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Antiarrhythmic Drugs

Antiarrhythmic Drugs USMLE 1

QuestionAnswer
Quinidine Class IA Sodium Channel blocker, inc AP duration, inc effective refractory period, inc qt interval
Quinidine Tox cinchonism - headache, tinnitus thrombocytopenia, torsades de points due to inc QT interval
Procainamide Class IA Sodium Channel blocker, inc AP duration, inc effective refractory period, inc qt interval
Procainamide Tox reversible SLE-like syndrome
Disodyramide Class IA Sodium Channel blocker, inc AP duration, inc effective refractory period, inc qt interval
Antiarrhythmic Na+ channel blockers Slow or block conduction in depolarized cells, dec slope of phase 0 depolarization, inc threshold for firing in abnormal pacemaker cells.
Lidocaine Class IB sodium channel blocker, dec AP duration, affect ischemic or depolarized purkinje and ventricular tissue. Useful in acute ventricular arrhythmias (post MI) and in digitalis induce arrhythmias
Class 1B tox local anesthetic, CNS stimulation/supression, cardi depression
Mexiletine Class IB sodium channel blocker, dec AP duration, affect ischemic or depolarized purkinje and ventricular tissue. Useful in acute ventricular arrhythmias (post MI) and in digitalis induce arrhythmias
Tocainide Class IB sodium channel blocker, dec AP duration, affect ischemic or depolarized purkinje and ventricular tissue. Useful in acute ventricular arrhythmias (post MI) and in digitalis induce arrhythmias
Phenytoin Class IB sodium channel blocker, dec AP duration, affect ischemic or depolarized purkinje and ventricular tissue. Useful in acute ventricular arrhythmias (post MI) and in digitalis induce arrhythmias
Flecainide Class 1C. no effect of AP duration. Useful in V-tachs that progress to VF and in intractable SVT. Use on patients without structural abnormalities.
Class 1C Tox proarrhythmic, especially post-MI (contraindicated) Significantly prolongs refractory period in AV node
Hyperkalemia and Class 1 drugs casues inc tox for all class 1 drugs
Encainide Class 1C. no effect of AP duration. Useful in V-tachs that progress to VF and in intractable SVT. Use on patients without structural abnormalities.
Propafenone Class 1C. no effect of AP duration. Useful in V-tachs that progress to VF and in intractable SVT. Use on patients without structural abnormalities.
Propranolol B-blocker (class 2) dec camp, dec calcium currents, dec slope of phase 4 in pacemakers. AV node most sensitive, inc PR interval. Use v-tach, SVT, slow ventricular rate during a-fib and a-flutter.
Esmolol B-blocker (class 2) dec camp, dec calcium currents, dec slope of phase 4 in pacemakers. AV node most sensitive, inc PR interval. Use v-tach, SVT, slow ventricular rate during a-fib and a-flutter. Esmolol very short acting.
Metoprolol B-blocker (class 2) dec camp, dec calcium currents, dec slope of phase 4 in pacemakers. AV node most sensitive, inc PR interval. Use v-tach, SVT, slow ventricular rate during a-fib and a-flutter.
Timolol B-blocker (class 2) dec camp, dec calcium currents, dec slope of phase 4 in pacemakers. AV node most sensitive, inc PR interval. Use v-tach, SVT, slow ventricular rate during a-fib and a-flutter.
B-blocker tox impotence, exacerbation of asthma, cardio effects = bradycardia, av block, CHF. CNS effects = sedation and sleep alterations. May mask signs of hypoglycemia. Treat overdose with glucagon.
Metoprolol Tox can cause dyslipidemia
Sotalol K channel blocker Class III. Inc AP duration, Inc ERP, Inc QT interval
Sotalol Tox torsades de pointes, excessive B block
Ibutilide K channel blocker Class III. Inc AP duration, Inc ERP, Inc QT interval
Bretylium K channel blocker Class III. Inc AP duration, Inc ERP, Inc QT interval
Amiodarone K channel blocker Class III. Inc AP duration, Inc ERP, Inc QT interval
Ibutilid Tox torsades
Bretylium Tox new arrhythmia, hypotension
Amiodarone Tox pulmonary fibrosis, hepatotoxicity, hypothroidism/hyperthyroidism (has class 1, 2, 3, 4, effects because it alters the lipid membrane.
Verapamil Calcium channel blocker Class IV. dec conduction velocity, inc ERP, inc PR interval. Used in prevention of nodal arrhythmias (SVT)
Diltiazem Calcium channel blocker Class IV. dec conduction velocity, inc ERP, inc PR interval. Used in prevention of nodal arrhythmias (SVT)
Adenosine inc K out of cells hyper polarizes the cells and dec I-Ca. Drug of choice for abolishing supra ventricular trachycardia. Very short acting.
Adenosine Tox Flushing, hypotension, chest pain
Digoxin Inhibition of Na/K ATPase pump leads to indirect inhibition of Na/Ca exchanger. Inc intracellular Ca and inc inotropy. Used for CHF to inc contractility and a-fib to dec conduction at AV node and depression of SA node
Digoxin Tox Cholinergic. ECG - inc PR, dec QT, scooping, T-wave inversion, arrhythmia, hyperkalemia. Worsened by renal failure. Quinidine dec digoxin clearance.
Created by: sweetlu32