Mastering Antiarrhythmic Drug Therapy
92 Questions
0 Views

Mastering Antiarrhythmic Drug Therapy

Created by
@WondrousGrowth

Podcast Beta

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which ions are of primary importance in the action of antiarrhythmic drugs?

  • Na+
  • Ca++
  • K+
  • All of the above (correct)

    • What is the pharmacological goal of antiarrhythmic drug therapy?

  • To increase ectopic pacemaker activity
  • To produce minimum side effects
  • To modify critically impaired conduction (correct)
  • To increase mortality

    • What is the ideal characteristic of an antiarrhythmic drug in terms of its effect on different tissues?

  • To decrease mortality
  • To be more effective on normally depolarizing tissues
  • To produce maximum side effects
  • To be more effective on ectopic pacemaker and depolarized tissues (correct)

    • How does the Singh-Vaughn Williams system classify antiarrhythmic drugs?

    <p>By their effect on ion channels</p> Signup and view all the answers

    What is the effect of many of the drugs presently available for treating arrhythmias?

    <p>They increase mortality</p> Signup and view all the answers

    What leads to differential sensitivity to antiarrhythmic drugs?

    <p>Differential expression of ion channels, particularly Na+ channels</p> Signup and view all the answers

    What is the mechanism of action of antiarrhythmic drugs?

    <p>Altering ion fluxes within excitable tissues</p> Signup and view all the answers

    What is the ideal characteristic of an antiarrhythmic drug in terms of side effects?

    <p>To produce minimum side effects</p> Signup and view all the answers

    Which subclass of Class I drugs has the highest potency as sodium channel blockers and prolongs repolarization?

    <p>Subclass IA</p> Signup and view all the answers

    Which subclass of Class I drugs has the lowest potency as sodium channel blockers and may shorten repolarization (decrease QT interval)?

    <p>Subclass IB</p> Signup and view all the answers

    Which subclass of Class I drugs is the most potent sodium channel blocking agents (prolong QRS interval) and has little effect on repolarization (no effect on QT interval)?

    <p>Subclass IC</p> Signup and view all the answers

    Which class of antiarrhythmic drugs act indirectly on electrophysiological parameters by blocking beta-adrenergic receptors?

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

    Which class of antiarrhythmic drugs prolongs repolarization, increases refractoriness, and has no effect on QRS interval?

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

    Which class of antiarrhythmic drugs are relatively selective AV nodal L-type calcium-channel blockers and slow sinus rhythm?

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

    Which of the antiarrhythmic drugs have minimal effects on AV node depolarization?

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

    Which class of antiarrhythmic drugs is not included in the standard classes?

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

    Which class of antiarrhythmic drugs binds most strongly when the Na+ channels are open and is termed 'use dependent'?

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

    Which class of antiarrhythmic drugs is involved in blocking some of the K+ channels involved in repolarisation?

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

    Which class of antiarrhythmic drugs acts by blocking the fast inward sodium channel?

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

    Which class of antiarrhythmic drugs acts indirectly on electrophysiological parameters by blocking beta-adrenergic receptors?

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

    Which class of antiarrhythmic drugs blocks the fast outward potassium current?

    <p>Amiodarone, sotalol, dofetilide</p> Signup and view all the answers

    Which of the antiarrhythmic drugs blocks the slow inward sodium current?

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

    Which class of antiarrhythmic drugs blocks the sodium channels preferentially in refractory phase?

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

    Which class of antiarrhythmic drugs associate and dissociate very slowly from the sodium channels?

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

    Which class of antiarrhythmic drugs extends the duration of the action potential?

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

    Which class of antiarrhythmic drugs blocks voltage dependent calcium channels?

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

    Which class of antiarrhythmic drugs inhibits conduction through the Bundles of His and Purkinje fibers, thus prolonging QRS complex?

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

    Which class of antiarrhythmic drugs impairs impulse propagation in nodal and damaged areas?

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

    Which class of antiarrhythmic drugs blocks the slow inward sodium current?

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

    Which class of antiarrhythmic drugs prolongs repolarization and increases refractoriness?

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

    Which class of antiarrhythmic drugs has little preference for refractory channels?

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

    Which class of antiarrhythmic drugs reduces the force of contraction?

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

    Which adverse effect of chronic amiodarone use is fatal in 10% of patients?

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

    What is the incidence of hyperthyroidism and hypothyroidism in patients on chronic amiodarone?

    <p>2-24%</p> Signup and view all the answers

    What adverse effect of chronic amiodarone use can result in blue-gray skin color?

    <p>Dermatological reactions</p> Signup and view all the answers

    What adverse effect of chronic amiodarone use can interfere with vision?

    <p>Corneal micro deposits</p> Signup and view all the answers

    How often are clinical assessments and chest x-rays required in patients on chronic amiodarone?

    <p>Every 3 months</p> Signup and view all the answers

    What is the mean elimination half-life of amiodarone?

    <p>26-107 days</p> Signup and view all the answers

    What percentage of patients on chronic amiodarone develop hepatotoxicity, (looking for the percent of patients that have elevated serum liver enzyme?

    <p>30%</p> Signup and view all the answers

    What adverse effect of chronic amiodarone use has an incidence of 20-40% but is reversible by lowering dose?

    <p>Peripheral neuropathy</p> Signup and view all the answers

    Which drug, although formally classified as class III antiarrhythmic, it has multiple actions and is more appropriately considered a 'broad spectrum' antiarrhythmic?

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

    What is the approved use of amiodarone?

    <p>To treat refractory life-threatening ventricular arrhythmias</p> Signup and view all the answers

    What makes amiodarone a good drug when compared to other class III agents?

    <p>ts potential to cause proarrhythmias (torsades) is significantly lower than other Class III agents.</p> Signup and view all the answers

    Which antiarrhythmic drug is superior to lidocaine for the treatment of ventricular fibrillation?

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

    What is a potential risk of using amiodarone for chronic therapy?

    <p>All of the above</p> Signup and view all the answers

    Which patients should not use Flecainide (class IC) as an antiarrhythmic drug?

    <p>All of the above</p> Signup and view all the answers

    What is the effect of Flecainide on ventricular function?

    <p>It lowers ventricular function in most patients</p> Signup and view all the answers

    Which antiarrhythmic drug has consistently decreased mortality in many clinical trials?

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

    Which patients should Flecainide be used with caution in?

    <p>All of the above</p> Signup and view all the answers

    How long does it take to achieve steady-state plasma levels of amiodarone without loading doses?

    <p>Several weeks - months</p> Signup and view all the answers

    What is the primary use of flecainide?

    <p>Treating supraventricular arrhythmias and documented life-threatening ventricular arrhythemias</p> Signup and view all the answers

    Which class of antiarrhythmic drugs is flecainide classified under?

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

    What is the primary mechanism of action of flecainide?

    <p>Blocking sodium channels</p> Signup and view all the answers

    Which antiarrhythmic drug is specifically used for symptomatic supraventricular arrhythmias?

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

    Which class of antiarrhythmic drugs does procainamide belong to?

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

    What is the major metabolite of procainamide?

    <p>N-acetylprocainamide (NAPA)</p> Signup and view all the answers

    What percentage of the population are fast acetylators of procainamide?

    <p>50%</p> Signup and view all the answers

    What is the recommended initial dosing of procainamide when given orally?

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

    What percentage of patients discontinue procainamide therapy within 6 months due to side effects?

    <p>40%</p> Signup and view all the answers

    What percentage of patients develop a lupus-like syndrome with procainamide therapy?

    <p>Between 15 and 20%</p> Signup and view all the answers

    What are the early warning symptoms of the lupus-like syndrome associated with procainamide therapy?

    <p>Mild arthralgia</p> Signup and view all the answers

    What is the major metabolite of procainamide and what class of antiarrhythmic actions does it have?

    <p>N-acetylprocainamide (NAPA), Class III actions</p> Signup and view all the answers

    What types of arrhythmias is procainamide effective against?

    <p>Both supraventricular and ventricular arrhythmias</p> Signup and view all the answers

    Which class of antiarrhythmic drugs is lidocaine and mexiletine classified under?

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

    What is the primary route of administration for lidocaine for arrhythmias?

    <p>Intravenous (IV)</p> Signup and view all the answers

    Which drug is recommended before lidocaine for the treatment of ventricular fibrillation or pulseless ventricular tachycardia according to ECC/AHA 2000 guidelines?

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

    Which antiarrhythmic drug can be used in patients with a history of torsades or DILQTs?

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

    What is the primary use of lidocaine and mexiletine?

    <p>Treatment of acute, life-threatening ventricular arrhythmias</p> Signup and view all the answers

    What are the most frequent side effects of lidocaine and mexiletine?

    <p>Central nervous system (CNS) effects</p> Signup and view all the answers

    Which drug can cause severe interactions when co-administered with lidocaine or mexiletine?

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

    Which class of antiarrhythmic drugs is more effective than digoxin in controlling ventricular rate in patients with atrial fibrillation?

    <p>Verapamil and diltiazem Class IV</p> Signup and view all the answers

    What is the most common side effect of verapamil?

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

    Which combination of drugs can cause AV block or suppression of SA node when used with high doses of verapamil or diltiazem?

    <p>All of the above</p> Signup and view all the answers

    Which patients should be cautious when using verapamil or diltiazem?

    <p>All of the above</p> Signup and view all the answers

    What can happen if verapamil or diltiazem are administered to patients with atrial tachycardias resulting from WPW?

    <p>Worsen the arrhythmia</p> Signup and view all the answers

    What is a contraindication for using verapamil or diltiazem?

    <p>All of the above</p> Signup and view all the answers

    Which drug is known to increase the plasma concentrations of verapamil?

    <p>Grapefruit juice</p> Signup and view all the answers

    Which of the antiarrhythmic drugs is ineffective for prophylaxis of arrhythmias in post-MI patients?

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

    What can high doses of verapamil or diltiazem cause in terms of AV and SA node function?

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

    Which class of antiarrhythmic drugs is indicated for premature atrial, nodal or ventricular depolarization?

    <p>No drug therapy indicated</p> Signup and view all the answers

    What is the drug therapy indicated for atrial fibrillation, flutter, and PSVT?

    <p>Class II and IV</p> Signup and view all the answers

    Which arrhythmia should AV nodal blockers be avoided in?

    <p>Wolff-Parkinson-White syndrome</p> Signup and view all the answers

    Which class of antiarrhythmic drugs is indicated for ventricular tachycardia with remote myocardial infarction?

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

    Which drugs are indicated for ventricular fibrillation?

    <p>Lidocaine and amiodarone</p> Signup and view all the answers

    What is the acute treatment for Torsades de pointes?

    <p>Magnesium and Isoproterenol</p> Signup and view all the answers

    What is the chronic treatment for Torsades de pointes?

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

    What are the therapeutic considerations for antiarrhythmic drug therapy?

    <p>The benefits of therapy may be difficult to establish</p> Signup and view all the answers

    Which patients are most likely to benefit from antiarrhythmic drug therapy?

    <p>Patients with no symptoms at all</p> Signup and view all the answers

    What should be eliminated before starting antiarrhythmic drug therapy?

    <p>All of them</p> Signup and view all the answers

    Which statement about currently available antiarrhythmic drugs is most accurate?

    <p>They are often unpredictable and ineffective</p> Signup and view all the answers

    What should be considered when choosing an antiarrhythmic drug?

    <p>The benefits vs risks of treatment</p> Signup and view all the answers

    What is the therapeutic index of most antiarrhythmic drugs?

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

    More Like This

    Mastering Options Greeks
    24 questions

    Options Trading Quiz: Mastering Greeks

    UnfetteredHawkSEye avatar
    UnfetteredHawkSEye
    Mastering Antiarrhythmic Medications
    10 questions

    Mastering Antiarrhythmic Medications

    HappierMossAgate avatar
    HappierMossAgate
    Mastering Vaughan Williams Classification and Antiarrhythmics
    34 questions

    Vaughan Williams Classification Quiz and Flashcards

    AlluringHummingbird5874 avatar
    AlluringHummingbird5874
    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser