Anti-arrhythmics Flashcards
What type of drug are class 1 anti-arrhythmics?
Sodium channel blockers
Give an example of a class 1 anti-arrhythmic
Flecainide
Lidocaine
What is the action of Class 1 anti-arrhythmics? (3)
Bind and block sodium channels
Reduces phase 0 (depolarisation)
Decrease AP amplitude
Name another condition that sodium channel blockers can be used for
Epilepsy
What type of drug is a class 2 anti-arrhythmics?
Beta blockers
What is the action of class 2 anti-arrhythmics? (4)
Blocks sympathetic activity
Reduces rate and conduction of AP
Slows down phase 4 (prolongs time between AP)
Lowers HR
Give an example of a beta blocker
Atenolol
Bisoprolol
What can beta blockers also be used for?
Hypertension
Heart failure
How would you treat a beta blocker overdose?
Give atropine
Glucagon is atropine is not successful
What are class 3 anti-arrhythmics?
Potassium channel blockers
Give an example of a class 3 anti-arrhythmics
Amiodarone
Sotalol
What is the action of class 3 anti-arrhythmics? (5)
Delays repolarisation Increases duration of AP Prolongs phase 3 Prolongs refractory period Decreases HR
What type of drug are class 4 anti-arrhythmics?
Calcium channel blockers
What is the action of class 4 anti-arrhythmics?
Blocks L-type Ca2+ channels
Slows conduction through AVN
Prolongs phase 2
Decreases HR
What are calcium channel blockers used for a lot? Why?
SVT
They block re-entry mechanism by slowing down conduction through AVN
Give an example of a Calcium channel blocker
Verapamil (oral/IV)
Diltiazem (oral)
What is another use (aside from arrhythmias) of class 4 anti-arrhythmics?
Hypertension
Name the drug used for AF (not in any classes of anti-arrhythmics)
Digoxin
What is the action of digoxin?
Slows HR
Decreases conduction through AVN
Inhibits Na/K/ATPase - no RMP
Indirectly stimulates Vagus nerve - reduces SAN and conduction of AVN
Name some common side effects of anti-arrhythmics
Proarrhythmic
Dizziness
GI disturbances
Give a drug used to treat AF
Rhythm control:
Sotalol (3)
Flecainide (1) [w/ bisoprolol (2) for Atrial flutter]
Amiodarone (3)
Rate control:
Bisoprolol (2)
Verapamil (4)
Diltiazem (4) +/- digoxin
Give examples of drugs used to treat VT
Metoprolol (2)
Lignocaine (1)
Amiodarone (3)
Give examples of drugs used to treat Wolff-Parkinson-white syndrome
Amiodarone (3) (not for long term)
Flecainide (1)
Give examples of drugs for re-entrant SVT
Chronic (oral):
Bisoprolol (2) and verapamil (4)
Sotalol (3)
Amiodarone (3) - last choice due to side effects
Acute (IV):
Adenosine (blocks AVN)
Verapamil (4)
Flecainide (1)
Give examples of drugs used for ectopic beats
Flecainide (1) - as long as there is no structural or IHD
Sotalol (3)
Amiodarone (3)
Bisoprolol (2)
Give examples of drugs used for sinus tachycardia
Bisoprolol (2)
Verapamil (4)
Ivabradine
