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Medicine (MD/DO)
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USMLE Step 1
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Cardiology
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Antiarrhythmic Agents

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Cardiology | Medicine (MD/DO) School Study Aid

Antiarrhythmic Agents
16 Picmonics to Learn | 27 mins
Class I Antiarrhythmics (Na+ Channel Blockers) Overview
Indications
Arrhythmias
Local Anesthesia
Mechanism of Action
Block or Slow Conduction
Block Na+ Channels
Raise Threshold
State Dependent
Contraindication
Hyperkalemia
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1 min
Class IA Antiarrhythmics (Na+ Channel Blockers)
Indications
Arrhythmias
Mechanism of Action
Increase AP, ERP, and QT interval.
Drugs
Disopyramide
Procainamide
Drug-induced Lupus
Quinidine
Cinchonism
Shared Side Effects
Thrombocytopenia
Torsades de Pointes
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1 min
Class IB Antiarrhythmics (Na+ Channel Blockers)
Indications
Arrhythmias
After Myocardial Infarction
Mechanism of Action
Affect Ischemic Tissue
Decrease AP duration
Drugs
Mexiletine
GI Upset
Lidocaine
CNS Depression
Tocainide
Phenytoin
Hirsutism
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2 mins
Class IC Antiarrhythmics (Na+ Channel Blockers)
Indications
Used as Last Resort
V-Tach
Mechanism of Action
No Effect on AP Duration
Drugs
Propafenone
Flecainide
Contraindications
Post-Myocardial Infarction
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56 secs
Selective Beta-1 Blockers
Characteristics
"-olol" Suffix
Drug Names
Beta-1 Selective
Atenolol
Esmolol
Metoprolol
Partial Beta agonists
Acebutolol
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1 min
Cardiovascular Effects of Beta-Blockers
Cardiac Myocytes and Vasculature
Decrease cAMP
Decreases SA and AV Node Conduction Velocity
Lower Blood Pressure
Decrease O2 Consumption
Decreases Mortality Post-MI
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2 mins
Class III Antiarrhythmics (K+ Channel Blockers)
Indications
Arrhythmias
Mechanism of Action
Increase AP Duration, ERP, and QT Interval
Drug Names
Amiodarone
Check Function Tests
Dirty Drug
Ibutilide
Dofetilide
Sotalol
Beta-Blocker
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2 mins
Class IV Antiarrhythmics (Ca2+ Channel Blockers)
Indications
SVT
Subarachnoid Hemorrhage
Mechanism of Action
Decrease Conduction Velocity
Increase PR Interval and ERP
Drugs
Verapamil
Diltiazem
Nimodipine
Side Effects
Cardiovascular
Constipation
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2 mins
Adenosine (Adenocard)
Mechanism
Slows AV Conduction
Indications
Supraventricular Tachycardia (Paroxysmal)
Side Effects
Bradycardia
Flushing
Dyspnea
Considerations
Rapid IV Push
Caffeine and Theophylline Decrease Effectiveness
Dipyridamole May Intensify Effects
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2 mins
Lidocaine
Mechanism
Blocks Na+ Channels
Indications
Ventricular Arrhythmia
Anesthetic
Side Effects
Paresthesias
Seizures
Respiratory Depression
Drowsiness
Consideration
Anesthetic Effects Extended with Epinephrine
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1 min
Magnesium Sulfate
Mechanism
Muscle Relaxant
Indications
Preterm Labor Contractions
Preeclampsia
Side Effects
Warm Feeling
Hypotension
Decreased Deep Tendon Reflexes (DTRS)
Decreased Respiratory Rate
Decreased Urine Output
Paralytic Ileus
Antidote
Calcium Gluconate
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2 mins
Digoxin Mechanism and Indication
Direct inhibition of Na K ATPase
Indirect inhibition of Na Ca exchanger
Increase Ca in cell
Positive Inotropy
CHF
Stimulates Vagus Nerve
Decreased conduction at AV node
Atrial Fibrillation
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1 min
Acute Digoxin Toxicity
Clinical Symptoms
Hyperkalemia
Cholinergic (Nausea, Vomiting, Diarrhea)
Blurry Yellow Green Vision with Halo of Light
Arrhythmia
Bradycardia
EKG Changes
Prolonged PR interval
Decreased QT
Scooping on EKG
T Wave Inversion
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2 mins
Digoxin Toxicity Treatment
Activated Charcoal
Slowly Normalize K+
Digibind (Anti-Digoxin Fab)
Magnesium Sulfate
Lidocaine
Cardiac Pacing
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2 mins
Amiodarone
Mechanisms
Class III Antiarrhythmic (K+ Channel Blocker)
Decreases SA and AV Node Conduction
Inhibits Cytochrome P450
Indications
Supraventricular Tachycardia with Heart Failure
Ventricular Tachycardia
Side Effects
Hepatotoxicity
Pulmonary Fibrosis
Bradycardia
Heart Block
Thyroid Disorders
Blue/Gray Skin Deposits
Corneal Deposits
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3 mins
Ivabradine
Mechanism of Action
Inhibition If-channels (funny channels) in sinus node
Medical uses
Stable Angina Pectoris
Heart Failure
ADVERSE EFFECTS
Luminous Phenomena, or Visual Brightness
Bradycardia
Headache
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2 mins

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