Anti-arrhythmics Flashcards
(33 cards)
What are the class IA anti-arrhythmias?
Quinidine
Procainamide
Disopyramide
What is the mechanism of action of the class IA anti-arrhythmias?
Block inward K+ rectifying channel at normal concentrations
Blocks Na+ channels at high concentrations
What are the uses of the class IA anti-arrhythmics?
Atrial fibrillation/flutter
Paroxysmal supraventricular tachycardia
Ventricular tachycardia
What are the side effects of the class IA anti-arrhythmics?
QT prolongation TdP arrhythmias Heart block Hypotension Lupus-like syndrome
Thrombocytopenia with quinidine
Anticholinergic effects with disopyramise
What are the class IB anti-arrhythmics?
Lidocaine
Mexiletine
What is the mechanism of action of the class IB anti-arrhythmics?
Block Na+ channels in inactivated state
What is the use for the class IB anti-arrhythmics?
Digitalis toxicity
What are the side effects of the class IB anti-arrhythmics?
Tremor
Nausea
Seizures
Local anesthetic action
GI toxicity with mexiletine
What are the class IC anti-arrhythmics?
Flecainide
Propafenone
Moricizine
What is the mechanism of action of the class IC anti-arrhythmics?
Sodium channel blockers acting as negative inotrope
What are the uses of class IC anti-arrhythmics?
Atrial fibrillation/flutter
Paroxysmal supraventricular tachycardia
Ventricular tachycardia
What are the side effects of the class IC anti-arrhythmics?
Worsened heart failure
Proarrhythmia in ischemic tissue
Increased mortality
Blurred vision with flecainide
Sinus bradycardia and bronchospasm with propafenone
Contraindicated in HF and post-MI–increased mortality
Class II anti-arrhythmics?
Beta-blockers–non-selective
Propanolol
Carvedilol
Beta-blockers–selective
Metoprolol
Acebutolol
Esmolol
What is the mechanism of action the class II anti-arrhythmics?
Blocks beta-adrenergic receptors
Decrease SA, AV node activity –phase 4 depolarization
What are the uses for the class II anti-arrhythmics?
Control of ventricular rate in atrial fibrillation/flutter
Long term suppression of SVTs and PVCs
What are the side effects of the class II anti-arrhythmics?
Heart block
Hypotension
Bronchospasm
Bradycardia
What are the class III anti-arrhythmics?
Sotalol Amiodarone Dofetilide Ibutelide Dronedarone
What is the mechanism of action of the class III anti-arrhythmics?
K channel blockade–prolongs refractoriness
What are the uses of the class III anti-arrhythmics?
Atrial fibrillation/flutter
Paroxysmal supraventricular tachycardia
Ventricular tachycardia
What are the side effects of the class III anti-arrhythmics?
Torsades de Pointes QT prolongation Bradycardia Pulmonary fibrosis Peripheral neuropathy Hepatic dysfunction Hypotension Bronchospasm
Photosensitivity–blue-gray skin
What are the class IV anti-arrhythmics?
Nifedipine
Amlodopine
Verapamil
Diltiazem
What is the mechanism of action of the class IV anti-arrhythmics?
Blockade of L-type Ca++ channels
Slows SA and AV nodal activity
Prolong AV refractoriness
What are the uses of the class IV anti-arrhythmics?
Prevent or terminate reentrant SVTs
What are the side effects of the class IV anti-arrhythmics?
Hypotension Bradycardia Constipation Dizziness Increased serum digoxin levels***
