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Antiarrhythmics
Question | Answer |
---|---|
Class 1A Antiarrhythmic Use | Effect: Increases AP, ERP, QT interval. USE: Atrial & Ventricular arrhythmias, esp reentrant & ectopic SVT & ventricular tachycardia. |
Class 1B Antiarrhythmic Use | Affect ischemic/depolarized Purkinje & ventricular tissue. Use: Acute ventricular arrhythmia (esp post-MI), Dig-induced arrhythmias. |
Class IC Antiarrhythmic Use | Ventricular tachs ->VFib, intractable SVT. A last resort reatment. |
Class 2 Antiarrhythmic Use | Beta Blockers lower cAMP -> lower Ca current. Suppress abnormal pacemakers by slowing phase 4. Increase PR interval. USE: VTach, SVT, slow ventricular rate in AFib/Flutter. |
Class 3 Antiarrhythmic Use | Increase AP, ERP, QT. Last resort tx. |
Class 4 Antiarrhythmic Use | Slow AV node conductance, increase ERP, PR. Use: Prevent nodal arrhythmias (SVT). |
Class 1A Antiarrhythmic Drugs | Quinidine, Amiodarone, Procainamide, Disopyramide (Queen Amy Proclaims Disco's Pyramid) SE: HyperK. Quinidine SE: HA, tinnitus, thrombocytopenia, torsades de pointes (long QT). Procainamide (SLE-like syndrome) |
Class 1B Antiarrhythmic Drugs | Lidocaine, Mexiletine, Tocinide. SE: Local anesthesia, CNS stimulation/depression, CV depression. HyperK. |
Class 1C Antiarrhythmic Drugs | Flecainide, Encainide, Propafenone. SE: Proarrhythmic (CI'd post-MI), prolongs AV ERP. HyperKHyperK |
Class 2 Antiarrhythmic Drugs | Propanolol, Esmolol, Metoprolol, Atenolol, Timolol. SE: Asthma, bradycardia, AV block, CHF, mask hypoglycemia sx. |
Class 3 Antiarrhythmic Drugs | Sotalol (TdP, excessive Beta block) Ibutilide (TdP), Bretylium (arrhythmia & HypoTN), Amiodarone (Pulm Fibrosis, Hepatotoxicity, Hypo/HyperThyroid, loads of others) |
Class 4 Antiarrhythmic Drugs | Verapamil, Diltiazem. SE: Constipation, flushing, edema, CHF, AV block, TdP. |
Adenosine | K Efflux-> hyperpolarization. Use: #1 for AV nodal arrhythmias. Short-acting. SE: HypoTN, flushing, Chest Pain. |
Potassium | Depress ectopic pacemakers in hypokalemia (ie-dig toxicity) |
Magnesium | Treates Dig-toxicity & TdP |