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Questions and Answers
Which class of cardioactive drugs includes quinidine?
Which class of cardioactive drugs includes quinidine?
What is the primary therapeutic action of digoxin?
What is the primary therapeutic action of digoxin?
Which drug is used to treat ventricular arrhythmias in cases of acute myocardial infarction?
Which drug is used to treat ventricular arrhythmias in cases of acute myocardial infarction?
What is the half-life of digoxin in the average adult?
What is the half-life of digoxin in the average adult?
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What factor can influence the therapeutic actions and toxicities of digoxin?
What factor can influence the therapeutic actions and toxicities of digoxin?
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Which of the following drugs cannot be administered orally due to hepatic removal after absorption?
Which of the following drugs cannot be administered orally due to hepatic removal after absorption?
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What is the therapeutic level range for digoxin?
What is the therapeutic level range for digoxin?
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Which of the following side effects is not associated with digoxin toxicity?
Which of the following side effects is not associated with digoxin toxicity?
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Hyperthyroid individuals exhibit resistance to which drug?
Hyperthyroid individuals exhibit resistance to which drug?
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What is a common binding protein for lidocaine in the bloodstream?
What is a common binding protein for lidocaine in the bloodstream?
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What is the primary product of hepatic metabolism for the drug related to CNS depression?
What is the primary product of hepatic metabolism for the drug related to CNS depression?
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Which of the following drugs can cause a reversible lupus-like syndrome as a toxic effect?
Which of the following drugs can cause a reversible lupus-like syndrome as a toxic effect?
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What is the therapeutic range for Propranolol?
What is the therapeutic range for Propranolol?
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Which drug has a peak serum level that occurs 4-5 hours after an oral dose?
Which drug has a peak serum level that occurs 4-5 hours after an oral dose?
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What is a common toxic effect of Amiodarone?
What is a common toxic effect of Amiodarone?
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Which of the following drugs is primarily eliminated via renal filtration?
Which of the following drugs is primarily eliminated via renal filtration?
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What is the toxic level for Procainamide?
What is the toxic level for Procainamide?
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Which drug is primarily protein-bound and used for the treatment of arrhythmias?
Which drug is primarily protein-bound and used for the treatment of arrhythmias?
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What is the therapeutic level range for Quinidine?
What is the therapeutic level range for Quinidine?
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Which toxic effect is associated with higher concentrations of Disopyramide?
Which toxic effect is associated with higher concentrations of Disopyramide?
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Study Notes
Classification of Cardioactive Drugs
- Class I: Rapid sodium channel blockers (e.g., Quinidine, Procainamide, Lidocaine)
- Class II: Beta receptor blockers (e.g., Propranolol)
- Class III: Potassium channel blockers (e.g., Amiodarone)
- Class IV: Calcium channel blockers (e.g., Verapamil)
- Digoxin: Cardiac glycoside for atrial arrhythmia and CHF
Digoxin
- Therapeutic range: 0.5-2 ng/mL; toxic level: >2 ng/mL
- Inhibits Na-K-ATPase in high doses, causing decreased K+ and Mg2+, and increased Ca2+ for increased cardiac contractility
- Absorbed variably through the gastrointestinal tract (GIT); renal clearance affects serum concentration
- 25% protein-bound; free form sequestered into muscle cells
- Timing of blood sample critical for accurate drug level interpretation
- Half-life in adults: 38 hours; peak serum levels occur 8 hours post-oral dose
- Toxic effects include nausea, vomiting, visual disturbances, and AV node blockage
Lidocaine (Xylocaine)
- Used for treating ventricular arrhythmia, particularly in acute myocardial infarction
- Administered via continuous IV infusion following a loading dose; cannot be given orally due to hepatic extraction
- Protein-bound; primarily eliminated through hepatic metabolism
- Therapeutic level: 1.5-4.0 µg/mL; toxicity begins at >4.0 µg/mL
- Toxic effects include CNS depression, seizures, CHF, and heart block
Quinidine
- Naturally occurring drug for arrhythmia management; 85% protein-bound
- Delivered orally; common formulations are quinidine sulfate and gluconate
- Peak serum levels: 2 hours for sulfate, 4-5 hours for gluconate
- Therapeutic level: 2.3-5 µg/mL; toxicity level: >5 µg/mL
- Toxic effects include cinchonism, blood dyscrasia, and hepatitis
Procainamide (Pronestyl)
- Treats ventricular arrhythmia with rapid and complete GIT absorption
- 20% protein-bound; elimination through renal filtration and hepatic metabolism
- Peak serum level occurs one hour after dosing; therapeutic level: 4-10 µg/mL; toxic level: >12 µg/mL
- Toxic effects include reversible lupus-like syndrome, nephrotic syndrome, and urticaria
Disopyramide
- Substituted for quinidine in treating cardiac arrhythmias
- Given orally with complete and rapid absorption; shares anticholinergic effects (e.g., dry mouth, constipation)
- Therapeutic level: 3-5 µg/mL; toxic level: >10 µg/mL
- Toxic effects include bradycardia and AV node blockage
Propranolol
- A beta-receptor blocker for angina pectoris, hypertension, coronary artery disease, and thyrotoxicosis treatment
- Suppresses conversion of T4 to T3
- Therapeutic range: 50-100 ng/mL
- Toxic effects include bradycardia, arterial insufficiency (Raynaud's type), platelet disorders, and pharyngitis
Amiodarone (Cordarone)
- Blocks potassium channels; treats ventricular arrhythmias
- Iodine-containing drug; can induce hyperthyroidism or hypothyroidism
- Therapeutic level: 1.0-2.5 µg/mL; toxicity >2.5 µg/mL
- Toxic effects include bradycardia, hepatitis, photodermatitis, and thyroid dysfunction
Verapamil
- Used for angina, hypertension, and supraventricular arrhythmias
- Therapeutic range: 80-400 ng/mL
- Toxic effects may include hypotension, peripheral edema, and ventricular fibrillation
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Description
This quiz covers the classification and usage of cardioactive drugs, including their roles in treating arrhythmias and congestive heart failure (CHF). You will learn about the different classes of drugs and specific examples such as Quinidine and Amiodarone. Test your knowledge on these crucial pharmaceuticals and their therapeutic actions.
