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19 Cards in this Set

  • Front
  • Back
Class I
Na channel blockers
hyperkalemia increases their cardiac toxicity
Class Ia
Procainamide, Disopyramide, Quinidine
all types of arrhythmias
slows conduction in atria, P fibers, ventricle
Class Ib
Lidocaine, tocainide
Selectively inhibits P fibers and ventricle
Flecainide
Class Ic: prolongs QRS
Approved only for v tach that tends to progress to vfib at unpredictable times
(Ic drugs cause greater mortality than placebo)
Procainamide
common use: arrhythmia during acute phase MI
**causes reversible Lupus (HIPP)
Quinidine
ass'd w/ torsade de pointes
can cause thrombocytopenic purpura
decreases clearance of digoxin
Disopyramide
Class IA
-reduces velocity of phase 0 depol (Na channel blockade)
-increases AP duration
-atrial and vent extrasystoles and tachyarrhythmias
Lidocaine
attenuates phase 4 depol (Ib)
esp for post-MI arrhythmias, digoxin toxicity (Qbank: acute management of vent arrhythmias during ischemia - surgery or MI)
-IV admin
Class II
Beta-blockers
dec cAMP -> dec Na/Ca currents
esmolol: short-acting, exclusively for acute arrhythmias
Propanolol: prophylactic in px w/ MI b/c has protective effect
Class III
K channel blockers
increased refractory per and dec ability to respond to tachycardia (hallmark is prolonged AP)
Sotalol
K blocker, Class III
may -> torsade de pointes
Ibutilide
for a.flutter and afib
may -> torsade de pointes
Amiodarone
Class III (increases duration of AP)
broad spectrum
many toxicities, so not used as much
approved for use for refractory arrhythmias (esp ventricular)
Class IV
Ca channel blockers (verapamil)
AV node
Adenosine
given as IV bolus -> slows AV node conduction
v. effective against AV node arrhythmias (Drug of Choice)
v. short duration
Digitalis
for rapid atrial or AV node arrhythmias (has parasympathomimetic action)
-afib, a.flutter
-never give for WPW - makes arrhythmia worse
K+
depresses ectopic pacemakers, including those caused by digitalis toxicity
Mg+
sim to K+
may be effective in some cases of torsade de pointes
Propanolol
-Class II
-dec SA automaticity, slows AV conduction, inc AV node refratoriness
-ventricular/supraventricular arrhythmias and for slowing vent rate during afib/aflutter