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BBC pharm

Ch 31: antiarrhythmic drugs

what are the four classes of antiarrhythmics? sodium channel blocker, beta blocker, potasium channel blocker, calcium channel blocker
what are the class 1 antiarrhythmics? sodium channel blockers.
effect of sodium channel blockers? thye decrease the upstroke (Na entry) during depolarization and, overall, decrease cardiac action potential amplitude. many also cause a prolongaqtion of the AP. all cause a decrease in conduction velocity in injuured tissues (normal tissue not affected)
with sodium channel blockers, the decrease in conduction velocity in injured tissues also increases the chance for what? re-enterant arrhythmias.
what are the thee classes of class 1 antiarrhythmics? class 1A, 1B, 1C
what are the class 1A antiarrhythmatics? quinidine, procainamide.
thi sis effective for both atrial and ventricular tachycardias quinidine
this is used for ventricular and supraventricular tachycardias. procainamide
class 1B antiarrhythmatics? lidocaine, phenytoin. the later is rarely used as antiarrhythmics.
though this is commonly used as antiarrhythmatic, it is used for ventricular tachycardia or ventricular fibrillation. all drugs in this class mildly slow phase 0 while significantly shortening phase 3 repolarization (shortened action potential). lidocaine
what are class 1C antiarrhythmics? flecainide
what is flecainaide effective for? minimizing the chance of ectopic beats in ventricle. however, bc it is also pro-arrhythmic, it is rarely used because of the risk of causing death. all drugs in this class work like class 1A drugs, except their effect on phase 0 is much more profound.
class II antiarrhythmic agents? beta one antagonists. no effective as antiarrhythmics, they improve overall survival by decreasing sympathetic tone of the heart. (propanolol)
why is metoprolol preferred as a class II antiarrhythmic? because it is a beta one specific BB. it can be used post MI prophylactically because the number one cause of death post MI is arrhythmia. dminishes automaticity.
beta blockers are particulasrly suited to treat what kind of tachyarrhythmias? sympathetically driven tachyarrhythmias, as well as atrial fibrillation, atrial flutter, and AV nodal re-entrant tachycardia.
what are the class III antiarrhythmic agnets? potassium channel blockers. they block potasssium outflow during repolarization. hence, te action potential duration is increased as phase 3 depolarization is prolonged. phase 0 remains unchanged.
result of potassium channel blockers? the action potential is significantly prolonged; this can allow for control of an arrhythmia, but can also induce an arrhythmia.
examples of potassium channel blockers? amiodarone, bretylium
this is the first line agent for many ventricular and supraventricular arrhythmias. it has significant side effects, most notable if used long term. amiodarone
major AE of amiodarone? pulmonary fibrosis and thyroid function derangements
class 4 antiarrhythmics? calcium channel blockers. they minimize rrhythmias primarily in two ways: slow calcium conduction in tissues, they slow phase 4, yielding a prolonged actin potential.
what drugs belong to class 4: verpamil, diltiazam.
side effects of quinidine? potentiates digoxin toxicity because it displaces digoxin from plasma proteins.
AE of procainamide? reversible drug induced lupus
Created by: aferdo01