Term
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Definition
Class: anti-arrhythmic, Class IA
Mechanism: block Fast Na+ channels, increase AP duration and effective refractory period (blocks K+ channels), anticholinergic effects (increase AV conduction speed); intermediate dissocation rate from channels
Indication: terminate re-entrant arrhythmia, prevent supra-ventricular and ventricular tachyarrhythmias; best at moderately high HR; combine with B-block or CCB for atrial fib/flutter (to counter anticholinergic effects on AV node)
Adverse effects: N, V, D, depress cardiac contractility, hypotension (alpha blockade), thrombocytopenia, allergic rxn, cinchonism, SYNCOPE (PROLONGS QT, tachycardia, decrease CO)
Drug interaction: DOUBLES DIGOXIN PLASMA LEVEL |
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Term
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Definition
Class: anti-arrhythmic, Class IA
Mechanism: block Fast Na+ channels, increase AP duration and effective refractory period (blocks K+ channels), anticholinergic effects (increase AV conduction speed); intermediate dissocation rate from channels
Indication: terminate re-entrant arrhythmia, prevent supra-ventricular and ventricular tachyarrhythmias; best at moderately high HR; combine with B-block or CCB for atrial fib/flutter (to counter anticholinergic effects on AV node)
Adverse effects: N, V, allergic rxn, LUPUS-LIKE AUTOIMMUNE syndrome, proarrhythmia TORSADE DEPOINTES (caused by metabolite NAPA which blocks K+ channels) |
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Term
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Definition
Class: anti-arrhythmic, Class IB
Mechanism: block Fast Na+ channels, IV ONLY; rapidly dissociate from channels
Indication: short-term management of life-threatening ventricular arrhythmia; best at high HR
Adverse effects: drowsiness, tremors, convulsions |
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Term
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Definition
Class: anti-arrhythmic, Class IC
Mechanism: block Fast Na+ channels, blocks K+ current involved in repolarization, prolongs AP duration in ventricles; very slowly dissociate from channels
Indication: treatment of life-threatening ventricular arrhythmias and atrial fibrillation; effective at normal and low HRs
Contraindications: PATIENTS WITH PREVIOUS MI --> INCREASED MORTALITY |
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Term
| proranolol (antiarrhythmic) |
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Definition
Class: anti-arrhythmic, Class II
Mechanism: NONSELECTIVE block Beta-R; decrease rate of Phase 4 depolarization in automatic cells (dec. HR and ectopic automaticity), slow AV conduction (enhance AV blocks), reduce myocardial contractility and oxygen demand; (dec. cAMP --> less phosphorylation of Ca++ channels --> decreased Ca++ influx)
Indication: supraventricular tachycardias, atrial and ventricular arrhythmias, prevents SCD in post-MI pts |
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Term
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Definition
Class: anti-arrhythmic, Class II
Mechanism: beta1 SELECTIVE block Beta-R; decrease rate of Phase 4 depolarization in automatic cells (dec. HR and ectopic automaticity), slow AV conduction (enhance AV blocks), reduce myocardial contractility and oxygen demand; (dec. cAMP --> less phosphorylation of Ca++ channels --> decreased Ca++ influx)
Indication: rapid control of ventricular rate in atrial fib/flutter in emergent circumstances where short-term control of ventricular is desirable |
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Term
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Definition
Class: anti-arrhythmic, Class III
Mechanism: block K+ channels and prolong repolarization, prolongs AP duration and refractory period; also blocks Ca++ ch. and Na+ ch.; some non-competitive alpha and beta block;
Indication: supraventricular and ventricular tachycardia, maintenance of sinus rhythm in afib pts
Adverse effects: long term --> fatal PULMONARY FIBROSIS w/ high dose, photosensitivity, corneal deposits, hypo/hyperthyroidism; PROLONG QT |
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Term
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Definition
Class: anti-arrhythmic, Class IV
Mechanism: block Ca++ channels
Indication: supraventricular tachyarrhtyhmia that use the AV node as reentrant pathway (slows AV conduction and prevent reentry), atrial fibrillation (reduce rate of ventricular response)
Contraindication: CHF
Adverse effects: decreased cardiac contractility, relax arterial SMC (dec arterial pressure and barorceptor response --> increase HR) |
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Term
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Definition
Class: anti-arrhythmic, other
Mechanism: inhibit Na+/K+ ATPase, vagal stimulation; changes Ca++ handling; INCREASE ARRHYTYHMOGENICITY OF HEART MUSCLE, INTERFERE WITH CA++ HANDLING --> DELAYED AFTER DEPOLARIZATIONS |
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Term
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Definition
Class: anti-arrhythmic, other
Mechanism: binds ligand-gated K+ channel, hyperpolarization of AV nodal cells, decreases AV node excitability, decreases AV node condution, interrupts AV reentry tachycardia
Indication: IV ONLY; 1st choice drug for termination of supra-ventricular tachycardia involving AV node in re-entry pathway; reduction of ventricular response during atrial flutter/fibrillation
Adverse effects: flushing, dyspnea, transient bradycardia, AV block |
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Term
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Definition
Class III antiarrhythmic
supraventricular and ventricular tachyarrhytmias |
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Term
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Definition
class III antiarrhythmic
acute termination of atrial flutter and fibrillation |
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Term
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Definition
class III antiarrhythmic
maintenance of sinus rhythm after conversion of atrial flutter and fibrillation |
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Term
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Definition
Class III antiarrhythmic
treatment of atrial fibrillation/flutter |
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