics

  • Marked effect on conduction
  • Examples: Flecainide, Propafenone

Propafenone

  • Primary adverse effect: Bradycardia, heart block

Class IV Antiarrhythmics

  • Examples: Verapamil, Diltiazem
  • They have a negative inotropic effect, meaning they reduce the force of contraction of the heart muscle.
  • They also slow the heart rate.

Atrial Fibrillation

  • Most common class of antiarrhythmics used for maintenance: Class III (potassium channel blockers)
  • Examples: Amiodarone, Sotalol, Dronedarone

Amiodarone

  • Notable adverse effects: Pulmonary toxicity, thyroid dysfunction

Adenosine

  • Primary mechanism of action: It stimulates adenosine receptors in the heart, slowing down the rate of depolarization and reducing conduction velocity.
  • Contraindicated in patients with asthma: Because it can trigger bronchospasm.

Digoxin

  • Not effective for all arrhythmias: It's only effective for atrial arrhythmias, not ventricular arrhythmias

Rate Control in Atrial Fibrillation

  • Commonly used: Beta-blockers and Calcium Channel Blockers (Class IV antiarrhythmics)
  • Note: Beta-blockers are contraindicated in patients with heart failure.

Class Ib Antiarrhythmics

  • Effective for both atrial and ventricular arrhythmias
  • Examples: Lidocaine, Mexiletine, Tocainide

Torsades De Pointes

  • Most common antiarrhythmic drug associated with Torsades de Pointes: Dofetilide

Repolarization

  • Refractory period: The delay between the initiation of an action potential and the time when the cell can be re-excited.
  • Repolarization: The time it takes for a cell to return to its resting membrane potential after an action potential.

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Description

This quiz focuses on the drug therapy for dyrrhythmias covered in BMS 204 Pharmacology. Students will explore classifications of antiarrhythmic drugs, their applications in treating various arrhythmias, and the specific uses of digoxin and lidocaine. Understanding the adverse effects of these agents is also integral to this study.

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