Antiarrhythimics 2 Flashcards
Treats refractory life threatening ventricular tachycardia and sustained ventricular tachycardia
Amiodarone
Highly lipophilic
Very long t1/2 (months)
Amiodarone
Can cause pulmonary fibrosis, hyper/hypothyroidism, hepatotoxicity, AV block, bradycardia
Proarrhythmic
Amiodarone
Class 3 and Class 1 actions
Prevents a flutter and a fib
t1/2 = 24 hrs
Droned alone
Increased mortality in CHF
Dronedarone
Causes liver injury/failure so monitor liver fn for 6 months
Dronedarone
Prolong ADP/ERP
Terminate a flutter and a fib
Proarrhythmic, so can cause torsades de pointes
Ibutilide/Dofetilide
Class 3 and non-selective beta blocker
Used in life threatening ventricular arrhythmias
Prevents recurrence of symptomatic a flutter and a fib
Prolongs QT causing torsades de pointes
Sotolol
Decrease firing rate of SA node > Decreased HR
Decreased conduction velocity AV node
Increased APD and ERP
Verapamil (Ca channel blocker - class 4)
Decreases contractility in atrial and ventricular muscle
Verapamil
Causes vasodilation and decreased CO to decrease BP
Verapamil
Verapamil inhibits phase _____ in SA and AV nodes
0
Verapamil inhibits phase _____ in skeletal muscle
2
Used for supraventricular arrhythmias, PSVT with AV nodal re-entry, and a flutter/Afib
Verapamil
Adversely causes hypotension, CHF, AV block, and constipation
Verapamil
Avoid with other beta blockers, digoxin, antiarrhythmics, and has hepatic metabolism interactions with cimetidine
Verapamil
Decrease AV conduction Short acting and rapid uptake Bonus Acute termination of PSVT Avoid asthma and COPD
Adenosine
Controls ventricle rate in Afib and a flutter
Digoxin
Use valsalva and carotid sinus massage to terminate
PVST
Used to treat bradycardia by increasing AV and SA nodes
Atropine and isoproterenol
Increases QRS and QT intervals
Procainamide
No effect on PR, QT, or QRS
Lidocaine
Dramatically increases QRS
Flecainide
Increase PR interval (slowing AV node)
Propanolol
Dramatically increases QT interval
Amiodarone
Increase PR interval
Verapamil
Highly efficacious.
DOC acute suppression of ventricular arrhythmias
Amiodarone
