Exam (elaborations)
FORGOROS ANTI-ARRYTHMIC DRUGS
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FORGOROS ANTI-ARRYTHMIC DRUGSdisopyramide therapeutic uses and electrophysiologic effects -
ANSWER Class 1A
uses: similar to quinidine (treat AFl, AF, reentrant SVTs, VT)
use is limited by negative inotropic potential and strong anticholinergic
properties term-91
EP effects: blocks NA+ channel and slows depolarization, blocks K+
channel to prolong refractory period
comments: similar to quinidine (may suppress automaticity of purkinje
fibers or cause torsades de pointes) but causes fewer GI side effects
dry mouth, eyes, and throat, urinary difficulty, urinary retention
Class 1a antiarrythmic drugs (the names of them) - ANSWER quinidine,
procainamide, disopyramide
Class 1b antiarrythmic drugs (the names of them) - ANSWER lidocaine,
mexiletine, phenytoin
Class 1 antiarrythmic drugs (explanation) - ANSWER have effect on the
rapid sodium channel
classified into 1a, 1b, 1c
Class 1A antiarryhmic drugs effect on action potential - ANSWER slows
upstroke of action potential (and thus slows conduction velocity)
prolongs duration and refractoriness of action potential (because of
blocking potassium channel)
all drugs that prolong refractoriness can cause what - ANSWER early
after depolarizations and thus torsades de pointes
quinidine effect on conduction velocity - ANSWER (like all class 1a)
decrease ++
, quinidine effect on refractory period - ANSWER (like all class 1a)
increase ++
quinidine effect on automaticity - ANSWER (like all class 1a)
suppress +
will quinidine cause afterdepolarizations? - ANSWER (like all class 1a)
may cause EADs
quinidine AF/AFl efficacy, AVN reentry efficacy macroreentry efficacy,
PVCs, VT/VF - ANSWER (like all class 1a)
AF/AFl ++
AVNRT +
AVRT +
PVCs ++
VT/VF ++
major concern with all 1a drugs - ANSWER proarrhythmic
early after depolarizations due to increased refractory periods that
causes torsades de pointes
also any drug that alters conduction velocity can exacerbate reentrant
arrythmias
any drug that alters conduction velocity can do what? - ANSWER
exacerbate reentrant arrythmias
procainamide effect on conduction velocity - ANSWER (like all class 1a)
decrease ++
procainamide effect on refractory period - ANSWER (like all class 1a)
increase ++
procainamide effect on automaticity - ANSWER (like all class 1a)
suppress +
procainamide AF/AFl efficacy, AVN reentry efficacy macroreentry
efficacy, PVCs, VT/VF - ANSWER (like all class 1a)
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