Question # 1 (Multiple Choice) Class I antiarrhythmic: similar to quinidine gluconate (Quinaglute, Quinalan); greater antimuscarinic effects compared to quinidine; approved use (USA) ventricular arrhythmias:

A) lidocaine (Xylocaine)
B) procainamide (Procan SR, Pronestyl-SR)
C) disopyramide (Norpace)
D) mexiletine (Mexitil)
E) tocainide (Tonocard)

Question # 2 (Multiple Choice) Beta adrenergic receptor blockers:

A) increased AV conduction time
B) decreased AV nodal refractoriness
C) both
D) neither

Question # 3 (Multiple Choice) Particularly effective in suppressing ventricular arrhythmias associated with digitalis toxicity:

A) lidocaine (Xylocaine)
B) quinidine gluconate (Quinaglute, Quinalan)
C) procainamide (Procan SR, Pronestyl-SR)
D) phenytoin (Dilantin)
E) esmolol (Brevibloc)

Question # 4 (Multiple Answer) Mechanism(s) of quinidine gluconate (Quinaglute, Quinalan) antiarrhythmic effect:

A) depresses ectopy
B) decreases conduction velocity
C) decreases excitability

Question # 5 (Multiple Choice) Very short-acting, cardioselective beta adrenergic receptor antagonist:

A) propranolol (Inderal)
B) metoprolol (Lopressor)
C) esmolol (Brevibloc)
D) adenosine (Adenocard)
E) theophylline

Question # 6 (Multiple Choice) Shortens QT interval more than any other antiarrhythmic drug:

A) lidocaine (Xylocaine)
B) phenytoin (Dilantin)
C) mexiletine (Mexitil)
D) esmolol (Brevibloc)
E) adenosine (Adenocard)

Question # 7 (Multiple Choice) Major clinical antiarrhythmic use of calcium channel blockers:

A) ventricular arrhythmias
B) reentrant supraventricular tachycardia
C) both
D) neither

Question # 8 (Multiple Choice) Basis for quinidine gluconate (Quinaglute, Quinalan)-mediated longer action potential duration:

A) reduces outward potassium current
B) increases outwardpotassium current

Question # 9 (Multiple Choice) Antiarrhythmic drug: may cause hypothyroidism or hyperthyroidism (frequency -- 2%-4%): approved for use only in the treatment of serious ventricular arrhythmias (USA); also use for refractory supraventricular arrhythmias

A) mexiletine (Mexitil)
B) tocainide (Tonocard)
C) adenosine (Adenocard)
D) amiodarone (Cordarone)
E) procainamide (Procan SR, Pronestyl-SR)

Question # 10 (Multiple Choice) Antiarrhythmic drug: 37% iodine by weight, structurally similar to thyroxine:

A) propranolol (Inderal)
B) mexiletine (Mexitil)
C) flecainide (Tambocor)
D) amiodarone (Cordarone)
E) esmolol (Brevibloc)

Question # 11 (Multiple Answer) Side effects/toxicities: disopyramide (Norpace)

A) negative inotropism -- very significant
B) dry mouth
C) urinary hesitancy
D) paradoxical ventricular tachycardia
E) QT interval prolongation (ECG)

Question # 12 (Multiple Choice) Effect of quinidine gluconate (Quinaglute, Quinalan) on digoxin (Lanoxin, Lanoxicaps) plasma concentration:

A) increases digoxin (Lanoxin, Lanoxicaps) levels
B) decreases digoxin (Lanoxin, Lanoxicaps) levels

Question # 13 (Multiple Choice) Fluorinated local anesthetic analog of procainamide:

A) tocainide (Tonocard)
B) lidocaine (Xylocaine)
C) flecainide (Tambocor)
D) disopyramide (Norpace)
E) none of the above

Question # 14 (Multiple Answer) Side effects associated with quinidine gluconate (Quinaglute, Quinalan) administration:

A) prolongation PR interval
B) syncope
C) bradycardia (SA nodal)
D) hypotension
E) positive inotropism

Question # 15 (Multiple Answer) Concerning procainamide (Procan SR, Pronestyl-SR)-induced lupus erythematosus-like syndrome:

A) include serositis, arthralgia, arthritis
B) includes vasculitis
C) irreversible
D) positive antinuclear antibody test -- common

Question # 16 (Multiple Choice) Amine lidocaine analog-- orally active, really used because of possibly fatal bone marrow aplasia and pulmonary fibrosis:

A) mexiletine (Mexitil)
B) tocainide (Tonocard)
C) quinidine gluconate (Quinaglute, Quinalan)
D) procainamide (Procan SR, Pronestyl-SR)
E) esmolol (Brevibloc)

Question # 17 (Multiple Choice) Antiarrhythmic drug which is a local anesthetic analog and which with long-term use may cause a lupus-related side effect--

A) lidocaine (Xylocaine)
B) disopyramide (Norpace)
C) procainamide (Procan SR, Pronestyl-SR)
D) diltiazem (Cardiazem)
E) mexiletine (Mexitil)

Question # 18 (Multiple Choice) Major noncardiac side effect of lidocaine (Xylocaine):

A) hepatic
B) renal
C) pulmonary
D) CNS
E) endocrine

Question # 19 (Multiple Choice) Comparing quinidine gluconate (Quinaglute, Quinalan) and procainamide (Procan SR, Pronestyl-SR): this drug more likely to produce antimuscarinic and hypotensive reactions

A) quinidine gluconate (Quinaglute, Quinalan)
B) procainamide (Procan SR, Pronestyl-SR)

Question # 20 (Multiple Choice) Local anesthetic administered by IV for management of ventricular arrhythmias:

A) quinidine gluconate (Quinaglute, Quinalan)
B) procainamide (Procan SR, Pronestyl-SR)
C) lidocaine (Xylocaine)
D) flecainide (Tambocor)
E) adenosine (Adenocard)

Question # 21 (Multiple Choice) Sodium channel blocker -- antiarrhythmic drug that slows the rate of action potential rise and prolongs ventricular effective refractory period

A) lidocaine (Xylocaine)-type 1b
B) quinidine gluconate (Quinaglute, Quinalan)-type 1a
C) flecainide (Tambocor)-type 1c

Question # 22 (Multiple Choice) Nonselective beta adrenergic receptor blocker that also blocks potassium currents

A) esmolol (Brevibloc)
B) propranolol (Inderal)
C) metoprolol (Lopressor)
D) sotalol (Betapace)
E) labetalol (Trandate, Normodyne)

Question # 23 (Multiple Choice) Lidocaine (Xylocaine):

A) greater effect on supraventricular tachyarrhythmias
B) greater effect on ventricular arrhythmias

Question # 24 (Multiple Choice) Quinidine effects on neuromuscular transmission:

A) augments
B) interferes

Question # 25 (Multiple Choice) Possesses antimalarial antipyretic properties:

A) flecainide (Tambocor)
B) esmolol (Brevibloc)
C) quinidine gluconate (Quinaglute, Quinalan)
D) procainamide (Procan SR, Pronestyl-SR)
E) disopyramide (Norpace)

Question # 26 (Multiple Choice) Most serious adverse effect with long-term treatment: rapidly progressive pulmonary fibrosis:frequency: 5%-15%

A) lidocaine (Xylocaine)
B) propranolol (Inderal)
C) amiodarone (Cordarone)
D) procainamide (Procan SR, Pronestyl-SR)

Question # 27 (True/False) Quinidine gluconate (Quinaglute, Quinalan) effect on the ECG: QT interval lengthening

A) true
B) false

Question # 28 (Multiple Answer) Clinical uses for quinidine gluconate (Quinaglute, Quinalan):

A) prevent recurrence of supraventricular tachyarrhythmias
B) ventricular tachycardia
C) atrial fibrillation
D) atrial flutter