Pharm 2 - Cardio 3

drraythe's version from 2015-09-30 15:56

Class II

Question Answer
Class II are/do what?β blockers (ΒBlock= 2Bs= Class2), prolonged AV conduction, shortens the AP, ↓ contractility & hypersensativity of the Symp. Nervous System (tachycardia & ↑ acetacholine)
Name the 4 drugs in this ClassPropanolol, Atenolol, Esmolol, Metaprolol (ALL END IN "OLOL" 2 OLs = Class II)
Explain the relationship btwn arrhythmia & β-blockersBlocking β → Shortens AP & refractory periods
What are the 2 Class II drugs we care about?Atenolol & Propanolol
Do not mix Class II w/ Class ___?Class IV

Class III

Question Answer
Class III's do what?Agents that significantly prolong AP duration & Refractory period (3's...long. ifyaknowwhatimean)
What are the 2 drugs in Class III?Bretylium, Amiodarone (Ami & Bret had a 3some)
Bretylium (MOA? results in? contraindicated in?)Adrenergic neuronal blocking agent. Promotes release of NE followed by permanent blockage. Usually contraindicated in animals previously anesthetized w/ halogenated hydrocarbon anesthetics. (BRET shouldnt be using halogenated hydrocarbon anesthetics...he'd fuck it up by releasing all of it as he said "NEat!" & then the adrenergic system is permanently blocked)
Amiodarone (MOA? use?)K channel blocker in cardiac muscle, weak blocker of Ca channel & β1 receptor blocker. Well suited for supraventricular/ventricular arrhythmias. (AMI & DARONE have my BCK (β, Ca, K) in case my heart hits rock BOTTOM (ventricles on bottom of heart) ) However it does have alot of interactions w/ other drugs & its conc. will remain high when co-admined.

Class IV

Question Answer
Class IV do what?Ca channel blockers
Significant SFx of Class IV?Hypotension & bradycardia (VASODILATORS, also Ca is needed for heart to beat so of course it slows down. Ca statues dont move fast)
Which probs are Class IV drugs used for?Ventricular hypertrophy & atrial tachyarrhythmia (Ca will make your heart BIG & STRONG (perhaps too much), to the point where the little atria have to run super-fast just to keep up---so Class 3 will block those for you!!)
What are the 2 drugs in this Class?Verapamil, Diltiazem (Class IV is Very Dull) (remember Diltiazem was in tx kidney failure & also in vasodilator section too)
Do not use Class IV w/ Class ___?II
What is special about Diltiazem?Its name starts w/ D bc it effects the excretion of Digoxin
Whats special about Verapamil?It is a Prodrug


Question Answer
What is Epinephrine used for?Used for anaphylactic shock/hypersensitivity rxns (& has topical forms)
What is Isoproterenol used for?Used for cardiac arrest or short term in heart block EMCs (I SO PRO that i can fix things that are totally stopped!)
What is Dopamine used for?Used in cardiogenic shock in Oliguric renal failure (obv kidney stuff, that was used in Werners notes too & shock you will stop peeing too so tie that in)
When would you NOT use epinephrine?Not in left ventricular failure (you will make the heart try to go harder & kill it)
What kind of receptor agonist is Epi?MIXED (α, β1, β2) agonist
Isoproterenol is a _________ agonist?Non-selective β-adrenoreceptor agonist

Check yo'self

Question Answer
Quinidine is in what Class? (& does what? Used for what?)CLASS IA - Vagolytic action improves AV conduction & controls atrial tachyarrhythmia – used for atrial arrhythmias
Procainamide is in what Class? (& does what? Used for what?)CLASS IA - Vagolytic action here is less prominent, so more preferred for ventricular arrhythmias
Disopyramide is in what Class?CLASS IA
Phenytoin is in what Class?CLASS IB (not in A or C, must be B. remember that phen B after the arrhythmia)
Lidocaine is in what Class?CLASS IB
Only used for emergencies (arrhythmias during sx/anesthesia or infarctions)Lidocaine (no oral & short duration of action mean not useful for maintenance)
Avoid 1st pass so longer acting & able to be used for maintenance (in Class IB)Tocainide
Tx ventricular tachycardiaAprinidine (the ap that tx the refractories w/ the SFx is an ap which yells from the bottom of its heart (ventricle) for you to chill out) but only use when there is no other way, its very dangerous
SFx include leukopenia, hepatotoxicosis, hypotension, ataxiaAprinidine (this is dangerous shit, only use when you MUST)
Reserved for refractory (resistant to other txs) arrhythmiasAprinidine (cz its so dangous)
Which drug is both stronger than Aprinidine & has less SFx?Indecainide
Effective against ventricular tachycardia & premature beats of atrial or ventricular originAll the drugs in Class IC (Lorcainide, Flecainde, Encainide)
Flecainide is in what Class?IC
Encainide is in what Class?IC
Lorcainide is in what Class?IC
Propanolol is in what Class?II
Atenolol is in what Class?II
Esmolol is in what Class?II
Metaprolol is in what Class?II
Contraindicated in animals previously anesthetized w/ halogenated hydrocarbon anestheticsBretylium
Bretylium is in what Class?III
Amiodarone is in what Class?III
Well suited for supraventricular/ventricular arrhythmiasAmiodarone
Verapamil is in what Class?IV
Diltiazem is in what Class?IV
Used in cardiogenic shock in oliguric renal failureDopamine
Used for cardiac arrest or heart blockIsoproterenol (& Epi in EMCs)