Quiz on Antiarrhythmic drugs

Which of the following is a significant pharmacokinetic consideration for the antiarrhythmic drug dofetilide? *

Which antiarrhythmic drug is primarily used for the acute termination of stable supraventricular tachycardias and has a very short half-life, requiring rapid intravenous administration? *

A 72-year-old male with a history of hypertension and hyperlipidemia presents to the emergency department with palpitations and shortness of breath that began approximately 6 hours ago. His vital signs are: BP 155/90 mmHg, HR 170 bpm, RR 22/min, SpO2 94% on room air. EKG reveals rapid, irregular atrial activity with no discernible P waves and a ventricular rate of 170 bpm. He is hemodynamically stable. Which of the following is the most appropriate initial pharmacologic management to convert this patient to sinus rhythm? *

The mechanism of action of beta-blockers (Class II antiarrhythmics) in treating arrhythmias involves: *

A 70-year-old male with a history of hypertension and a recent anterior myocardial infarction is admitted with new-onset ventricular fibrillation (VF). He is successfully resuscitated with defibrillation. Post-resuscitation, his EKG shows a sinus rhythm with ST-segment elevation in the anterior leads. He is hemodynamically stable but remains at high risk for recurrent ventricular arrhythmias. Which of the following is the most appropriate long-term pharmacologic strategy to reduce the risk of recurrent VF? *

Which antiarrhythmic drug is known for its significant iodine content and can cause pulmonary fibrosis, thyroid dysfunction, and corneal microdeposits as long-term adverse effects? *

A 40-year-old male presents with a 3-day history of syncope. His EKG shows a heart rate of 30 bpm with third-degree atrioventricular block. He is hypotensive and requires a temporary pacemaker. His blood work reveals a therapeutic level of digoxin. Which of the following is the most likely cause of his current arrhythmia? *

A 70-year-old female with a history of gout and chronic kidney disease (CKD stage 3) is diagnosed with new-onset atrial fibrillation. Her creatinine is 1.8 mg/dL. She is asymptomatic but her physician wants to initiate rhythm control. Which of the following antiarrhythmic agents would require the most significant dose adjustment or caution due to her renal impairment? *

A 55-year-old female with a history of hyperthyroidism and atrial fibrillation is being considered for rhythm control. She is currently on warfarin for stroke prevention. Her thyroid function tests are within normal limits on propylthiouracil (PTU). Which of the following antiarrhythmic agents carries a significant risk of exacerbating or unmasking hyperthyroidism, making it a less ideal choice in this patient? *

Which of the following antiarrhythmic agents is a Class Ic drug that is generally contraindicated in patients with significant structural heart disease due to its potential for proarrhythmia, including increased risk of mortality? *

A 65-year-old female with known ischemic cardiomyopathy and a history of ventricular tachycardia (VT) is admitted after experiencing recurrent episodes of sustained VT. Her current EKG shows a monomorphic VT at 150 bpm, and she is hemodynamically stable. She has been on oral amiodarone for 3 months with good tolerance. Which of the following is the most appropriate next step in management? *

A 45-year-old male with a known history of long QT syndrome (LQTS) presents to the clinic for routine follow-up. His baseline EKG shows a corrected QT interval (QTc) of 500 ms. He is currently asymptomatic. Which of the following antiarrhythmic agents would be most appropriate to consider for long-term management if he were to require therapy for symptomatic arrhythmias? *

A 68-year-old male with a history of chronic obstructive pulmonary disease (COPD) and a recent myocardial infarction (MI) presents with symptomatic premature ventricular contractions (PVCs). His EKG shows frequent unifocal PVCs. He is otherwise hemodynamically stable. Which of the following antiarrhythmic agents should be used with extreme caution or avoided in this patient due to his underlying conditions? *

A 75-year-old male with a history of congestive heart failure (CHF) and persistent atrial fibrillation is being managed for rate control. His current medications include furosemide, lisinopril, and carvedilol. His resting heart rate is 85 bpm, but he experiences episodes of significant palpitations and shortness of breath when his heart rate exceeds 120 bpm during exertion. Which of the following antiarrhythmic agents would be most appropriate to add to his regimen for improved rate control, considering his CHF? *

Which class of antiarrhythmic agents primarily works by blocking L-type calcium channels, leading to decreased automaticity and slowed conduction through the AV node? *

A 58-year-old male with a history of Wolff-Parkinson-White (WPW) syndrome and paroxysmal atrial fibrillation presents with a 2-hour history of rapid palpitations. His EKG shows an irregular rhythm with a ventricular rate of 200-250 bpm and wide QRS complexes, with delta waves evident between beats. He is hypotensive (BP 80/50 mmHg) and diaphoretic. Which of the following is the most appropriate immediate intervention? *

Which of the following antiarrhythmic agents is a Class III drug that also possesses beta-blocking properties? *

Which of the following antiarrhythmic drug classes primarily acts by blocking fast sodium channels in the heart? *

A 60-year-old female with a history of paroxysmal supraventricular tachycardia (PSVT) is experiencing an acute episode. She is hemodynamically stable and her EKG shows a narrow-complex regular tachycardia at 180 bpm. She has no significant cardiac history. Which of the following is the most appropriate first-line pharmacologic treatment? *