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kyleannkelsey
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Does Flecainide cause EADs or torsades de pointes?
No
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What is Flecainide used to treate?
Maintains sinus rhythm in patients with supraventricular arrhythmias, may increase mortality 2.5 fold in patients with MI
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Propranolol has effects similar to what other drug?
Quinidine
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What are the MOAs of Propranolol in the treatment of Arrhythmias?
B-blockade, ↓ automaticity, ↓conduction and automaticity in AV node, Perkinje and ventricles
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What are the adverse effects of Propranolol?
Reduced Myocardial contractility, Bradycardia, Angina and sudden withdrawal, Bronchospasm
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What is Propranolol used for?
Supraventricular tachycardia
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Does Propranolol cause increased risk, like Flecainide after MI?
No, very beneficial
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What is the most widely used antiarrhythmic in clinical use?
Amiodarone
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What are the indications for Amiodarone?
Unstable Ventricular Tachycardia, Ventricular Fibrillation, Supraventricular tachycardia, atrial fibrillation (off-label)
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What are the adverse effects of Amiodarone?
Systemic toxicity: Pulmonary arrhythmias and Bradyarrhythmias with Loading Dose
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What changes in AP duration and ERP would you expect with Amiodarone?
Both Increase
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What effect does Amiodarone have on Automaticity?
Decreases
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What effect does Amiodarone have on Conduction?
Slows
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What effect does Amiodarone have on blood vessels?
Dilation
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What channel/receptor types does Amiodarone block?
Na, Ca, K, B-receptors
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By what mechanism does Amioadrone delay repolarization and increase refractory period?
K channel blockade
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What characteristics are being sought after in Antiarrhythmic drug development?
Multiple pharmacological actions on Cardiac tissue (rather than selective)
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A battery of testing including Cardiac, Hepatic, Thyroid, Pulmonary, Dermatologic, Neurologic and Ophthalmic are required for what drug?
Amiodarone
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What is Amiodarone used for?
Recurrent ventricular tachycardia, fibrillation resistant to other drugs, atrial fibrillation
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Intravenous amiodarone more effective than ________ for out-of-hospital Ventricular Fibrillation resistant to shocks and epinephrine.
Lidocaine
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Does Amiodarone exacerbate CHF?
No
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Is Amiodarone rarely proarrhythmic?
Rarely
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What s Dronedarone?
Structural derivative of Amiodarone with reduced toxicity for suppression of atrial fibrillation
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What is the MOA of Dronedarone?
Multichannel blocking properties and sympatholytic abilities similar to Amiodarone, reduces ventricular rate and rate of recurrent AF
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What group may Dronedarone increase mortality in?
HF
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What is the half-life of Dronedarone?
24-30 hours
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What metabolizes Dronedarone?
CYP3A4
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Which antiarrhythmatic should not be given with any of the following: ketoconazole, cyclosporine, ritonavir, clarithromycin and nefazodone?
Dronedarone, because they compete for CYP3A4 metabolism
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How does Sotalol prolong Cardiac action potentials?
By inhibiting delayed rectifier and possibly other K currents
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What enantiomer of Sotalol is more potent at the B-receptor and which one is less?
More: l-enantiomer, Less: d-enantiomer
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What is the indication for Sotalol?
Ventricular tachyarrhythmias and atrial fibrillation or flutter
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What is the major toxicity associated with Sotalol and at what rate does it occur?
Torsades de pointes at ~5%
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