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2024 NR 565 PHARMACOLOGY WEEK 3 EXAM WITH CORRECT ANSWERS
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2024 NR 565 PHARMACOLOGY WEEK 3 EXAM WITH CORRECT ANSWERS
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2024 NR 565 PHARMACOLOGYWEEK 3 EXAM WITH CORRECT
ANSWERS
Atrial fibrillation - CORRECT ANSWERS-Conduction system is disrupted
electrical signals move erratically around atria
Atrial fibrillation: Treatment goals - CORRECT ANSWERS-Reestablish normal
heart rate and rhythm
Prevent cardiac related ischemia/embolic events
Atrial fibrillation: initial assessment - CORRECT ANSWERS-ECG
Fasting lipids
Chest x-ray
CBC
DM
Thyroid and renal function
Atrial fibrillation: Typical initial medication management - CORRECT
ANSWERS-Beta blockers
CCBs
Digoxin
Antiarrythmics: Class 1 - CORRECT ANSWERS-Block sodium channels
No longer recommended as 1st line treatment due to pro-arrhythmic
tendencies and safer alternatives
Antiarrythmics: Class II - CORRECT ANSWERS-Block beta adrenergic
receptors
Blocks adrenaline and noradrenaline
Causes decreased heart rate and force = decreased blood pressure and
cardiac workload
Decreased ischemia and increased rhythmic pulse firing
Antiarrythmics: When class II is recommended - CORRECT ANSWERS-
Coexistent heart disease
Underlying CAD
Cardiomyopathy
,Antiarrythmics: Class II, cardioselective - CORRECT ANSWERS-Targets beta
receptors in the heart:
Atenolol (tenormin)
Bisoprolol (Bystolic)
Metoprolol (lopressor)
Metoprolol succinate (toprol-XL)
Antiarrythmics: Class II, non-cardioselective - CORRECT ANSWERS-Targets
beta receptors in heart and other organs
Lungs, blood vessels, bladder, liver, GI tract
Cavedilol (coreg)
Labetolol (trandate)
Nadolol (coragard)
Propranolol (infernal)
Sotalol (betapace)
Side effects: Antiarrythmics class II - CORRECT ANSWERS-Hypotension
Bradycardia
AV block
Bronchospasms
Special considerations: Antiarrythmics class II - CORRECT ANSWERS-
Pulmonary disease (i.e. asthma)
DM-can mask symptoms of hypoglycemia
Thyrotoxicosis-may mask increased HR and BP
Older adults-start low, go slow
Contraindications: Antiarrythmics class II - CORRECT ANSWERS-
Uncompensated HF
Pulmonary edema
Bradycardia
Heart block
Sick sinus syndrome (no pacemaker)
Antiarrythmics: Class III - CORRECT ANSWERS-Block potassium channels that
allow k+ to leave cells
Delays phase 3 repolarization = increased action potential duration and
effective refractory period
Medications: Antiarrythmics class III - CORRECT ANSWERS-Amiodarone
Blocks Na+, K+, and Ca++ channels
Blocks alpha + beta receptors = vasodilation
Treats tachyarrythmias (a-flutter, a-fib, v-tach, v-fib, SVT)
Side effects: Antiarrythmics class III - CORRECT ANSWERS-Dizziness
Fatigue
, Corneal microdeposits
Bradycardia
hypotension
Anorexia
Constipation
N/V
Tremors
Special considerations: Antiarrythmics class III - CORRECT ANSWERS-HF
Thyroid disorders (hypo/hyper)
Corneal refractive laser surgery
Older adults
Contraindications: Antiarrythmics class III - CORRECT ANSWERS-Cardiogenic
shock
Severe sick sinus syndrome
Bradycardia
2nd + 3rd degree AV block
Iodine hypersensitivity
Antiarrythmics class IV - CORRECT ANSWERS-Block calcium channels =
decreased rate of automaticity, decreased conduction velocity, and
prolonged refractoriness
Blocks Na+/k+ pump > increased parasympathetic activation = decreased
HR, increased vagal tone, and decreased sympathetic activity
Medications: Antiarrythmics class IV (dihydropyridines) - CORRECT
ANSWERS-Amlodine (norvasc)
Felodipine (plendil)
Isaradipine SR (dynacirc SR)
Nicardipine SR (cardene SR)
Nifedipine (procardia)
Medications: Antiarrythmics class IV (non-dihydropyridines) - CORRECT
ANSWERS-Diltiazem (cardizem SR, CD)
Verapamil (calan SR)
*Causes electrophysiological effects
*Adverse chronotropic/inotropic effects
Side effects: Antiarrythmics class IV - CORRECT ANSWERS-Peripheral edema
*Amlodipine and nifedipine are associated with edema at higher doses
Special considerations: Antiarrythmics class IV - CORRECT ANSWERS-HF
Aortic stenosis
Severe hepatic impairment
Older adults-increased risk of hypotension
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