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Antiarrhythmics

  1. What is the fx of the SA node?
    sets the pace of the heart (70-80 bpm)
  2. What is the fx of the AV node?
    time delay mechanism to allow the ventricles to fill with blood
  3. Where do Na and K have an effect on the heart?
    in the tissues
  4. Where does Ca have an effect on the heart?
    in the nodes
  5. What does the P wave indicate?
    depolarization of the atria by the SA node
  6. What does the upstroke of the QRS wave indicate?
    conduction down from the AV node
  7. What does the downstroke of the QRS wave indicate?
    conduction up and out from the AV node (in the ventricles)
  8. What does the T wave indicate?
    repolarization of the ventricles
  9. What are the Class Ia antiarrhythmics (Na channel blockers)?
    • quinidine
    • procainamide
    • disopyramide
  10. What are the Class Ib antiarrhythmics (Na channel blockers)?
    lidocaine
  11. What are the Class Ic antiarrhythmics (Na channel blockers)?
    • flecainide
    • propafenone
  12. What are the SE of Class I antiarrhythmics?
    • systemic lupus erythematosis
    • diarrhea
    • confusion
    • dizziness
    • seizures
    • GI
    • (-) inotropic
    • QT prolongation
  13. What effect do the Class I antiarrhythmics have on the SA node?
    none
  14. What effect do the Class I antiarrhythmics have on the AV node?
    none
  15. What effect do the Class I antiarrhythmics have on conduction/automaticity?
    they decrease it
  16. What effect do the Class I antiarrhythmics have on the refractory period?
    they increase it
  17. What are the Class I antiarrhythmics used for?
    2nd or 3rd line for atrial and ventricular arrhythmias
  18. What effect do the Class II antiarrhythmics have on the SA node?
    mainly decrease
  19. What effect do the Class II antiarrhythmics have on the AV node?
    decrease
  20. What effect do the Class II antiarrhythmics have on conduction/automaticity?
    decrease
  21. What effect do the Class II antiarrhythmics have on the refractory period?
    increase
  22. What are Class II antiarrhythmics used for?
    • a-fib rate control
    • SVT
    • adjunct for ventricular arrhythmias
  23. What effect do the Class III antiarrhythmics have on the SA node?
    none except sotalol and amiodarone which decrease it
  24. What effect do the Class III antiarrhythmics have on the AV node?
    none except sotalol and amiodarone which decrease it
  25. What effect do the Class III antiarrhythmics have on conduction/automaticity?
    decrease
  26. What effect to do the Class III antiarrhythmics have on the refractory period?
    increase it
  27. What are the Class III antiarrhythmics used for?
    • low dose: atrial arrhythmia conversion and maintenance
    • high dose: ventricular arrhythmia conversion and maintenance
  28. What effect do the Class IV antiarrhythmics have on the SA node?
    decrease
  29. What effect do the Class IV antiarrhythmics have on the AV node?
    decrease
  30. What effect do the Class IV antiarrhythmics have on conduction/automaticity?
    none
  31. What effect do the Class IV antiarrhythmics have on the refractory period?
    none
  32. What are the Class IV antiarrhythmics used for?
    • a-fib rate control
    • SVT
  33. What effect does digoxin have on the SA node?
    decrease
  34. What effect does digoxin have on the AV node?
    decrease
  35. What effect does adenosine have on the SA node?
    decrease
  36. What effect does adenosine have on the AV node?
    decrease
  37. What is adenosine used for?
    SVT
  38. What is digoxin used for?
    adjunct to B-blocker or CCB to control ventricular rate in chronic a-fib
  39. At what ejection fraction should you avoid the use of B-blockers and CCBs?
    < 40%
  40. What are the SE of Class II antiarrhythmics?
    • negative inotrope
    • bradycardia
    • depression
    • dyslipidemia
    • heart block
    • peripheral vascular disease
  41. What are the SE of the Class III antiarrhythmics?
    • negative inotrope
    • QT prolongation
    • bradycardia
    • pulmonary fibrosis
    • hyper or hypothyroidism
    • peripheral neuropathy
    • corneal deposits
    • tremor
    • ataxia
    • blue/gray skin
  42. What are the risk factors associated with CHADS2?
    • CHF
    • HTN
    • over 75 yo
    • diabetes
    • hx of stroke or TIA (2 pts)
  43. How do you treat chronic a-fib?
    • 1. convert to and maintain normal sinus rhythm
    • amiodorone
    • propofenal
    • Class Ia
    • 2. control ventricular rate
    • Class II or IV
    • +/- digoxin
  44. How do you treat acute a-fib?
    • shock
    • propofenone
    • ibutilide
    • amiodarone
    • dofetilide
Author
giddyupp
ID
50591
Card Set
Antiarrhythmics
Description
Antiarrhythmics
Updated

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