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23 Cards in this Set
- Front
- Back
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Class IA
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Local anesthetic properties
Lengthen AP duration *Mgmt of AFib and Flutter |
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Procainamide
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ClassIA: Blocks Na Channels
Decreases slope of phase 4 (Less automaticity) Decreases conduction velocity throughout the heart INCREASES AP DURATION AND RP (blocks K efflux) Prolongs PR, QRS, and QT Adverse Effects: SLE-like syndrome and possible Torsades Short T1/2 and some individuals convert to cardioactive metabolite very fast and have increased risk of Torsades but less of SLE |
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Quinidine
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ClassIA: Blocks Na Channels
Same effects as Procainamide to increase AP duration and decrease conduction velocity Prolongs PR, QRS and QT Adverse effects are hypotension, diarrhea, dizziness, tennitis, blurry vision and Torsade *No autoimmune risk Do not give IV (Hypotension) |
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Lidocain
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ClassIB:
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Class IB
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Local anesthetics: Block Na
Decrease AP by stimulating K *Useful only for ventricular arrhythmias |
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Class IA
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Local anesthetic properties
Lengthen AP duration *Mgmt of AFib and Flutter |
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Procainamide
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ClassIA: Blocks Na Channels
Decreases slope of phase 4 Decreases conduction velocity throughout the heart INCREASES AP DURATION AND RP (blocks K efflux) Prolongs PR, QRS, and QT Adverse Effects: SLE-like syndrome and possible Torsades Short T1/2 and some individuals convert to cardioactive metabolite very fast and have increased risk of Torsades but less of SLE |
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Quinidine
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ClassIA: Blocks Na Channels
Same effects as Procainamide to increase AP duration and decrease conduction velocity Prolongs PR, QRS and QT Adverse effects are hypotension, diarrhea, dizziness, tennitis, blurry vision and Torsade *No autoimmune risk Do not give IV (Hypotension) |
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Lidocain
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ClassIB
Used in emergency treatment of ventricular arrhythmias Decreases slope of 4 *Shortens ventricular AP and RP (stimulates K efflux) Adverse Effects: CNS Don't give orally-liver eliminates |
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Class IB
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Local anesthetics: Block Na
Decrease AP only (No effect on K) *Useful only for ventricular arrhythmias |
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Rx for Ventricular Tachycardia
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Lidocaine
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Mexilitine
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An oral congener of Lidocaine that has a long half life and also is useful for treating chronic pain (diabetic nephropathy)
Adverse effects: GI, tremors, dizziness |
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Flecainide
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Class IC
Marked affinity for and blockade of Na channels Slowing of conduction velocity No K effect so little change in AP duration Toxicity: Proarrhythmic in MI pts. *Treats Ventricular Arrhythmias |
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Class II: Propranolol
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B Blockers
Blocks effects of catecholamines on automaticity (lowers HR), AV Conduction, and Refractory period Uses: Paroxysmal Atrial Tachycardia, Arrhytmias from hydrocardbon anesthetics, Atrial arrhythmias, arrhythmias from Ldopa or antidepressants or pheochromocytoma Anesthetic to membranes Heavy first pass metab Adverse effects: Negative ionotrope (CI in CHF), Brochospasm (B2), Rebound sensitivity, AV block, depression and nightmares |
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Metoprolol
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Same as propranolol but cardioselective so fewer unwanted bronchiolar and vascular effects
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Esmolol
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Short acting B Blocker for acute use
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Class III
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Increase AP duration by prolonging the refractory period
Amiodorone, Sotalol, Dofetilide |
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Amiodorone
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Class III
Effective in resistant arrhythmias but many adverse effects Blocks outward K- delays repolarizing (even in accessory tissue of WPW) Adverse effects: Yellow corneal deposits, blue color to skin, pulmonary fibrosis, thyroid dysfunction and *decreased risk of Torsade T1/2 of 100 days (hard to dose) Treats life threatening arrhythmias (VF/VT/AF) and those assoc w/ WPW |
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Dofetilide
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Pure K current blocker
Prolongs AP by prolonging RP Long QT puts at risk for Torsades |
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Verapamil
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Suppresses Ca flux in SA and AV node
Prolongs AV refractory period Adverse effects: bradycardia, AV block, decreased cardiac contraction and hypotension Used for AFib and Flutter |
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Diltiazem
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Blocks Ca in coronary smooth muscle and heart tissue
Coronary vasodilator Decreased SA/AV node and contractile functions |
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Digoxin(Digitalis)
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Inhibits Na/K Atpase to hypopolarize the cell membrane
Prolongs AV refractory period so good for AFib and Flutter |
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Adenosine
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Adenosine is a product of hypoxia
Inhibits adenylate cyclase Activates K channels and hyperpolarizes nodes- slowing conduction Rapid onset in 10s and short half life Side effects due to vasodilation, also possible angina symptoms Use in PSVT |
