PHARM EXAM 3 > Chapter 52 > Flashcards

Chapter 52 Flashcards

Antiarrhtyhmic Drugs (45 cards)

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1
Q

What are dysrhythmias?

A

When your heart is beating weird –> too fast, too slow, or irregular

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2
Q

QUINIDINE
-What is the drug class?

A

Class I sodium channel blocker

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3
Q

QUINIDINE: Therapeutic Uses
-What is this used for?

A

-Long term suppression of: (1) supraventricular dysrhythmias (2) atrial flutter (3) atrial fibrillation (4) sustained ventricular tachycardia
-Severe malaria

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4
Q

QUINIDINE: Mechanism of Action
-What does it block?

A

Sodium channels

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5
Q

QUINIDINE: Mechanism of Action
-Due to blockage of sodium channels, what 3 things will this cause?

A
  1. SLOW impulse conduction
  2. Delayed repolarizatoin
  3. Blocks vagal input
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6
Q

QUINIDINE: Pharmacokinetics
-What is the route?

A

PO

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7
Q

QUINIDINE: Adverse Effects
-What are the 4? SHACC

A

-Severe diarrhea
-Hypotension
-Arterial embolism
-Cinchonism
-Cardiotoxicity

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8
Q

QUINIDINE: Adverse Effects
-What can severe diarrhea be reduced with?

A

Food

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9
Q

QUINIDINE: Adverse Effects
-What does cinchonism consist of? (5)

A
  1. Headache
  2. Tinnitus
  3. Vertigo
  4. Nausea
  5. Visual disturbances
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10
Q

QUINIDINE: Adverse Effects
-What does cardiotoxicity result in?

A

Widened QRS & prolonged QT (torsades de pointes)

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11
Q

QUINIDINE: Adverse Effects
-What are the s/s of an arterial embolism?

A

Chest pain & dyspnea

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12
Q

QUINIDINE: Drug Interactions
-What drug does quinidine double the levels of & increases toxicity risk?

A

Digoxin

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13
Q

QUINIDINE: Drug Interactions
-What can you use to prevent excessive ventricular rate (suppress AV conduction)?

A

Digoxin, beta blockers, or verapamil

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14
Q

QUINIDINE: Nursing Actions
-Teach the patient to take the medication with _____
-Report what?
-Check _____ regularly

A

-food
-SOB, chest pain, tinnitus
-BP

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15
Q

PROPRANOLOL
-What is the drug class?

A

Class II beta blocker

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16
Q

PROPRANOLOL: Therapeutic Use
-What does this treat?

A

Dysrhythmias caused by excessive sympathetic stimulation of the heart

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17
Q

PROPRANOLOL: Therapeutic Use
-What are 4 examples of these dysrhythmias?

A
  1. Sinus tachycardia
  2. Severe recurrent ventricular tachycardia
  3. Exercise-induced tachydysrhythmias
  4. Paroxysmal atrial tachycardia
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18
Q

PROPRANOLOL: Mechanism of Action
-What does this block?

A

B1 & B2 receptors

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19
Q

PROPRANOLOL: Mechanism of Action
-What does blockage of beta receptors result in? (3)

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A
  1. Decreased automaticity of SA node
  2. Decreased AV conduction
  3. Decreased myocardial contractility
20
Q

PROPRANOLOL: Pharmacokinetics
-What is the route?

21
Q

PROPRANOLOL: Adverse Effects
-What two systems does this affect?

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A

Cardiovascular & respiratory

22
Q

PROPRANOLOL: Adverse Effects
-What are the cardiac adverse effects? (6)

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A
  1. Bradycardia
  2. Hypotension
  3. AV block
  4. Sinus arrest
  5. HF
  6. Prolonged PR interval
23
Q

PROPRANOLOL: Adverse Effects
-What is the respiratory adverse effect?

24
Q

PROPRANOLOL: Drug Interactions
-It is okay to use this with CCBs (T/F)

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A

FALSE; can lead to further bradycardia

25
**AMIODARONE** -What is the drug class?
Class III potassium channel blocker
26
**AMIODARONE**: *Therapeutic Use* -What is this used for?
-Life-threatening ventricular dysrhythmias like: (1) recurrent ventricular fibrillation (2) unstable ventricular tachycardia -Atrial fibrillation
27
**AMIODARONE**: *Therapeutic Use* -This is the most effective drug for what?
Atrial fibrillation
28
**AMIODARONE**: *Mechanism of Action* -What does this delay? -What does it prolong?
-Repolarization -Action potential duration
29
**AMIODARONE**: *Pharmacokinetics* -What is the route? -How is it excrete?
-PO, IV -in bile
30
**AMIODARONE**: *Adverse Effects* -What are they? Remember: Can Pully Think Like Opal? Don't Care Gary.
-Cardiotoxicity -Pulmonary toxicity -Thyrotoxicity -Liver toxicity -Opthalmic effects -Dermatologic toxicity -CNS disturbances -GI effects
31
**AMIODARONE**: *Adverse Effects* -What are the 5 cardiotoxicity s/s?
1. AV block 2. Prolonged QT & PR intervals 3. Widened QRS 4. HF 5. Bradycardia
32
**AMIODARONE**: *Adverse Effects* -s/s of pulmonary toxicity?
dyspnea, cough, chest pain
33
**AMIODARONE**: *Adverse Effects* -S/S of thyrotoxicity?
Hyper/Hypothyroidism
34
**AMIODARONE**: *Adverse Effects* -S/S of liver toxicity? (5)
Anemia, N/V, dark urine, jaundice, itching
35
**AMIODARONE**: *Adverse Effects* -2 opthalmic effects?
1. Optic neuropathy (leads to blindness) 2. Visual changes
36
**AMIODARONE**: *Adverse Effects* -What is the dermatologic toxicity effect?
Photosensitive skin reactions
37
**AMIODARONE**: *Adverse Effects* -GI effects? (2)
N/V, anorexia
38
**AMIODARONE**: *IMPORTANT* -Who would avoid these medications?
Pregnant or breastfeeding women
39
**AMIODARONE**: *IMPORTANT* -How does it cause harm to the developing fetus? -How does it cause harm to the breastfeeding infant?
-By crossing the placenta -By entering breast milk
40
**AMIODARONE**: *Drug Interactions* -What 5 medications does this increase the levels of?
1. Digoxin 2. Quinidine 3. Warfarin 4. Phenytoins 5. Statins
41
**AMIODARONE**: *Drug Interactions* -AVOID what food? -Why?
Grapefruit juice -It increases risk of toxicity
42
**AMIODARONE**: *Drug Interactions* -Levels of amiodarone can be reduced by what two things?
1. Cholestyramine 2. CYP3A4 inducers (St. Johns Wort, rifampin)
43
**AMIODARONE**: *Drug Interactions* -What do diuretics in combination with amiodarone do?
Increase risk of dysrhythmias
44
**AMIODARONE**: *Drug Interactions* -What medications in combination with amiodarone can lead to excessive bradycardia?
Beta blockers, verapamil, diltiazem
45
**AMIODARONE**: *Patient Education* 1. Minimize _______ exposure 2. Monitor ______ 3. Report what three things?
1. sun 2. HR 3. SOB, dark urine, visual changes
PHARM EXAM 3
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