AADs Flashcards
Class 1A: AAD
-Quinidine
-Procainamide
-Disopyramide
(DQP)
*All primarily Na blockers, some K blocking
*FOR supra ventricular and ventricular
= DQP VNS
Quinidine
AE:
-Cinchonism (ND, dizzy, HA, tinnitus, visual, diarrhea)
-Hemolytic anemia
-QTP, TDP
-Thrombocytopenia
DDI:
-Warfarin
-Digoxin
-Pheno, pheny, rifampin
-Class 3 AAD
-Propafenone, flecainide
-BB, verapamil
*can produce beta receptor blockade and vaginal inhibition
=Quin is a QT goes to the PDW
Procainamide
IV
-15-18 mg/kg (max 25) LD, 1-4 mg/min MD
AE:
-Hypotension
-Lupus, BMS
-QTP, TDP
-GI, nausea, fever
DDI:
-Cimetidine, ranitidine
-Trimethoprim
-Class 3 AADs
-Diuretics
*NEGATIVE INOTROPE
*Monitor PA and NAPA (4-8, 4-10)
= she plays PRO at = QT BG NHL DIRTC
Disopyramide
Dose range: 300-1200
-decrease if CHF, HI, RI
-d/c if qrs/qtc increases by 25% or if heart block occurs
AE:
-Anticholinergic
-Hypotension
-Heart failure
-Proarrhythmia = TDP
DDI:
-Pheny, pheno, rif
-Class Ia, Ic, III
-Erythromycin
-Diuretics
-Digoxin
-Tricyclic AD
PAHH PGP TEDD
Class 1B: AAD
-Lidocaine
-Mexiletine
Primarily Na blocker
FOR VENTRICULAR arrhythmias
Lidocaine
LD 1-1.5 mg/kg
MD 1-4 mg/min
AE:
-CNS
= 5+: confusion, dizzy, vertigo, numb, tinnitus
= 9+: psychosis, seizure, sinus arrest, heart block
DDI:
-Cimetidine
-Pheny, pheno, rif
-BB
B CPR
Mexiletine
600-1200 mg/day
AE:
-CNS (tremor)
-Proarrhythmias
-GI upset
-Thrombocytopenia
DDI:
-Cimetidine
-PPR
PACC G to mex
Class 1C: ADD
-Flecainide
-Propafenone
Primarily Na blocker
-QRS/QT/PR widens
FOR supra ventricular and ventricular
(rarely for ventricular tho)
BOTH CI IN STRUCTURAL HEART DISEASE
Flecainide
200-400 mg/day
AE:
-Proarrhythmia
-CHF new/worsening
-Heart block
-CNS: bv, diz
-GI upset: NV
DDI:
-Amiodarone
-Cimetidine
-Digoxin
-BB, CCB (VD)
CI: structural HD
FLEX CCC DABAGS
Propafenone
300-900 mg/day
FOR maintain SR in SVT Arr (AF)
AE:
-Proarrhythmia
-CHF worsens
-Bronchospasm
-CNS
-GI, metallic taste
DDI:
-Digoxin
-Warfarin
-Cimetidine
-Cyclo, theo, BB
-PPR
CI: structural HD and asthma/COPD
none CAB to GMC
Class 2: AAD
Beta blockers
-Atenolol, metoprolol, esmolol
FOR terminating re-entrant and ventricular rate control in AF
AE:
-Brady, hypo, AV block
-CHF worsening
-CNS, GI
-Bronchospasm, dsyp
-Hypo/hyperglycemia, lipid
DDI:
-Cimetidine
-Verapamil
Esmolol Specific Indication
Also used to control wall stress in acute aortic dissection
LD 500 mcg/kg
MD 50 mcg/kg/min
C3: Amiodarone
-FOR VT, VF, AF, AF1, sinus rhythm maintaining
AE:
-TDP
-Pulmonary fibrosis
-Thyroid
-Per neuropathy
-High LFTs
-Corneal microdeposits
-Macular degen
-Skin discoloration
-Phlebitis
-Hepatitis
DDI:
-Thiazide, mycin, zole TCAD
-Phenytoin
-Warfarin
-Digoxin
Caution: Iodine allergy
Dofetilide
Class 3
-FOR AF/1 conversion to sinus rhythm and maintaining
CRCL DOSING
-20-60, dose is 125-500
AE:
-HA, dizzy, nausea, flu
-Tachycardia, TDP, VF, QTP, AV block
DDI:
-Verapamil
-Cimetidine
-Megestrol
-Trime, azole, prochloro
Avoid in QTc 440+
Ibutilide
Class 3
-FOR AF/1 conversion to SR
AE:
-Every arrhythmia
-AV block
-HA, NV, hypotension
Avoid in QTc 440+
Dronedarone
Class 3
-FOR AF/1, maintain SR, reduce ventricular rate
AE:
-NVD, rash, QTc, liver injury, asthenia
Less ae than amiodarone but less effective
DONT use in permanent AF/1
DONT use in Brady (HR < 50), QTc 500+, or 2/3 heart block
CI (QB has AB)
Sotalol
Class 3
-FOR AF/1, VT
AE:
-Fatigue, dep, Brady, NVD, QTP, TDP, broncospasm
DDI:
-Diuretics
-Verapamil, diltiazem
-Amiodarone
-Phenothiazines
Class 4: AAD
-Diltiazem
-Verapamil
FOR automatic or reentrant tachy from SA/AV nodes
and
terminating arrthymias and controlling VR in AF
Class 4: AE
-Brady, AVB, hypotension, dizzy, HA, lethargy, GI
Dilt; edema
Vera; proarrhythmias
Class 4: DDI
Diltiazem
-Propranolol, nitrates, statins (SAL)
Verapamil
-Statins, digoxin, PPR
Adenosine
Max 30 mg, 20-30 ml saline flush must be given right after
AE: HA, dysp, flushing, asystole, broncho
DDI: Theo, caffeine, dipyridamide
1st line for:
-Terminating PSVT
-AV nodal reentry
-Concealed accessory pathway
CATA
Digoxin
AE: GI, neuro, cardiac, blood
-arrhythmias, cog, vision
DDI: PGP, verapamil, quinidine, amiodarone, propa, flecainide
Reserved for VR control in AF pts with low EF or HF or when other agents maxed