Dr.

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218 17. Antiarrhythmics

Study Questions

Choose the ONE best answer.

17.1 A 66-year-old man had a myocardial infarct. Which

one of the following would be appropriate prophy- Correct answer = B. β-Blockers, such as metoprolol,
lactic antiarrhythmic therapy? prevent cardiac arrhythmias that occur subsequent
to a myocardial infarction. None of the other drugs
A. Lidocaine. has been shown to be particularly effective in pre-
B. Metoprolol. venting postinfarct arrhythmias.
C. Procainamide.
D. Quinidine.
E. Verapamil.

17.2 Suppression of arrhythmias resulting from a reentry

focus is most likely to occur if the drug:
A. Has vagomimetic effects on the AV node.
B. Is a β-blocker.
C. Converts a unidirectional block to a bidirectional
block.
D. Slows conduction through the atria.
E. Has atropine-like effects on the AV node.
17.3 A 57-year-old man is being treated for an atrial
arrhythmia. He complains of headache, dizziness,
and tinnitus. Which one of the following antiarrhyth-
mic drugs is the most likely cause?
A. Amiodarone.
B. Procainamide.
C. Propranolol.
D. Quinidine.
E. Verapamil.
Correct answer = C. Current theory holds that a
reentrant arrhythmia is caused by damaged heart
muscle so that conduction is slowed through the
damaged area in only one direction. A drug that
prevents conduction in either direction through
the damaged area interrupts the reentrant arrhyth-
mia. Class I antiarrhythmics, such as lidocaine, are
capable of producing bidirectional block. The other
choices do not have any direct effects on the direc-
tion of blockade of conduction through damaged
cardiac muscle.
Correct answer = D. The clustered symptoms of
headache, dizziness, and tinnitus are characteristic
of cinchonism, which is caused by quinidine. The
other drugs have characteristic adverse effects, but
not this particular group of effects.

17.4 A 58-year-old woman is being treated for chron-

Correct answer = A. The patient is exhibiting symp-
ic suppression of a ventricular arrhythmia. After 2
toms of hypothyroidism, which is often associated
months of therapy, she complains about feeling tired
with amiodarone therapy. Propran­olol could slow
all the time. Examination reveals a resting heart rate
the heart but would not produce the changes in
of 10 beats per minute lower than her previous rate.
thyroid function. None of the other antiarrhythmics
Her skin is cool and clammy. Laboratory test results
is likely to cause hypothyroidism.
indicate low thyroxin and elevated thyroid-stimulat-
ing hormone levels. Which of the following antiar-
rhythmic drugs is the likely cause of these signs and
symptoms?
A. Amiodarone.
B. Procainamide.
C. Propranolol.
D. Quinidine.
E. Verapamil.

Pharm 5th 3-21-11.indb 218 3/21/11 2:24:21 PM