Mastering Esmolol
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Questions and Answers

Which drug is contraindicated in patients with prolonged QT interval and taking quinolone antibiotics that also prolong QT interval?

  • Procainamide (correct)
  • Disopyramide
  • Mexiletine
  • Lidocaine

    • Which drug requires dose adjustment in renal impairment due to its renal clearance?

  • Procainamide
  • Mexiletine
  • Disopyramide (correct)
  • Lidocaine

    • Which drug is used for acute management of ventricular arrhythmias during myocardial infarction or digoxin toxicity?

  • Procainamide
  • Disopyramide
  • Mexiletine
  • Lidocaine (correct)

    • Which drug is metabolized in the liver by CYP2D6 into inactive metabolites?

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

    Which medications are indicated in heart failure based on the neurohormonal model of HF?

    <p>Beta blockers and ACE inhibitors/ARBs</p> Signup and view all the answers

    Which types of heart failure patients should not receive beta blockers (BB)?

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

    Describe the mortality benefits of ACE inhibitors/ARBs in heart failure treatment.

    <p>Reduces cardiac remodeling, improves LV function, and reduces morbidity and mortality</p> Signup and view all the answers

    Which drug is contraindicated in patients with recent decompensation or NYHA class IV heart failure and chronic atrial fibrillation?

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

    Which drug is indicated for rapid conversion to normal sinus rhythm in paroxysmal supraventricular tachycardia?

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

    Which drug has a narrow therapeutic index and requires caution when used with 3A4 inhibitors/inducers?

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

    Which drug is the most frequent cause of drug-induced lupus?

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

    Which antiarrhythmic agent has a half-life of 40-60 days when taken orally?

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

    Which antiarrhythmic agent has a high incidence of QT prolongation and can cause pulmonary fibrosis at doses greater than 300mg/day?

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

    Which antiarrhythmic agent must be initiated in a setting with continuous EKG monitoring and ability to assess CrCl for 3 days?

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

    Which antiarrhythmic agent is indicated for recent onset Afib/flutter for rapid conversion to NSR and must be discontinued as soon as arrhythmia is terminated or prolonged QT interval occurs?

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

    Which medication in the Vaughan Williams Classification has the ability to control ventricular rate in patients with atrial fibrillation caused by enhanced sympathetic activity?

    <p>Class 2</p> Signup and view all the answers

    Which medication in the Vaughan Williams Classification has the ability to widen the QRS complex?

    <p>Class 1c</p> Signup and view all the answers

    Which medication in the Vaughan Williams Classification delays phase 3 repolarization, resulting in marked prolongation of action potential duration (APD) and refractory period?

    <p>Class 3</p> Signup and view all the answers

    Which medication in the Vaughan Williams Classification blocks L-type calcium channels in cardiac tissue, slowing AV and SA node conduction velocity and decreasing automaticity?

    <p>Class 4</p> Signup and view all the answers

    Which medication is contraindicated in patients with a history of angioedema?

    <p>ACE inhibitor</p> Signup and view all the answers

    What is the mechanism of action of SGLT2 inhibitors in heart failure?

    <p>Inhibits Na-glucose cotransporter 2 in the proximal renal tubules</p> Signup and view all the answers

    Which medication combination is indicated for African Americans with NYHA class III-IV heart failure who are still symptomatic despite optimal treatment with ACE inhibitors/ARBs/ARNi and beta blockers?

    <p>Isosorbide dinitrate/hydralazine</p> Signup and view all the answers

    What is the indication for ivabradine in heart failure patients?

    <p>Reduces risk of hospitalizations for worsening heart failure</p> Signup and view all the answers

    Which medication is contraindicated in patients with a blood pressure lower than 90/50 and has an effect on mortality?

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

    What is the mechanism of action of digoxin and its inotropic effects?

    <p>Inhibits Na-K-ATPase pump= increased CO (positive inotropy)</p> Signup and view all the answers

    What are the adverse drug reactions (ADRs) of digoxin and how are ADRs enhanced?

    <p>Dizziness, mental disturbances, HA, N/V/D; Enhanced by electrolyte abnormalities and drugs that decrease K and Mg levels</p> Signup and view all the answers

    Which medications are indicated for heart failure with reduced ejection fraction (HFrEF)?

    <p>ACE inhibitors/ARBs, beta blockers</p> Signup and view all the answers

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