I Class
Drug
Indication
ADE
Class Sodium Channel Blockers
-
Blocks the Na current and slows the conduction between the cells
Slow conduction (phase 0 block)
Suppress automaticity phase 4 whenever these processes depend on Na Channel
Alter phase 3 K current (IK) and may change the action potential duration (APD)
In the past, class 1 drugs commonly used in V in patient after myocardial infarction increased motility NO LONGER USED FOR ventricular arrhythmias
-
A fib with rapid V response due to AV bypass
tract (WPW)
Class IC
Lidocaine
-
V-Tach
-
Class IB
Used to be used
for A Fib not
anymore because
too much ProR
-
Chronic use is
limited by SE
HTN
Drug induced
lupus
-
CNS toxicity :
dizziness,
confusion,
seizures;
-
Procainamide
VT/VF
-
Class IA
Recurrent VF
OT prolongation
-
o
Quinidine
-
Class IA
rarely malignant
hyperthermia
VFib
Flecainide
-
Suppression of A Fib (requires structurally normal heart)
Propafenone
-
Suppression of A Fib (requires structurally normal heart)
-
Has addition beta blocker activity
-
Class
Drug
MOA
Indication
-
Class IV: Calcium Channel
Blocker
- Decrease phase 0 and
phase 2 calcium current in
AV node, increasing AV
node refractory period and
slowing conduction
- Additional, phase 4
diastolic current can be
reduced slows
automaticity
WPW
AVN
RT
-
Inhibi
ts the
Na-K
ATPa
se
-
Adjunct to beta
blockers/Ca++ channel
blockers for ventricular rate
control in atrial fibrillation
-
** should not be used alone
for rate control in Afib or
atrial flutter
-
Management of arrhythmias
involving AV node
-
Only works if it the
AV involves (can be used as
diagnosis)
Hypotension
-
Atrica
l
fibrill
ation
Adenosine
-
Most
freq
uent
ly
used
to
slow
cond
ucti
on
thro
ugh
the
Digoxin
ADE
Bradycardia
No eff e c t o n a t ri al flut t e r,
a t ri al fibrilla tion, v e n t ric ul a r
t a c h y c a r di a
Class
Drug
Class II beta blockers
Metoprolol
Propranolol
-
Arrhythmia
management
Can be selective
or non-selective
MOA
Indication
-
-
-
Block outward
Amiodarone
phase 3 K+
current,
prolonging the
effective
refractory period
*function in all class
Bradycardia
-
Hypotension
-
-
Bronchospasm
(asthma patient)
-
Rate control:
B blockers slow AV
nodal conduction,
and are used in A
fib to decrease the V
response rate
- AR
prevention: can
reduce mortality in
pt after MI, in part
of suppression of V
AR
Class III K+ Channel Blocker
-
ADE
Worsening of HF
Several atrial and ventricular
arrhythmias
-antiarrhythmic
- pulmonary fibrosis (irreversible)
**consider lung function, eye, thyroid, livervisual side effects
testings
- hypothyroidism
- liver enzyme elevations
Phase 4 is NOT
affect
- peripheral neuropathy
- photosensitivity
Dofetilide
Atrial fibrillation
-
Prolonged QT
Sotalol
-
-
Suppress artial fibrillation
and ventricular tachycardia
-
Require monitor of the QT
(some pt may have
prolonged thatrisk of
Cleared by renal
No beta blocker
effects
-
Beta blocker
effects
torsades)
Dronaderone
-
-
-
No iodine less
toxic than above
-
CI: pt w/ history
of CHF
-
Bradycardia
-
QT interval
prolongation
-
Nausea
-
Diarrhea
-
Rash
-
Increase in serum
creatinine