Medical Pharmacology Practice Questions: Antiarrhythmic Drugs

Antiarrhythmic drugs classified as sodium channel blockers:
1. quinidine gluconate (Quinaglute, Quinalan)
2. procainamide (Procan SR, Pronestyl-SR)
3. lidocaine (Xylocaine)
4. tocainide (Tonocard)
5. all the above
Antiarrhythmic drugs -- class I: slow the rate of action potential rise and prolong ventricular effective refractory period
1. type Ia
2. type Ib
3. type Ic
Antiarrhythmic drug with antimalarial and antipyretic effects:
1. tocainide (Tonocard)
2. procainamide (Procan SR, Pronestyl-SR)
3. metoprolol (Lopressor)
4. quinidine gluconate (Quinaglute, Quinalan)
5. lidocaine (Xylocaine)
Pharmacokinetic characteristics of quinidine gluconate (Quinaglute, Quinalan)
1. only slightly bound to plasma albumin
2. typically administered by IM injection
3. commonly administered by IV injection
4. rapid oral absorption
5. all of the above
Quinidine gluconate (Quinaglute, Quinalan): mechanism(s)/properties of antiarrhythmic activity:
1. activated sodium channel blockade
2. depression of conduction velocity
3. reduced excitability
4. B & C
5. A, B & C
Quinidine gluconate (Quinaglute, Quinalan) effects on QT interval:
1. shortened
2. lengthened
Quinidine gluconate (Quinaglute, Quinalan): major clinical use--
1. atrial fibrillation
2. atrial flutter
3. ventricular tachycardia
4. A & B
5. A, B & C
Quinidine gluconate (Quinaglute, Quinalan) is effective in suppressing supraventricular tachyarrhythmias due to Wolff-Parkinson-White syndrome:
1. true
2. false
In management of atrial fibrillation: the purpose of administering digitalis before quinidine gluconate (Quinaglute, Quinalan) --
1. digitalis improves the inotropic state of the heart
2. digitalis insures adequate renal excretion of quinidine
3. digitalis enhances vagal tone and reduces AV nodal transmission
4. digitalis blocks muscarinic receptors
Prominent quinidine-mediated actions at receptors:
1. beta adrenergic agonist
2. muscarinic, cholinergic antagonist
3. alpha adrenergic antagonist
4. B & C
5. A, B & C
Hypotensive response following quinidine IV administration -- mechanism/risk:
1. myocardial depression; reduce cardiac output
2. alpha-adrenergic receptor blockade-mediated peripheral vasodilation
3. increased hypotension risk: quinidine gluconate (Quinaglute, Quinalan) + verapamil (Isoptin, Calan)
4. B & C
5. A, B & C
quinidine gluconate (Quinaglute, Quinalan): effect on heart rate -- mechanism:
1. decreased --increased vagal tone
2. decreased-- decreased sympathetic activity
3. increased -- antimuscarinic effects
4. increased -- ganglionic blockade
5. none of the above
Drug-drug interaction: quinidine & digoxin:
1. quinidine gluconate (Quinaglute, Quinalan) increases digoxin (Lanoxin, Lanoxicaps) plasma concentration-- may cause toxicity
2. quinidine gluconate (Quinaglute, Quinalan) decreases digoxin (Lanoxin, Lanoxicaps) plasma concentration -- may precipitate congestive heart failure due to reduced digoxin effect
Quinidine gluconate (Quinaglute, Quinalan) and neuromuscular transmission effects:
1. Enhances the effect of neuromuscular-blocking drugs
2. Skeletal muscle paralysis postoperatively may reoccur with quinidine administration
3. both
4. neither
Antiarrhythmic drug: long-term use associated with a lupus-related side effect:
1. quinidine gluconate (Quinaglute, Quinalan)
2. hydralazine (Apresoline)
3. procainamide (Procan SR, Pronestyl-SR)
4. verapamil (Isoptin, Calan)
Antiarrhythmic drug with more antimuscarinic activity:
1. quinidine gluconate (Quinaglute, Quinalan)
2. procainamide (Procan SR, Pronestyl-SR)
3. about equal
More likely to be administered by IV infusion:-Effective in suppression of premature ventricular contractions and paroxysmal ventricular tachycardia:
1. quinidine gluconate (Quinaglute, Quinalan)
2. procainamide (Procan SR, Pronestyl-SR)
NOT a characteristics of procainamide (Procan SR, Pronestyl-SR)-mediated lupus erythematosus-like syndrome:
1. serositis, arthralgia, arthritis
2. pluritis, pericarditis, parenchymal pulmonary disease
3. vasculitis
4. positive antinuclear antibody test
5. more frequent occurrence in slow acetylators
Not a first-line antiarrhythmic age and because of its negative inotropic effects:
1. procainamide (Procan SR, Pronestyl-SR)
2. disopyramide (Norpace)
3. quinidine gluconate (Quinaglute, Quinalan)
4. lidocaine (Xylocaine)
5. esmolol (Brevibloc)
Type I antiarrhythmic agent: the greater antimuscarinic effects:
1. quinidine gluconate (Quinaglute, Quinalan)
2. disopyramide (Norpace)