Pharm 14 Flashcards

Antiarrhythmic drugs can help arrhythmias by doing which overall action?

A) Increasing preload only

B) Slowing heart firing

C) Increasing potassium loss

D) Increasing AV speed

Which drug group slows heart firing according to the notes?

A) Class II beta blockers

B) Class IA sodium blockers

C) Class IB sodium blockers

D) Class IC sodium blockers

Which drug listed can slow heart firing by blocking L-type calcium channels?

A) Flecainide

B) Lidocaine

C) Verapamil

D) Procainamide

Which non-Vaughan-Williams drug slows heart firing by affecting the AV node?

A) Adenosine

B) Quinidine

C) Mexiletine

D) Propafenone

Which drug from prior angina material is listed as slowing heart firing?

A) Dofetilide

B) Ivabradine

C) Disopyramide

D) Ibutilide

Which antiarrhythmic goal means reducing how quickly impulses travel through the heart?

A) Increasing automaticity

B) Increasing contractility

C) Slowing conduction

D) Shortening refractoriness

Which class slows conduction by blocking sodium channels?

A) Class I

B) Class II

C) Class III

D) Class IV

Which drug class helps slow conduction through beta receptor blockade?

A) Class III

B) Class II

C) Class IB only

D) Class IA only

Which drug class slows conduction through L-type calcium channel blockade?

A) Class III

B) Class IC

C) Class IV

D) Class IB

Which antiarrhythmic goal means cells must wait longer before firing again?

A) Shorter AP duration

B) Increased refractory period

C) Faster AV conduction

D) Higher excitability

Which classes are especially associated with making cells wait longer before firing again?

A) Class IA and III

B) Class IB and IC

C) Adenosine and magnesium

D) Potassium and lidocaine

In the AV node, which classes can increase the waiting period before firing again?

A) Class IB and IC

B) Class II and IV

C) Class IA and IB

D) Class III and IC

Which drug is a Class IA antiarrhythmic?

A) Lidocaine

B) Procainamide

C) Metoprolol

D) Diltiazem

Which drug is a Class IA antiarrhythmic?

A) Quinidine

B) Mexiletine

C) Flecainide

D) Esmolol

Which drug is a Class IA antiarrhythmic?

A) Sotalol

B) Propafenone

C) Disopyramide

D) Adenosine

Class IA drugs block which channels?

A) Calcium and chloride channels

B) Sodium and potassium channels

C) Beta and alpha receptors

D) BNP and D1 receptors

What is the main electrophysiologic effect of Class IA drugs?

A) Shortened AP duration

B) Faster AV conduction

C) Prolonged AP duration

D) Increased ischemic firing

Class IA drugs prolong which cellular period?

A) Refractory period

B) Depolarization leak only

C) SA pacemaker slope only

D) AV nodal delay only

Class IA drugs are used for which arrhythmia types?

A) Only atrial arrhythmias

B) Only ventricular arrhythmias

C) Atrial and ventricular arrhythmias

D) Only digitalis arrhythmias

Which side effect is associated with Class IA drugs?

A) Bronchoconstriction only

B) QT prolongation/torsades

C) Severe cyanide toxicity

D) Thrombocytopenia only

Which Class IA drug is linked to lupus-like syndrome?

A) Procainamide

B) Quinidine

C) Disopyramide

D) Lidocaine

Which drug is a Class IB antiarrhythmic?

A) Lidocaine

B) Procainamide

C) Dofetilide

D) Metoprolol

Which drug is a Class IB antiarrhythmic?

A) Flecainide

B) Mexiletine

C) Quinidine

D) Sotalol

Class IB drugs block sodium channels especially in which tissue?

A) Healthy atrial tissue only

B) AV nodal tissue only

C) Damaged ischemic ventricular tissue

D) Normal SA nodal tissue

Class IB drugs have which effect on action potential duration?

A) Prolong AP duration

B) Shorten AP duration

C) No sodium effect

D) Prolong QT strongly

Although Class IB drugs shorten AP duration, they suppress which activity?

A) Normal AV nodal delay

B) Abnormal ischemic ventricular activity

C) BNP receptor signaling

D) Aldosterone receptor activity

Which clinical use best matches Class IB drugs?

A) Ventricular tachycardia

B) Chronic hypertension

C) Stable angina

D) Supraventricular arrhythmias

Class IB drugs can help prevent which rhythm after cardioversion?

A) Atrial flutter only

B) Ventricular fibrillation

C) Sinus bradycardia

D) AV block

Which class is best for sodium channel blockade in damaged ischemic ventricular tissue?

A) Class IA

B) Class IB

C) Class IC

D) Class IV

Which drug best matches “ventricular tachycardia after ischemic damage”?

A) Lidocaine

B) Diltiazem

C) Adenosine

D) Propranolol

Which drug is a Class IC antiarrhythmic?

A) Flecainide

B) Lidocaine

C) Amiodarone

D) Verapamil

Which drug is a Class IC antiarrhythmic?

A) Procainamide

B) Propafenone

C) Mexiletine

D) Adenosine

Class IC drugs are defined by which major mechanism?

A) Strong Na+ channel blockade

B) Strong K+ channel blockade

C) L-type calcium blockade

D) Beta receptor activation

Class IC drugs mainly slow which cardiac property?

A) Heart preload

B) Renal sodium excretion

C) Conduction

D) Contractility

Slowed conduction from Class IC drugs prevents which problem?

A) Impulses spreading too quickly

B) Cells waiting too long

C) Calcium leaving cells

D) Venous return increasing

Class IC drugs are used for supraventricular arrhythmias in which patients?

A) Patients with normal hearts

B) Patients after MI

C) Patients with ischemic disease

D) Patients with torsades

What is the big warning for Class IC drugs?

A) Avoid in asthma

B) Avoid in post-MI disease

C) Avoid in hypokalemia only

D) Avoid in AVNRT only

Why should Class IC drugs be avoided in ischemic heart disease or post-MI patients?

A) They worsen arrhythmias

B) They cause lupus only

C) They reverse hypokalemia

D) They block BNP receptors

A post-MI patient has arrhythmias. Which drug should be avoided because it can worsen arrhythmias?

A) Flecainide

B) Lidocaine

C) Magnesium

D) Adenosine

Which class strongly blocks sodium channels and is used only in normal hearts for supraventricular arrhythmias?

A) Class II

B) Class IC

C) Class IA

D) Class III

Which drugs are Class II antiarrhythmics?

A) Propranolol, esmolol, metoprolol

B) Verapamil, diltiazem, adenosine

C) Lidocaine, mexiletine, flecainide

D) Amiodarone, dofetilide, ibutilide

Class II antiarrhythmics are also known as which drug group?

A) Calcium channel blockers

B) Sodium channel blockers

C) Beta blockers

D) Potassium channel blockers

Beta blockers help arrhythmias by decreasing which stimulation?

A) Sympathetic stimulation

B) Parasympathetic stimulation

C) BNP stimulation

D) Aldosterone stimulation

Class II beta blockers slow firing in which cardiac node?

Class II beta blockers slow conduction through which cardiac node?

Which clinical use matches Class II beta blockers?

A) Atrial arrhythmias

B) Cyanide toxicity

C) Hypokalemia only

D) Lupus-like syndrome

Beta blockers are useful for which arrhythmia treatment goal?

A) Rate control

B) QT shortening only

C) Cardioversion anesthesia

D) Potassium repletion

Class II beta blockers help prevent which cardiac outcomes?

A) Recurrent MI/sudden death

B) Digitalis toxicity only

C) Torsades only

D) Lupus-like syndrome

Which side effect is associated with Class II beta blockers?

A) Bradycardia

B) Cyanide toxicity

C) Gingival hyperplasia

D) Hearing loss

Class II beta blockers can cause which conduction adverse effect?

A) AV block

B) QT shortening

C) SA node acceleration

D) Ventricular fibrillation prevention only

Which side effect is associated with beta blockers due to reduced sympathetic activity?

A) Fatigue

B) Constipation

C) Lupus-like syndrome

D) Visual brightness

Bronchoconstriction is especially associated with which beta blockers?

A) Nonselective beta blockers

B) Beta-1 selective blockers

C) Class III agents

D) Class IV agents

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Which drugs are Class III antiarrhythmics?

A) Amiodarone, dofetilide, sotalol

B) Propranolol, esmolol, metoprolol

C) Flecainide, propafenone, lidocaine

D) Verapamil, diltiazem, adenosine

Which drug is a Class III antiarrhythmic?

A) Amiodarone

B) Procainamide

C) Mexiletine

D) Verapamil

Which drug is a Class III antiarrhythmic?

A) Dofetilide

B) Flecainide

C) Adenosine

D) Magnesium

Which drug is a Class III antiarrhythmic?

A) Sotalol

B) Esmolol

C) Quinidine

D) Potassium

Which drug is a Class III antiarrhythmic?

A) Ibutilide

B) Lidocaine

C) Diltiazem

D) Propafenone

Which drug is a Class III antiarrhythmic?

A) Dronedarone

B) Disopyramide

C) Metoprolol

D) Adenosine

Class III drugs mainly block which channels?

A) Potassium channels

B) Sodium channels

C) Calcium channels

D) Chloride channels

What is the main effect of Class III drugs?

A) Prolong AP and refractory period

B) Shorten AP and refractory period

C) Speed AV conduction

D) Increase SA firing

Amiodarone has extra actions on which targets?

A) Na+, Ca2+, beta receptors

B) SGLT2, ACE, renin

C) BNP, D1, alpha-1

D) Aldosterone, GABA, NMDA

Class III drugs are used for which arrhythmias?

A) Serious ventricular and supraventricular

B) Hypokalemia only

C) AVNRT only

D) Digitalis toxicity only

Which side effect is associated with Class III drugs?

A) QT prolongation/torsades

B) Lupus-like syndrome only

C) Bronchoconstriction only

D) Thiocyanate toxicity

A patient receiving dofetilide develops torsades de pointes. Which class toxicity is this?

A) Class III toxicity

B) Class IB toxicity

C) Class II toxicity

D) Class IV toxicity

Which class prolongs refractory period mainly by blocking potassium channels?

A) Class III

B) Class IB

C) Class IC

D) Class II

Which drugs are Class IV antiarrhythmics?

A) Verapamil and diltiazem

B) Propranolol and esmolol

C) Lidocaine and mexiletine

D) Flecainide and propafenone

Class IV drugs directly block which channels?

A) L-type Ca2+ channels

B) Fast Na+ channels

C) K+ channels

D) HCN pacemaker channels

Which drug is a Class IV antiarrhythmic?

A) Verapamil

B) Adenosine

C) Procainamide

D) Amiodarone

Which drug is a Class IV antiarrhythmic?

A) Diltiazem

B) Metoprolol

C) Mexiletine

D) Quinidine

Class IV drugs are clinically used for which arrhythmia type?

A) Supraventricular tachycardias

B) Ventricular fibrillation after cardioversion

C) Digitalis-induced arrhythmias

D) Hypokalemia-associated arrhythmias

Besides arrhythmias, Class IV drugs are used for which condition?

A) Hypertension

B) Cyanide toxicity

C) Lupus-like syndrome

D) Thrombocytopenia

Besides arrhythmias and hypertension, Class IV drugs are used for which condition?

A) Angina

B) Asthma

C) Hypokalemia

D) Digitalis toxicity

Which side effect is associated with verapamil and diltiazem?

A) Bradycardia

B) Cyanide toxicity

C) Lupus-like syndrome

D) Ototoxicity

Class IV calcium channel blockers can cause which conduction adverse effect?

A) AV block

B) Ventricular acceleration

C) QT shortening

D) Hyperkalemic arrest

Which gastrointestinal side effect is associated with Class IV drugs?

A) Constipation

B) Diarrhea

C) Metallic taste

D) Vomiting

Which vascular side effect is associated with Class IV drugs?

A) Hypotension

B) Hypertension

C) Cyanosis

D) Pulmonary edema

Adenosine acts primarily in which cardiac structure?

A) AV node

B) SA node only

C) Ventricular muscle only

D) Purkinje fibers only

Adenosine activates which current in the AV node?

A) Potassium current

B) Sodium current

C) Chloride current

D) Pacemaker current

Adenosine blocks which current in the AV node?

A) Calcium current

B) Potassium current

C) Chloride current

D) Sodium-glucose current

Adenosine is clinically used for which arrhythmia?

A) Paroxysmal supraventricular tachycardia

B) Ventricular tachycardia after ischemia

C) Digitalis-induced arrhythmia

D) Torsades de pointes

Which drug is used for paroxysmal supraventricular tachycardia by affecting AV nodal K+ and Ca2+ currents?

A) Adenosine

B) Lidocaine

C) Flecainide

D) Potassium

Magnesium helps arrhythmias by doing which general action

A) Stabilizes cardiac electrical activity

B) Blocks ACE

C) Releases nitric oxide

D) Blocks beta receptors

Magnesium interacts with what to stabilize cardiac electrical activity?

A) Ion channels

B) Aldosterone receptors

C) Beta receptors

D) BNP receptors

Magnesium is clinically used for which arrhythmia?

A) Torsades de pointes

B) Stable angina

C) Chronic hypertension

D) Recurrent MI prevention

Magnesium is also used for arrhythmias caused by which drug toxicity?

A) Digitalis-induced arrhythmias

B) Beta blocker-induced fatigue

C) Procainamide-induced lupus

D) Nitroprusside cyanide toxicity

Which agent is used for torsades de pointes?

A) Magnesium

B) Flecainide

C) Ivabradine

D) Diltiazem

Potassium helps arrhythmias by correcting which abnormality?

A) Hypokalemia

B) Hypercalcemia

C) Hypernatremia

D) Hypoglycemia

Why can hypokalemia promote arrhythmias (think for example what happens when you have digoxin and no k+)?

A) Cells become too excitable

B) Cells stop conducting completely

C) BNP receptors activate

D) AV node calcium rises

Potassium can be used for arrhythmias caused by which drug toxicity?

A) Digitalis-induced arrhythmias

B) Beta blocker fatigue

C) Calcium blocker constipation

D) Procainamide lupus

Compared with procainamide, disopyramide has which pharmacokinetic feature?

A) Shorter duration

B) No oral activity

C) Longer duration

D) No cardiac effect

Which toxicity is associated with disopyramide?

A) Antimuscarinic effects

B) Cinchonism

C) Tendon rupture

D) Methemoglobinemia

Disopyramide can worsen which cardiac condition?

A) Hypertension

B) Atrial flutter

C) Angina

D) Heart failure

A patient taking disopyramide develops dry mouth, urinary retention, and blurry vision. Which toxicity explains this?

A) Beta blockade

B) Antimuscarinic effects

C) Calcium toxicity

D) Folate blockade

Compared with procainamide, quinidine is described as having what?

A) Less toxicity

B) No toxicity

C) Only renal toxicity

D) Greater toxicity

Which symptom set best matches quinidine cinchonism?

A) Dry mouth, urinary retention

B) Tinnitus, vertigo, headache

C) Cough, angioedema, rash

D) Wheezing, fatigue, bradycardia

Which side effect set best matches quinidine?

A) Tendonitis, neurotoxicity, GI upset

B) Cinchonism, GI disturbance, thrombocytopenia

C) Methemoglobinemia, pulmonary irritation, hypotension

D) Antimuscarinic effects, heart failure only

Compared with lidocaine, mexiletine has which pharmacokinetic feature?

A) Shorter duration

B) Longer duration

C) No absorption

D) IV use only

Which statement best describes mexiletine?

A) Similar to lidocaine, oral

B) Similar to quinidine, shorter

C) Similar to verapamil, IV only

D) Similar to adenosine, AV node

Which drug is similar to lidocaine but has longer duration and neuropathic pain use?

A) Quinidine

B) Disopyramide

C) Mexiletine

D) Esmolol

Esmolol is also used for arrhythmias associated with which condition?

A) Hypokalemia

B) Thyrotoxicosis

C) Heart failure only

D) Toxoplasmosis

A patient with thyrotoxicosis develops tachyarrhythmia. Which drug from the notes is especially useful?

A) Disopyramide

B) Quinidine

C) Esmolol

D) Nifedipine

Which statement best describes esmolol use?

A) Neuropathic pain treatment

B) Toxoplasmosis folate blockade

C) Pulmonary hypertension therapy

D) Perioperative and thyrotoxicosis arrhythmias

Dihydropyridine calcium channel blockers may sometimes do what to arrhythmias?

A) Cure all arrhythmias

B) Prevent digitalis toxicity

C) Shorten QT only

D) Precipitate arrhythmias

Which statement best contrasts dihydropyridines with verapamil/diltiazem?

A) Dihydropyridines are arrhythmia drugs

B) Dihydropyridines are not useful

C) Verapamil cannot affect AV node

D) Diltiazem causes cinchonism

What effect does procainamide have on QRS duration?

What effect does procainamide have on the QT interval?

Besides Class IA activity, procainamide also shows actions similar to which class?

The Class III-like effect of procainamide mainly causes what?

A. Faster depolarization

B. Prolonged repolarization

C. Shortened ERP

D. Faster AV conduction

Excess procainamide can cause which dangerous arrhythmia?

A. Atrial flutter

B. Sinus tachycardia

C. Torsades de pointes

D. First-degree AV block

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Toxic quinidine concentrations can prolong which ECG interval?

A. PR

B. QRS only

C. RR

D. QT

QT prolongation from quinidine increases risk for what?

A. Atrial fibrillation

B. Torsades de pointes

C. Sinus bradycardia

D. AVNRT

Which organ system is commonly affected by quinidine toxicity?

A. GI system

B. Respiratory system

C. Urinary system

D. Endocrine system

Why may disopyramide be given with an AV nodal-blocking drug?

A. It causes renal failure

B. It lowers potassium

C. It increases digoxin clearance

D. It needs slower AV conduction

Which drug could be paired with disopyramide to slow AV conduction?

A. Lidocaine

B. Verapamil

C. Flecainide

D. Dofetilide

A man with an enlarged prostate receives disopyramide. Which adverse effect is especially concerning?

A. Diarrhea

B. Polyuria

C. Urinary retention

D. Hematuria

Which sodium-channel states does lidocaine preferentially block?

A. Activated and inactivated

B. Resting only

C. Closed only

D. Open calcium channels

Why is lidocaine given intravenously for arrhythmias?

A. Renal elimination

B. Poor tissue penetration

C. Slow absorption

D. Extensive first-pass metabolism

Lidocaine is used mainly for which type of arrhythmia?

A. Sinus arrhythmias

B. Ventricular arrhythmias

C. Atrial flutter

D. AV nodal reentry

Which specific arrhythmias can lidocaine treat?

A. AV block and flutter

B. AF and AVNRT

C. VT and ventricular fibrillation

D. Sinus tachycardia and PACs

Lidocaine preferentially affects which cardiac tissues?

A. Ventricles and Purkinje fibers

B. SA node

C. AV node

D. Atrial tissue

Lidocaine can also treat arrhythmias caused by which drug?

A. Warfarin

B. Verapamil

C. Adenosine

D. Digitalis

Flecainide and propafenone are contraindicated after what cardiac event?

A. Pericarditis

B. Myocardial infarction

C. Stable angina

D. Endocarditis

Amiodarone is primarily metabolized by which CYP enzyme?

A. CYP2D6

B. CYP2C9

C. CYP3A4

D. CYP1A2

What distinguishes dronedarone from amiodarone regarding thyroid effects?

A. More thyroid toxicity

B. Blocks TSH receptors

C. Lacks thyroxine metabolism effects

D. Causes hypothyroidism universally

What major toxicity is associated with dronedarone?

A. Hepatotoxicity

B. Nephrotoxicity

C. Ototoxicity

D. Pulmonary embolism

Sotalol increases the risk of which arrhythmia?

A. Sinus tachycardia

B. Atrial flutter

C. First-degree block

D. Torsades de pointes

An overdose of verapamil can produce what conduction abnormality?

A. AV block

B. WPW syndrome

C. Atrial flutter

D. Sinus tachycardia

What additional serious effect can occur with verapamil overdose?

A. Severe hypertension

B. Hypercontractility

C. Increased cardiac output

D. Severe cardiac depression

Verapamil is especially useful for treating which arrhythmia?

A. Ventricular fibrillation

B. Supraventricular tachycardia

C. Torsades de pointes

D. Ventricular escape rhythm

Why is verapamil useful for SVT?

A. It stimulates Purkinje fibers

B. It activates sodium channels

C. It acts at the AV node

D. It increases sympathetic tone

Which endogenous nucleoside has strong vasodilator and antiarrhythmic effects?

A. Adenosine

B. Guanosine

C. Cytidine

D. Thymidine

What is the drug of choice for acute supraventricular tachycardia in these notes?

A. Lidocaine

B. Procainamide

C. Amiodarone

D. Adenosine

Which antiarrhythmic can be used for Wolff-Parkinson-White syndrome?

A. Verapamil

B. Procainamide

C. Digoxin

D. Diltiazem

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According to these notes, procainamide acts on which cardiac tissues?

A. SA node

B. Atria

C. Purkinje fibers

D. AV node and ventricles