Antiarrhythmics

Anesthesia Pharmacology Chapter 9: Pharmacology of Antiarrhythmic Drugs Practice Questions

Not a class I antiarrhythmic Drug:
1. quinidine gluconate (Quinaglute, Quinalan)
2. lidocaine (Xylocaine)
3. encainide (Enkaid)
4. verapamil (Isoptin, Calan)
Not classified as a Type I antiarrhythmic
1. lidocaine (Xylocaine)
2. quinidine gluconate (Quinaglute, Quinalan)
3. adenosine (Adenocard)
4. encainide (Enkaid)
Correct match(es) between antiarrhythmic drugs and side effects:
1. quinidine gluconate (Quinaglute, Quinalan): diarrhea, cinchonism
2. tocainide (Tonocard): CNS-related side effects including drowsiness, paresthesias
3. procainamide (Procan SR, Pronestyl-SR): Like tocainide,CNS-related side effects including, drowsiness, paraesthesias, and hypotension
4. A & B
Corneal microdeposits, blurred vision, and photophobia:
1. adenosine (Adenocard)
2. encainide (Enkaid)
3. amiodarone (Cordarone)
4. diltiazem (Cardiazem)
Class III anti-arrhythmic drug which also blocks potassium channels:
1. quinidine gluconate (Quinaglute, Quinalan)
2. sotalol (Betapace)
3. bretylium (Bretylol)
4. propafenone (Rythmol)
A patient is diagnosed with atrial fibrillation and exhibits a ventricular following rate of 150 beats / min. Quinidine gluconate (Quinaglute, Quinalan) was administered and although atrial fibrillation was converted to atrial flutter, the ventricular rate increased to 190 beats / min. What is the most likely explanation for the effect on heart rate?
1. Quinidine activated beta-1 cardiac receptors which cause the increase in heart rate.
2. Quinidine converted the atrial fibrillation to atrial flutter which resulted in an increase in heart rate.
3. Quinidine produced an anti-vagal effect and converted atrial fibrillation to atrial flutter. Both effects caused the heart rate to increase.
4. Quinidine has an anti-vagal effect which facilitated transmission through the A-V node.
Agent(s) may be effective in terminating paroxysmal supraventricular tachycardia (PSVT)?
1. adenosine (Adenocard)
2. methoxamine (Vasoxyl)
3. propranolol (Inderal)
4. all of the above
Useful in treating third-degree (complete) heart block:
1. atropine
2. isoproterenol (Isuprel)
3. edrophonium (Tensilon)
4. A & B
A 70 year old female patient is being treated for ventricular arrhythmias following a myocardial infarction. Runs of ventricular tachyarrythmias, episodes of ventricular fibrillation requiring cardioversion, and pulmonary congestion have been noted. Myocardial ejection fraction is very poor at 25%. Which drugs might be appropriate in this case to suppress these malignant arrhythmias?
1. i.v. bretylium (Bretylol)
2. i.v. lidocaine (Xylocaine)
3. i.v. propranolol (Inderal)
4. A & B
Torsades de Pointes, a polymorphic ventricular arrhythmia, is associated with prolongation of Q-T intervals. Which antiarrhythmic agent is most likely to cause this arrhythmia?
1. lidocaine (Xylocaine)
2. quinidine gluconate (Quinaglute, Quinalan)
3. digoxin (Lanoxin, Lanoxicaps)
4. propranolol (Inderal)
Best indicator of digoxin (Lanoxin, Lanoxicaps) efficacy in treating atrial fibrillation:
1. shortened P-R interval
2. decreased ventricular rate
3. weight loss
4. accelerated ventricular repolarization
cardiac effects resemble those of quinidine gluconate (Quinaglute, Quinalan):
1. digoxin (Lanoxin, Lanoxicaps)
2. procainamide (Procan SR, Pronestyl-SR)
3. lidocaine (Xylocaine)
4. adenosine (Adenocard)
Intravenous lidocaine (Xylocaine):
1. supraventricular tachycardia
2. angina
3. congestive heart failure
4. ventricular arrhythmias
Most ominous sign of digoxin (Lanoxin, Lanoxicaps) intoxication:
1. nausea and vomiting
2. irregular P waves
3. ventricular tachycardia with alterations in the QRS complex
4. atrial fibrillation
Increases automaticity:
1. mechanical stretch
2. isoproterenol
3. hypokalemia
4. all of the above
A patient is admitted for treatment of myocardial infarction. During a prolonged recovery period, the patient experienced episodes of vetnricular tachycardia. Following discharge from hospital, the patient was instructed to take a drug to prevent recurrence of ventricular tachycardia. After a few days, the patient complained of dizziness and then lost consciousness. Upon admission to the hospital, the patient was found to be somewhat hypokalemic. A diagnosis of Torsades de Pointes was made. A test to determine the blood level of the antiarrhythmic reveal the drug was present in a slightly subtherapeutic level. What was the drug?
1. sotalol (Betapace)
2. procainamide (Procan SR, Pronestyl-SR)
3. quinidine gluconate (Quinaglute, Quinalan) than
4. lidocaine (Xylocaine)
Procainamide (Procan SR, Pronestyl-SR) side effects:
1. nausea
2. hypotension
3. drug-induced lupus
4. all of the above
A patient is being treated with digoxin (Lanoxin, Lanoxicaps) for congestive heart failure. To enhance inotropic effects, the dosage was increased. Soon afterwards, the patient complained of dizziness, fatigue, and disturbances in color vision. An ECG was taken. ECG finding(s) consistent with digitalis intoxication include:
1. ectopic A-V junctional beats
2. sinus bradycardia
3. third degree heart block
4. all of the above
A patient is being treated with digoxin for congestive heart failure. To enhance inotropic effects, the dosage was increased. Soon afterwards, the patient complained of dizziness, fatigue, and disturbances in color vision. An ECG was taken. What ECG finding(s) would be consistent with digitalis intoxication?A patient is being treated with digoxin for congestive heart failure. To enhance inotropic effects, the dosage was increased. Soon afterwards, the patient complained of dizziness, fatigue, and disturbances in color vision. An ECG was taken and exhibit arrhythmias consistent with digitialis intoxication.
What antiarrhythmic drugs might be used to treat worsening ventricular arrhythmias with hemodynamic compromise?
1. amiodarone (Cordarone)
2. lidocaine (Xylocaine)
3. adenosine (Adenocard)
4. propranolol (Inderal)
Phase of ventricular muscle action potential is associated with an inward,depolarizing Ca2+ current and an outward, repolarizing K+ current.
1. Phase 0
2. Phase 1
3. Phase 2
4. Phase 3
Automaticity:
1. Phase 0
2. Phase 2
3. Phase 4
4. none of the above