Anti arrhythmic drugs

VAUGHAN WILLIAM CLASSIFICATION

 Question 1
Which class and phase does
PROCAINAMIDE belongs to?
A. Class 2, phase 4
B. Class 4, phase 2
C. Class 4, phase 1
D. Class 3, phase 3
E. Class 1, phase 0
F. Class 1, phase 1
(2marks)
 ANSWER 1
Which class and phase does
PROCAINAMIDE belongs to?
A. Class 2, phase 4
B. Class 4, phase 2
C. Class 4, phase 1
D. Class 3, phase 3
E. Class 1, phase 0
F. Class 1, phase 1
(2marks)
Question 2
What is mechanism of action of CLASS 2
anti arrhythmic drugs?
A. block K+ channels
B. block the fast Na+ channel
C. block beta adrenoceptors
D. block L-type Ca+ channels
E. block Na+/K+-ATPase pump
(4 marks)
ANSWER 2
What is mechanism of action of CLASS 2
anti arrhythmic drugs?
A. block K+ channels
B. block the fast Na+ channel
C. block beta adrenoceptors
D. block L-type Ca+ channels
E. block Na+/K+-ATPase pump
(4 marks)
Question 3
Select 6 side effects of this drug?
1) Hyperthyrodisim

2) Photosensitivity

3) Pneumonitis

4) Hypertension

5) Corneal microdeposits

6) Facial flushing

7) Xanthopsia

8) Transaminitis

9) Hypoglycaemia

10) Bradycardia

(6 marks)
ANSWER 3
Select 6 side effects of this drug?
1) Hyperthyrodisim ✔︎

2) Photosensitivity ✔︎

3) Pneumonitis ✔︎

4) Hypertension

5) Corneal microdeposits ✔︎

6) Facial flushing

7) Xanthopsia

8) Transaminitis ✔︎

9) Hypoglycaemia

10) Bradycardia ✔︎

(6 marks)
Question 4 (T/F)
Regarding anti arrhythmics

A. Lidocaine lengthen the action potential duration

B. Amiodarone prolongs the refractory period of myocardium
C. Adenosine is metabolised by circulating deoxidase
D. Xanthopsia is an adverse effect of verapamil therapy
E. Digoxin inhibit Na-Ca+ exchanger of cardiac myocytes

(5marks)
ANSWER 4 (T/F)
Regarding anti arrhythmics

A. Lidocaine lengthen the action potential duration (F)

B. Amiodarone prolongs the refractory period of myocardium (T)
C. Adenosine is metabolised by circulating deoxidase (F)
D. Xanthopsia is an adverse effect of verapamil therapy (F)
E. Digoxin inhibit Na-Ca+ exchanger of cardiac myocytes (F)

(5marks)
Question 5
46 years old man presented with light headedness and near syncope
episode. He had history of WPW. On arrival, BP 132/76 PR 186. ECG
showed wide complex irregular tachycardia with ventricular pre
excitation. What is your medication of choice?
A. Diltiazem
B. Propanolol
C. Procainamide
D. Digoxin
E. Adenosine (5marks)
ANSWER 5
46 years old man presented with light headedness and near syncope
episode. He had history of WPW. On arrival, BP 132/76 PR 186. ECG
showed wide complex irregular tachycardia with ventricular pre
excitation. What is your medication of choice?
A. Diltiazem
B. Propanolol
C. Procainamide
D. Digoxin
E. Adenosine (5marks)
Question 6
A 60 year old man complained of chest pain and palpitation. ECG shows an
inferior myocardial infarction ventricular tachycardia. Lidocaine is ordered.
When used as an antiarythmic drug, lidocaine typically :
 
A. Increases action potential duration
B. Increases contractility
C. Increases PR interval
D. Reduces abnormal automaticity
E. Reduces resting potential (5marks)
ANSWER 6
A 60 year old man complained of chest pain and palpitation. ECG shows an
inferior myocardial infarction ventricular tachycardia. Lidocaine is ordered.
When used as an antiarythmic drug, lidocaine typically :
 
A. Increases action potential duration
B. Increases contractility
C. Increases PR interval
D. Reduces abnormal automaticity
E. Reduces resting potential (5marks)
Question 7
A 50 year old lady complained to her doctor of palpitation, insomnia, diarrhea and increased
sweating for the past 3 weeks. Physical examination a patient in moderate distress with mild
hand tremors and exophthalmos. Vital signs at that time : BP 142/64 mmHg , PR 125 bpm, RR
18/min, ECG showed atrial tachycardia. Which of the following drugs would be most appropriate
to treat the patients’s arrhythmia ?
A. Quinidine
B. Amiodarone
C. Verapamil
D. Propanolol
E. Digoxin
(5marks)
ANSWER 7
A 50 year old lady complained to her doctor of palpitation, insomnia, diarrhea and increased
sweating for the past 3 weeks. Physical examination a patient in moderate distress with mild
hand tremors and exophthalmos. Vital signs at that time : BP 142/64 mmHg , PR 125 bpm, RR
18/min, ECG showed atrial tachycardia. Which of the following drugs would be most appropriate
to treat the patients’s arrhythmia ?
A. Quinidine
B. Amiodarone
C. Verapamil
D. Propanolol
E. Digoxin
(5marks)
Question 8
A 50 year old lady presented with an abrupt onset of palpitations accompanied by a vague
complaint of “feeling ill”. Subsequent Holter monitoring revealed atrial fibrillation with a
ventricular response up to 152 bpm. Patient’s past history included primary
hyperparathyroidism and intermittent claudication for 3 years due to peripheral occlusive
arteriosclerosis. Which of the following drugs would be appropriate for the chronic control of
the patients arrhythmia?
A. Digoxin
B. Propanolol
C. Verapamil
D. Lidocaine
E. Phenytoin
F. Adenosine
(5marks)
ANSWER 8
A 50 year old lady presented with an abrupt onset of palpitations accompanied by a vague
complaint of “feeling ill”. Subsequent Holter monitoring revealed atrial fibrillation with a
ventricular response up to 152 bpm. Patient’s past history included primary
hyperparathyroidism and intermittent claudication for 3 years due to peripheral occlusive
arteriosclerosis. Which of the following drugs would be appropriate for the chronic control of
the patients arrhythmia?
A. Digoxin
B. Propanolol
C. Verapamil
D. Lidocaine
E. Phenytoin
F. Adenosine
(5marks)
Question 9
A 50 year old lady was admitted to the hospital because of dyspnea, non productive cough and
fever. The man had been receiving an antiarrhythmic drug for 2 months to treat refractory
supraventricular tachycardia. A chest X ray showed diffuse bilateral infiltrates. Bacterial , fungal
and viral cultures were negative. Which of the following drugs mosts likely caused the patient’s
pulmonary disorder?
A. Flecainide
B. Procainamide
C. Amiodarone
D. Lidocaine
E. Adenosine
(5marks)
ANSWER 9
A 50 year old lady was admitted to the hospital because of dyspnea, non productive cough and
fever. The man had been receiving an antiarrhythmic drug for 2 months to treat refractory
supraventricular tachycardia. A chest X ray showed diffuse bilateral infiltrates. Bacterial , fungal
and viral cultures were negative. Which of the following drugs mosts likely caused the patient’s
pulmonary disorder?
A. Flecainide
B. Procainamide
C. Amiodarone
D. Lidocaine
E. Adenosine
(5marks)
Question 10
A 50 year old lady was brought to emergency department by her sister, who stated she
consumed a full bottle of her medications in a suicide attempt. The woman had long history of
depression, bronchial asthma and supraventricular tachycardia. The patient was confused and
drowsy. Vital signs : BP 84/45 , PR 45 bpm, RR 23 breath permin. Which of the following drugs
most likely caused the patient’s signs and symptoms?
A. Ipratropium
B. Adenosine
C. Propanolol
D. Lidocaine
E. Verapamil
(5marks)
 
ANSWER 10
A 50 year old lady was brought to emergency department by her sister, who stated she
consumed a full bottle of her medications in a suicide attempt. The woman had long history of
depression, bronchial asthma and supraventricular tachycardia. The patient was confused and
drowsy. Vital signs : BP 84/45 , PR 45 bpm, RR 23 breath permin. Which of the following drugs
most likely caused the patient’s signs and symptoms?
A. Ipratropium
B. Adenosine
C. Propanolol
D. Lidocaine
E. Verapamil
(5marks)