Anti-Arrhythmic Flashcards
Quinidine Class/MoA
- class 1A
- blocks Na+ –> slow conduction velocity, prolonged refraction
- highly protein bound
Quinidine D-D interactions
- 2D6 inhibitor drugs (digoxin, warfarin, BBs)
- QT prolonging drugs such as digoxin
Quinidine AEs
- diarrhea
- lightheadedness
- thrombocytopenia, hepatitis, QT-prolongation
- torsades, Vtach
Procainamide class/MoA
- class 1A
- blocks Na+ –> slow conduction velocity, prolonged refraction
- IV, activated in liver
Procainamide drug interactions
- CYP2D6 substrate
- QT prolonging drugs
Procainamide AEs
- hypotension
- torsades de pointes
- nausea
- coagulation disorders
Disopyramide class and MoA
- class 1A
- sodium blockade –> slow conduction velocity, prolonged refraction
Disopyramide drug interactions & AEs
- QT-prolonging drugs
- AEs: decreases contractility, xerostomia, constipation, urinary hesitancy
Lidocaine class/MoA
- class 1B
- accelerates repolarization
Lidocaine uses
- treats ventricular arrhythmias associated with MI
- local anesthesia
chronic pain
Lidocaine AEs
- dizziness, drowsiness, N/V, blurred vision, hallucinations
- seizures, bradycardia, respiratory depression
Flecanide class/MoA
- Class 1C
- blocks Na+
- profoundly slows conduction velocity without altering refraction
Flecanide AEs/interactions
- AEs: dizziness, blurred vision, dyspnea, pro-arrhythmia, HF exacerbation
- interacts w/ CYP2D6 substrate
Propafenone class/MoA
- class 1C
- sodium blockade
- profoundly slows conduction velocity without altering refraction
Propafenone AEs
- new or worsening arrhythmia, VTach, bradycardia, HF exacerbation, CNS effects
Propafenone D-D interactions
- avoid with other anti arrhythmics and QT prolonging drugs
- CYP2D6 substrate/inhibitor (digoxin, warfarin, BB, etc)
Amiodarone class/MoA
- class III agent
- K, Ca, Na blockades
- slowed HR, AV conduction, QT prolongation
Amiodarone Uses
- treats/prevents V-Fib and V-Tach
- prevention of atrial tachycardia
Amiodarone AEs
- optic neuritis
- photosensitivity, blue slate skin discoloration
- hypothyroidism, GI issues
- corneal micro deposits
Amiodarone BBWs
- pt should be in hospital when initiating
- pro-arrhythmic (bradycardia)
- hypotension
monitor when using amiodarone
- Liver function tests
- thyroid function tests
- pulmonary function tests
Ibutilide class/MoA
- Class III
- K, Ca, and Na channel blockade –> slowed HR/AV conduction; QT prolongation
Ibutilide AEs/D-D interactions
- AEs: arrhythmias, hypotension (monitor EKG for at least 4 hrs after admin)
- do not use with other QT prolonging drugs
Sotalol class/MoA
- class III
- K, Ca, and Na channel blockade –> slowed HR/AV conduction; QT prolongation
- non selective BB
Sotalol AEs/D-D interactions
- AEs: bradycardia, hypotension, QT prolongation
- do not use with other QT prolonging drugs or those that decrease HR
Dofetilide Class and MoA
- class III
- K, Ca, and Na channel blockade –> slowed HR/AV
Dofetilide AEs/D-D interactions
- AEs: torsades and other arrhythmias
- do not use with other QT prolonging drugs
Drugs for rate control in atrial fibrillation
- Beta blockers
- Ca channel blockers
- Digoxin (must be in combo w/ another drug)
Drugs for rhythm control in atrial fibrillation
Class 1C: flecainide & propafenone
Class III: amiodarone, dofetilide, ibutilide
Drugs for ventricular arrhythmias
- Lidocaine
- Procainamide
- Amiodarone