Drugs for Tachycardia
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Questions and Answers

What is the mechanism of action for direct thrombin inhibitors like Dabigatran?

  • Inhibit thrombin (correct)
  • Inhibit Factor X directly
  • Activate antithrombin III
  • Inhibit platelet activation via P2Y12 receptors

    • Which of the following anticoagulants is a direct inhibitor of Factor X?

  • Warfarin
  • Xaban (correct)
  • Heparin
  • Dabigatran

    • What is a significant adverse drug reaction associated with Clopidogrel?

  • Increased blood pressure
  • Renal impairment
  • Synergistic bleeding (correct)
  • Pulmonary embolism

    • Which condition is a therapeutic use for administering direct thrombin inhibitors?

    <p>Atrial fibrillation</p> Signup and view all the answers

    Which of the following P2Y12 antagonists is a prodrug and ineffective in poor metabolizers?

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

    Which drug acts as a selective Beta-1 adrenoreceptor agonist and is used for heart failure?

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

    What is a contraindication of Warfarin?

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

    Which drug method of action involves inhibiting the enzyme phosphodiesterase to elevate cAMP levels?

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

    Calcium Channel Blockers are effective for which type of angina?

    <p>Variant angina</p> Signup and view all the answers

    What is a common adverse effect associated with sympathomimetic amines used in heart failure?

    <p>Lactic acid buildup</p> Signup and view all the answers

    Which type of drug inhibits the production of active vitamin K and is described as a 'Vitamin K antagonist'?

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

    What distinguishes Nicorandil from other nitrate alternatives?

    <p>Causes hyperpolarisation</p> Signup and view all the answers

    Which calcium channel blocker is noted for having a long duration of action and is often used when beta-blockers are ineffective?

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

    What is the mechanism of action of Alteplase?

    <p>Activates plasminogen to degrade fibrin</p> Signup and view all the answers

    For which condition is Tranexamic acid primarily used?

    <p>Heavy menstrual cycle</p> Signup and view all the answers

    Which of the following is a contraindication for Statins?

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

    What is the adverse effect associated with the use of Statins?

    <p>Increased liver enzymes</p> Signup and view all the answers

    What therapeutic use is indicated for Eptifibatide?

    <p>Cardiac surgery</p> Signup and view all the answers

    What mechanism does Ezetimibe utilize to lower cholesterol levels?

    <p>Cholesterol transport inhibition</p> Signup and view all the answers

    Which of the following is a common adverse effect of Fibrinolytics?

    <p>Bleeding complications</p> Signup and view all the answers

    What is a key property of Aspirin's action on platelets?

    <p>Irreversible inhibition of COX-1</p> Signup and view all the answers

    What is a therapeutic use of Streptokinase?

    <p>Post myocardial infarction treatment</p> Signup and view all the answers

    Which of the following agents is known to stimulate vWF release?

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

    What is the primary mechanism of action of Diltiazem?

    <p>Blocks Ca2+ (L-type)</p> Signup and view all the answers

    Which type of cardiac drug is Digoxin classified as?

    <p>Na+/K+ pump inhibitor</p> Signup and view all the answers

    In what condition is Adenosine primarily indicated for use?

    <p>Acute supraventricular tachycardia</p> Signup and view all the answers

    What is a contraindication for the use of Digoxin?

    <p>Ventricular tachycardias</p> Signup and view all the answers

    What is a common adverse effect of Adenosine administration?

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

    What effect does Diltiazem have on the myocyte action potential?

    <p>Decreases the amplitude of AP</p> Signup and view all the answers

    What is the action of IV Atropine in cardiac conditions?

    <p>Non-specific muscarinic antagonist</p> Signup and view all the answers

    Which drug is known for causing a risk of developing tolerance with prolonged use?

    <p>Glyceryl Trinitrate</p> Signup and view all the answers

    What therapeutic use is associated with IV Dobutamine?

    <p>Increase heart rate</p> Signup and view all the answers

    Which of the following represents an effects of negative inotropy caused by Diltiazem?

    <p>Decreased force of contraction</p> Signup and view all the answers

    What is the main mechanism of action for Class 1b drugs?

    <p>Block Na+ channels</p> Signup and view all the answers

    Which of the following is a contraindication for the use of Amiodarone?

    <p>Thyroid dysfunction</p> Signup and view all the answers

    Which drug is an example of a Class 1c antiarrhythmic?

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

    What therapeutic effect does Verapamil provide?

    <p>Reduces myocardial contractility</p> Signup and view all the answers

    Class lll drugs are primarily known to block which type of channels?

    <p>K+ channels</p> Signup and view all the answers

    Which of the following adverse effects is commonly associated with Sotalol?

    <p>Fatigue and dizziness</p> Signup and view all the answers

    What effect does Amiodarone have on heart rate relative to its mechanism of action?

    <p>It decreases heart rate</p> Signup and view all the answers

    What defines the therapeutic use of Class 1a drugs?

    <p>Control ventricular rate during atrial fibrillation</p> Signup and view all the answers

    Which of the following statements about Class 1 drugs is incorrect?

    <p>All Class 1 drugs block K+ channels</p> Signup and view all the answers

    What adverse effect may arise from the use of Class 1c antiarrhythmic drugs?

    <p>Heart block</p> Signup and view all the answers

    Study Notes

    Drugs for Tachycardia

    • Class 1a drugs (discontinued): Quinidine, Procainamide, Disopyramide

      • Mechanism of action: Slows down myocardial depolarization during phase 1
      • Use: Atrial/ventricular tachycardia
      • Contraindications: Avoid in people with hypotension and low ventricular output
      • Adverse effects: High risk of Torsades de pointes (TdP), heart attack, anti-cholinergic side effects (urinary retention, urinary hypertension). Negative inotropic effect (reduces contractility)

    • Class 1b drugs: Lidocaine

      • Mechanism of action: Blocks sodium channels
      • Use: Effective at very fast heart rates (ventricular tachycardia)
      • Administered: IV
      • Adverse effects: Low effect on atrial tachycardia

    Drugs for Tachycardia (Class 1c)

    • Flecainide:

      • Mechanism of action: Rapid dissociation
      • Use: Atrial fibrillation and ventricular tachycardia
      • Administered: Orally
      • Adverse effects: Low effect at atrial tachycardia, potentially harmful in myocardial infarction

    • Tocainide (discontinued):

      • Mechanism of action: Rapid dissociation
      • Use: Ventricular tachycardia, atrial fibrillation
      • Administered: Orally
      • Adverse effects: Low effect on atrial tachycardia

    • Propafenone:

      • Mechanism of action: Blocks Ca2+ channels
      • Use: Atrial fibrillation and ventricular tachycardia
      • Administered: Orally
      • Adverse effects: Potentially harmful in myocardial infarction (MI)

    Class II drugs

    • Mechanism of Action: Blocks Ca2+ channels.
    • Examples: Atenolol, Metoprolol, Propanolol
    • Use: Reduce arrhythmias, given post-MI
    • Contraindications: Asthma
    • Adverse effects: Hypotension, fatigue, dizziness, peripheral vasoconstriction

    Class III drugs

    • Mechanism of Action: Block K+ channels, extending both nodal and effective refractory periods.
    • Examples: Amiodarone
    • Use: Effective for slow heart rates, atrial fibrillation and ventricular tachycardia.
    • Contraindications: Bradycardia
    • Adverse Effects: Extremely toxic, thyroid dysfunction, Torsades de Pointes (TdP)

    Class IV drugs

    • Mechanism of Action: Blocks Ca2+ (L-type) channels, decreasing nodal AP amplitude and increasing nodal AP duration.
    • Examples: Verapamil, Diltiazem.
    • Use: Atrial fibrillation, paroxysmal supraventricular tachycardia, dilation of blood vessels.
    • Contraindications: Ventricular tachycardia
    • Adverse effects: Hypotension, dizziness, edema, constipation, Due to: shortens myocyte AP

    Drugs for Bradycardia

    • IV Atropine: Non-specific muscarinic antagonist
    • IV Adrenaline: Non-specific adrenergic agonist, primarily acts on Beta-1 receptors.
    • IV Dopamine: Acts on Beta-1 receptors in the heart.
    • IV Dobutamine: Slightly selective for Beta-1 receptors over Beta-2.

    Cardiac Drugs (Angina)

    • Glyceryl Trinitrate(GTN): Reduces O2 via vasodilation. Used for acute angina. Avoid liver metabolism tablet
    • Beta Blockers (e.g., Propranolol): Inhibits adrenaline & sympathetic nervous system on heart. Improves left ventricular end-diastolic volume and decreases ventricular mass. Used for treating angina.

    Other Beta-Blockers

    • Atenolol: 30-fold selectivity, water soluble.
    • Bisoprolol: 75-fold selectivity, water soluble.

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    Description

    This quiz covers different classes of drugs used to treat tachycardia, including the mechanisms of action, uses, contraindications, and adverse effects of Class 1a, 1b, and 1c drugs. It is essential for understanding pharmacological approaches to tachycardia management.

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