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