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Questions and Answers
Which of the following is the preferred agent for preload reduction in severe heart failure?
Which of the following is the preferred agent for preload reduction in severe heart failure?
What is the endogenous source of B-type natriuretic peptide (BNP)?
What is the endogenous source of B-type natriuretic peptide (BNP)?
Which of the following drugs used in the management of heart failure is not associated with improved survival?
Which of the following drugs used in the management of heart failure is not associated with improved survival?
Which class of antiarrhythmic agents is contraindicated in patients with structural heart disease?
Which class of antiarrhythmic agents is contraindicated in patients with structural heart disease?
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Which medication is the drug of choice for pharmacologic cardioversion (conversion to normal sinus rhythm)?
Which medication is the drug of choice for pharmacologic cardioversion (conversion to normal sinus rhythm)?
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Which antianginal drug is indicated for stable and Prinzmetal's angina, but contraindicated in vasospastic angina?
Which antianginal drug is indicated for stable and Prinzmetal's angina, but contraindicated in vasospastic angina?
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Which medication is recommended for patients with NYHA Class II-IV heart failure to reduce hospitalizations and cardiovascular death?
Which medication is recommended for patients with NYHA Class II-IV heart failure to reduce hospitalizations and cardiovascular death?
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Which medication is indicated for patients who cannot tolerate ACE inhibitors/ARBs due to poor renal function/history of angioedema, or hyperkalemia?
Which medication is indicated for patients who cannot tolerate ACE inhibitors/ARBs due to poor renal function/history of angioedema, or hyperkalemia?
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Which medication is recommended as adjunct therapy for patients with NYHA II-III heart failure, LVEF <35%, sinus rhythm with resting HR 70 BPM, and either on maximally tolerated beta blockers or have contraindications to beta blockers?
Which medication is recommended as adjunct therapy for patients with NYHA II-III heart failure, LVEF <35%, sinus rhythm with resting HR 70 BPM, and either on maximally tolerated beta blockers or have contraindications to beta blockers?
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Which neurohormonal factors are reduced by beta blockers in left ventricular systolic dysfunction?
Which neurohormonal factors are reduced by beta blockers in left ventricular systolic dysfunction?
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Which types of heart failure patients should not receive beta blockers?
Which types of heart failure patients should not receive beta blockers?
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What is the mechanism of action for sacubitril/valsartan in heart failure?
What is the mechanism of action for sacubitril/valsartan in heart failure?
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Which drug is contraindicated in patients with G6PD deficiency?
Which drug is contraindicated in patients with G6PD deficiency?
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What is the major metabolite of procainamide and how is it formed?
What is the major metabolite of procainamide and how is it formed?
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Which antiarrhythmic drug is not recommended for use in patients with chronic atrial fibrillation?
Which antiarrhythmic drug is not recommended for use in patients with chronic atrial fibrillation?
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Which drug is contraindicated in patients with congenital or acquired long QT syndrome, severe renal impairment, and a QT interval greater than 440 msec?
Which drug is contraindicated in patients with congenital or acquired long QT syndrome, severe renal impairment, and a QT interval greater than 440 msec?
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Which drug is indicated for the rapid conversion of paroxysmal supraventricular tachycardia (PSVT) to normal sinus rhythm (NSR)?
Which drug is indicated for the rapid conversion of paroxysmal supraventricular tachycardia (PSVT) to normal sinus rhythm (NSR)?
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Which drug is used for ventricular rate control in supraventricular arrhythmias, such as atrial fibrillation (AF)?
Which drug is used for ventricular rate control in supraventricular arrhythmias, such as atrial fibrillation (AF)?
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Which class of antiarrhythmic drugs blocks sodium channels and has varying effects on action potential duration (APD) and effective refractory period (ERP)?
Which class of antiarrhythmic drugs blocks sodium channels and has varying effects on action potential duration (APD) and effective refractory period (ERP)?
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Which class of antiarrhythmic drugs is most useful in tachycardias?
Which class of antiarrhythmic drugs is most useful in tachycardias?
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Which class of antiarrhythmic drugs blocks calcium channels and slows conduction of SA and AV nodes?
Which class of antiarrhythmic drugs blocks calcium channels and slows conduction of SA and AV nodes?
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Which route of administration is not mentioned in the text for nitroglycerin?
Which route of administration is not mentioned in the text for nitroglycerin?
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What effect does nitroglycerin have on coronary vascular resistance?
What effect does nitroglycerin have on coronary vascular resistance?
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How does nitroglycerin redistribute coronary blood flow?
How does nitroglycerin redistribute coronary blood flow?
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Which type(s) of angina are nitrates indicated for?
Which type(s) of angina are nitrates indicated for?
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What is the indication for using sublingual nitroglycerin?
What is the indication for using sublingual nitroglycerin?
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What are the side effects of nitroglycerin due to vasodilation?
What are the side effects of nitroglycerin due to vasodilation?
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What is the recommended storage condition for sublingual nitroglycerin tablets?
What is the recommended storage condition for sublingual nitroglycerin tablets?
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What is the consequence of continuous nitrate use?
What is the consequence of continuous nitrate use?
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What is the recommended method for preventing tolerance to nitroglycerin?
What is the recommended method for preventing tolerance to nitroglycerin?
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Study Notes
Overview of Vaughan Williams Classification and Medications for Antiarrhythmics
- Vaughan Williams Classification is a system used to categorize antiarrhythmic drugs based on their dominant electrophysiological effect.
- The classification is controversial because it does not include all antiarrhythmic drugs and some agents have mechanisms that overlap between classes.
- Class I drugs include Class IA (disopyramide, quinidine, procainamide), Class IB (lidocaine, mexiletine), and Class IC (flecainide, propafenone).
- Class II drugs are beta blockers, including acebutolol, propranolol, and esmolol.
- Class III drugs include amiodarone, sotalol, and dofetilide.
- Class IV drugs are calcium channel blockers, including verapamil and diltiazem.
- Class I drugs block sodium channels and have varying effects on action potential duration (APD) and effective refractory period (ERP).
- Beta blockers decrease myocardial activity and are most useful in tachycardias.
- Class III drugs prolong action potential duration and delay repolarization.
- Class IV drugs block calcium channels and slow conduction of SA and AV nodes.
- Indications for the medications vary, but include treatment of ventricular arrhythmias, conversion to normal sinus rhythm, and prevention of atrial fibrillation/flutter.
- Contraindications for quinidine include cinchonism, which can cause symptoms such as tinnitus, headache, and visual disturbances.
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Description
Test your knowledge on Vaughan Williams Classification and the medications used for antiarrhythmics. Learn about the different drug classes, their mechanisms of action, and their indications. Discover the controversies surrounding the classification system and understand the contraindications for specific medications.
