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 Anesthesia Pharmacology Chapter 9:  Pharmacology of Antiarrhythmic Drugs  Practice Questions
Antiarrhythmic Drugs: Exam #3

Antiarrhythmic Drugs: Exam #3

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Question # 1 (Multiple Choice) Class I antiarrhythmic: similar to quinidine gluconate (Quinaglute, Quinalan); greater antimuscarinic effects compared to quinidine; approved use (USA) ventricular arrhythmias:

    A) lidocaine (Xylocaine)
    B) procainamide (Procan SR, Pronestyl-SR)
    C) disopyramide (Norpace)
    D) mexiletine (Mexitil)
    E) tocainide (Tonocard)

Question # 2 (Multiple Choice) Beta adrenergic receptor blockers:

    A) increased AV conduction time
    B) decreased AV nodal refractoriness
    C) both
    D) neither

Question # 3 (Multiple Choice) Particularly effective in suppressing ventricular arrhythmias associated with digitalis toxicity:

    A) lidocaine (Xylocaine)
    B) quinidine gluconate (Quinaglute, Quinalan)
    C) procainamide (Procan SR, Pronestyl-SR)
    D) phenytoin (Dilantin)
    E) esmolol (Brevibloc)

Question # 4 (Multiple Answer) Mechanism(s) of quinidine gluconate (Quinaglute, Quinalan) antiarrhythmic effect:

    A) depresses ectopy
    B) decreases conduction velocity
    C) decreases excitability

Question # 5 (Multiple Choice) Very short-acting, cardioselective beta adrenergic receptor antagonist:

    A) propranolol (Inderal)
    B) metoprolol (Lopressor)
    C) esmolol (Brevibloc)
    D) adenosine (Adenocard)
    E) theophylline

Question # 6 (Multiple Choice) Shortens QT interval more than any other antiarrhythmic drug:

    A) lidocaine (Xylocaine)
    B) phenytoin (Dilantin)
    C) mexiletine (Mexitil)
    D) esmolol (Brevibloc)
    E) adenosine (Adenocard)

Question # 7 (Multiple Choice) Major clinical antiarrhythmic use of calcium channel blockers:

    A) ventricular arrhythmias
    B) reentrant supraventricular tachycardia
    C) both
    D) neither

Question # 8 (Multiple Choice) Basis for quinidine gluconate (Quinaglute, Quinalan)-mediated longer action potential duration:

    A) reduces outward potassium current
    B) increases outwardpotassium current

Question # 9 (Multiple Choice) Antiarrhythmic drug: may cause hypothyroidism or hyperthyroidism (frequency -- 2%-4%): approved for use only in the treatment of serious ventricular arrhythmias (USA); also use for refractory supraventricular arrhythmias

    A) mexiletine (Mexitil)
    B) tocainide (Tonocard)
    C) adenosine (Adenocard)
    D) amiodarone (Cordarone)
    E) procainamide (Procan SR, Pronestyl-SR)

Question # 10 (Multiple Choice) Antiarrhythmic drug: 37% iodine by weight, structurally similar to thyroxine:

    A) propranolol (Inderal)
    B) mexiletine (Mexitil)
    C) flecainide (Tambocor)
    D) amiodarone (Cordarone)
    E) esmolol (Brevibloc)

Question # 11 (Multiple Answer) Side effects/toxicities: disopyramide (Norpace)

    A) negative inotropism -- very significant
    B) dry mouth
    C) urinary hesitancy
    D) paradoxical ventricular tachycardia
    E) QT interval prolongation (ECG)

Question # 12 (Multiple Choice) Effect of quinidine gluconate (Quinaglute, Quinalan) on digoxin (Lanoxin, Lanoxicaps) plasma concentration:

    A) increases digoxin (Lanoxin, Lanoxicaps) levels
    B) decreases digoxin (Lanoxin, Lanoxicaps) levels

Question # 13 (Multiple Choice) Fluorinated local anesthetic analog of procainamide:

    A) tocainide (Tonocard)
    B) lidocaine (Xylocaine)
    C) flecainide (Tambocor)
    D) disopyramide (Norpace)
    E) none of the above

Question # 14 (Multiple Answer) Side effects associated with quinidine gluconate (Quinaglute, Quinalan) administration:

    A) prolongation PR interval
    B) syncope
    C) bradycardia (SA nodal)
    D) hypotension
    E) positive inotropism

Question # 15 (Multiple Answer) Concerning procainamide (Procan SR, Pronestyl-SR)-induced lupus erythematosus-like syndrome:

    A) include serositis, arthralgia, arthritis
    B) includes vasculitis
    C) irreversible
    D) positive antinuclear antibody test -- common

Question # 16 (Multiple Choice) Amine lidocaine analog-- orally active, really used because of possibly fatal bone marrow aplasia and pulmonary fibrosis:

    A) mexiletine (Mexitil)
    B) tocainide (Tonocard)
    C) quinidine gluconate (Quinaglute, Quinalan)
    D) procainamide (Procan SR, Pronestyl-SR)
    E) esmolol (Brevibloc)

Question # 17 (Multiple Choice) Antiarrhythmic drug which is a local anesthetic analog and which with long-term use may cause a lupus-related side effect--

    A) lidocaine (Xylocaine)
    B) disopyramide (Norpace)
    C) procainamide (Procan SR, Pronestyl-SR)
    D) diltiazem (Cardiazem)
    E) mexiletine (Mexitil)

Question # 18 (Multiple Choice) Major noncardiac side effect of lidocaine (Xylocaine):

    A) hepatic
    B) renal
    C) pulmonary
    D) CNS
    E) endocrine

Question # 19 (Multiple Choice) Comparing quinidine gluconate (Quinaglute, Quinalan) and procainamide (Procan SR, Pronestyl-SR): this drug more likely to produce antimuscarinic and hypotensive reactions

    A) quinidine gluconate (Quinaglute, Quinalan)
    B) procainamide (Procan SR, Pronestyl-SR)

Question # 20 (Multiple Choice) Local anesthetic administered by IV for management of ventricular arrhythmias:

    A) quinidine gluconate (Quinaglute, Quinalan)
    B) procainamide (Procan SR, Pronestyl-SR)
    C) lidocaine (Xylocaine)
    D) flecainide (Tambocor)
    E) adenosine (Adenocard)

Question # 21 (Multiple Choice) Sodium channel blocker -- antiarrhythmic drug that slows the rate of action potential rise and prolongs ventricular effective refractory period

    A) lidocaine (Xylocaine)-type 1b
    B) quinidine gluconate (Quinaglute, Quinalan)-type 1a
    C) flecainide (Tambocor)-type 1c

Question # 22 (Multiple Choice) Nonselective beta adrenergic receptor blocker that also blocks potassium currents

    A) esmolol (Brevibloc)
    B) propranolol (Inderal)
    C) metoprolol (Lopressor)
    D) sotalol (Betapace)
    E) labetalol (Trandate, Normodyne)

Question # 23 (Multiple Choice) Lidocaine (Xylocaine):

    A) greater effect on supraventricular tachyarrhythmias
    B) greater effect on ventricular arrhythmias

Question # 24 (Multiple Choice) Quinidine effects on neuromuscular transmission:

    A) augments
    B) interferes

Question # 25 (Multiple Choice) Possesses antimalarial antipyretic properties:

    A) flecainide (Tambocor)
    B) esmolol (Brevibloc)
    C) quinidine gluconate (Quinaglute, Quinalan)
    D) procainamide (Procan SR, Pronestyl-SR)
    E) disopyramide (Norpace)

Question # 26 (Multiple Choice) Most serious adverse effect with long-term treatment: rapidly progressive pulmonary fibrosis:frequency: 5%-15%

    A) lidocaine (Xylocaine)
    B) propranolol (Inderal)
    C) amiodarone (Cordarone)
    D) procainamide (Procan SR, Pronestyl-SR)

Question # 27 (True/False) Quinidine gluconate (Quinaglute, Quinalan) effect on the ECG: QT interval lengthening

    A) true
    B) false

Question # 28 (Multiple Answer) Clinical uses for quinidine gluconate (Quinaglute, Quinalan):

    A) prevent recurrence of supraventricular tachyarrhythmias
    B) ventricular tachycardia
    C) atrial fibrillation
    D) atrial flutter

Correct Answers

1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28






































Question # 1 (Multiple Choice) Class I antiarrhythmic: similar to quinidine gluconate (Quinaglute, Quinalan); greater antimuscarinic effects compared to quinidine; approved use (USA) ventricular arrhythmias:

Answer: (C) disopyramide (Norpace)

BACK







































Question # 2 (Multiple Choice) Beta adrenergic receptor blockers:

Answer: (A) increased AV conduction time

BACK







































Question # 3 (Multiple Choice) Particularly effective in suppressing ventricular arrhythmias associated with digitalis toxicity:

Answer: (D) phenytoin (Dilantin)

BACK







































Question # 4 (Multiple Answer) Mechanism(s) of quinidine gluconate (Quinaglute, Quinalan) antiarrhythmic effect:

(A) depresses ectopy

(B) decreases conduction velocity

(C) decreases excitability

BACK







































Question # 5 (Multiple Choice) Very short-acting, cardioselective beta adrenergic receptor antagonist:

Answer: (C) esmolol (Brevibloc)

BACK







































Question # 6 (Multiple Choice) Shortens QT interval more than any other antiarrhythmic drug:

Answer: (B) phenytoin (Dilantin)

BACK







































Question # 7 (Multiple Choice) Major clinical antiarrhythmic use of calcium channel blockers:

Answer: (B) reentrant supraventricular tachycardia

BACK







































Question # 8 (Multiple Choice) Basis for quinidine gluconate (Quinaglute, Quinalan)-mediated longer action potential duration:

Answer: (A) reduces outward potassium current

BACK







































Question # 9 (Multiple Choice) Antiarrhythmic drug: may cause hypothyroidism or hyperthyroidism (frequency -- 2%-4%): approved for use only in the treatment of serious ventricular arrhythmias (USA); also use for refractory supraventricular arrhythmias

Answer: (D) amiodarone (Cordarone)

BACK







































Question # 10 (Multiple Choice) Antiarrhythmic drug: 37% iodine by weight, structurally similar to thyroxine:

Answer: (D) amiodarone (Cordarone)

BACK







































Question # 11 (Multiple Answer) Side effects/toxicities: disopyramide (Norpace)

(A) negative inotropism -- very significant

(B) dry mouth

(C) urinary hesitancy

(D) paradoxical ventricular tachycardia

(E) QT interval prolongation (ECG)

BACK







































Question # 12 (Multiple Choice) Effect of quinidine gluconate (Quinaglute, Quinalan) on digoxin (Lanoxin, Lanoxicaps) plasma concentration:

Answer: (A) increases digoxin (Lanoxin, Lanoxicaps) levels

BACK







































Question # 13 (Multiple Choice) Fluorinated local anesthetic analog of procainamide:

Answer: (C) flecainide (Tambocor)

BACK







































Question # 14 (Multiple Answer) Side effects associated with quinidine gluconate (Quinaglute, Quinalan) administration:

(A) prolongation PR interval

(B) syncope

(D) hypotension

BACK







































Question # 15 (Multiple Answer) Concerning procainamide (Procan SR, Pronestyl-SR)-induced lupus erythematosus-like syndrome:

(A) include serositis, arthralgia, arthritis

(D) positive antinuclear antibody test -- common

BACK







































Question # 16 (Multiple Choice) Amine lidocaine analog-- orally active, really used because of possibly fatal bone marrow aplasia and pulmonary fibrosis:

Answer: (B) tocainide (Tonocard)

BACK







































Question # 17 (Multiple Choice) Antiarrhythmic drug which is a local anesthetic analog and which with long-term use may cause a lupus-related side effect--

Answer: (C) procainamide (Procan SR, Pronestyl-SR)

BACK







































Question # 18 (Multiple Choice) Major noncardiac side effect of lidocaine (Xylocaine):

Answer: (D) CNS

BACK







































Question # 19 (Multiple Choice) Comparing quinidine gluconate (Quinaglute, Quinalan) and procainamide (Procan SR, Pronestyl-SR): this drug more likely to produce antimuscarinic and hypotensive reactions

Answer: (A) quinidine gluconate (Quinaglute, Quinalan)

BACK







































Question # 20 (Multiple Choice) Local anesthetic administered by IV for management of ventricular arrhythmias:

Answer: (C) lidocaine (Xylocaine)

BACK







































Question # 21 (Multiple Choice) Sodium channel blocker -- antiarrhythmic drug that slows the rate of action potential rise and prolongs ventricular effective refractory period

Answer: (B) quinidine gluconate (Quinaglute, Quinalan)-type 1a

BACK







































Question # 22 (Multiple Choice) Nonselective beta adrenergic receptor blocker that also blocks potassium currents

Answer: (D) sotalol (Betapace)

BACK







































Question # 23 (Multiple Choice) Lidocaine (Xylocaine):

Answer: (B) greater effect on ventricular arrhythmias

BACK







































Question # 24 (Multiple Choice) Quinidine effects on neuromuscular transmission:

Answer: (B) interferes

BACK







































Question # 25 (Multiple Choice) Possesses antimalarial antipyretic properties:

Answer: (C) quinidine gluconate (Quinaglute, Quinalan)

BACK







































Question # 26 (Multiple Choice) Most serious adverse effect with long-term treatment: rapidly progressive pulmonary fibrosis:frequency: 5%-15%

Answer: (C) amiodarone (Cordarone)

BACK







































Question # 27 (True/False) Quinidine gluconate (Quinaglute, Quinalan) effect on the ECG: QT interval lengthening

Answer: True

BACK







































Question # 28 (Multiple Answer) Clinical uses for quinidine gluconate (Quinaglute, Quinalan):

(A) prevent recurrence of supraventricular tachyarrhythmias

(B) ventricular tachycardia

(C) atrial fibrillation

(D) atrial flutter

BACK