anti-arrhythmics

anti-arrhythmics -...

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Antiarrhythmic Therapy Antiarrhythmic Therapy UTHSCSA Pediatric Resident Curriculum for the PICU
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Antiarrhythmic Therapy Antiarrhythmic Therapy Empiric Arrhythmia Diagnosis Interventions Clinical Outcomes Interventions Clinical Outcomes Pathophysiologic Arrhythmia Diagnosis Known or suspected mechanisms Critical components Vulnerable parameters Targeted subcellular units BLACK BOX
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Antiarrhythmic Therapy Antiarrhythmic Therapy Pathophysiologic Arrhythmia Diagnosis Interventions Clinical Outcomes Known or suspected mechanisms Critical components Vulnerable parameters Targeted subcellular units AV node reentrant tachycardia AV node reentry Anatomical fast/slow pathway AV node (slow conduction) AV nodal action potential L-type Ca ++ channel Ca ++ channel blocker β -blocker Sinus rhythm
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Vaughn-Williams Classification Vaughn-Williams Classification Based on cellular properties of normal His-Purkinje cells Classified on drug’s ability to block specific ionic currents (i.e. Na + , K + , Ca ++ ) and beta-adrenergic receptors Advantages: Physiologically based Highlights beneficial/deleterious effects of specific drugs
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Antiarrhythmic Therapy Antiarrhythmic Therapy Empiric Arrhythmia Diagnosis Interventions Clinical Outcomes BLACK BOX Goals Identify the type of dysrhythmia Be familiar with more common antiarrhythmics and their Vaughn-Williams Classification
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Arrhythmia Types Arrhythmia Types Slow Fast Fast wide Fast narrow Too fast
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Arrhythmia-focused Therapy Arrhythmia-focused Therapy Fast Narrow Supraventricular tachycardias Re-entry type Orthodromic SVT Automatic A.E.T. , Atrial Flutter J.E.T.
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Arrhythmia-focused Therapy Arrhythmia-focused Therapy Fast Wide (rare) Antidromic SVT or SVT with abberancy Ventricular tachycardia Inappropriate automaticity of ventricular or His-Purkinje tissue
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Arrhythmia-focused Therapy Arrhythmia-focused Therapy Select one antiarrhythmic or a limited group of antiarrhythmics to treat the disorder.
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Antiarrhythmic Agents Antiarrhythmic Agents Vaughn-Williams Classification Vaughn-Williams Classification Class I - Na + - channel blockers (direct membrane action) Class II - Sympatholytic agents Class III - Prolong repolarization Class IV- Ca ++ - channel blockers Purinergic agonists Digitalis glycosides
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The Action Potential The Action Potential Phase 0 Phase 4 Phase 3 Phase 2 Phase 1 - 90 mV 0 mV 30 mV
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Class I Class I Na+ Channel Blockers Na+ Channel Blockers IA - Quinidine/Procainamide/Disopyramide IB - Lidocaine/Mexiletine/Phenytoin IC - Flecainide/Propafenone/Ethmozine 1 0 2 3 4 ERP RRP Affects Phase 0
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Class IA - Class IA -
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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anti-arrhythmics -...

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