Antiarrhythmic Flashcards
Quinidine
Class 1A (Na channel blocker)
Phase 0 去極化 duration increase
Increase ERP
Increase APD
Decrease reentry 頻率
Treat
Tachyarrhythmias
Atrial flutter
Side effect
TdP syndrome (long QT interval)
骨骼肌鬆弛
Atropine-like 作用 (讓正常人心搏過速）
Negative inotropic effect (心肌收縮力減少)
Procainamide
Class 1A (Na channel blocker)
Phase 0 去極化 duration increase
Increase ERP
Increase APD
Decrease reentry 頻率
Metabolite: NAPA class 3 activity
Side effect
長期使用 紅斑性狼瘡
白血球過少過敏症狀
Lidocaine
Class 1B
Phase 3 再極化 duration increase
Decrease APD
Increase ERP
Blocks active & inactive Na channel
Treat
Digitalis/ischemia 引起的 arrhythmias
Side effect
CNS drowsiness
Mexiletine
Class 1B
Phase 3 再極化 duration increase
Decrease APD
Increase ERP
Blocks active & inactive Na channel
口服
Treat
Ventricle arrhythmias
Side effect
CNS drowsiness
Tocainide
Class 1B
Phase 3 再極化 duration increase
Decrease APD
Increase ERP
Blocks active & inactive Na channel
口服
Treat
Ventricle arrhythmias
Side effect
CNS drowsiness
Pulmonary fibrosis
Flecainide
Class 1C （死馬當活馬醫用）
Block Na & K channel
Decrease APD
Increase threshold
Treat
頑強心律不整
Side effect
Negative inotropic effect
Congestive heart failure
Life-threatening
Propafenone
Class 1C （死馬當活馬醫用）
Block Na & K channel
Decrease APD
Increase threshold
減緩所有cardiac tissue conductance
Treat
頑強心律不整
Side effect
Negative inotropic effect
Congestive heart failure
Life-threatening
Amiodarone
Class 3 (K channel blocker)
Increase APD & ERP
有 iodine
Treat
Severe tachyarrhythmias
Side effect
Pulmonary fibrosis
Liver toxicity
Hyper/hypothyroidism
Blindness
Sotalol
Class 3 (K channel blockade)
有beta blocker 屬性
Phase 3 repolarization
Increase APD & ERP
Decrease O2 demand
Treat
Long term MI 後 sudden death rate
Side effect
TdP (increase QT interval)
Verapamil
Class 4 (Ca channel blockade)
Increase APD & ERP
Treat
Hypertension
Angina 心絞痛
Side effect
Negative inotropic property
Diltiazem
Class 4 (Ca channel)
Increase APD & ERP
Treat
Hypertension
Angina
Side effect
Negative inotropic property
Adenosine
Class 5
Half life < 10 sec
Increase AV conduct time &ERP
Less effective with theophylline & caffeine (receptor blocker)
Potentiate by dipyridamole (inhibit uptake)
Treat
陣發性上心室心搏過速
Side effect
Flushing
Atrial fibrillation
Magnesium
Class 5
Treat
Digitalis induced arrhythmias
Torsade de points
心律不整病人平常可補充
Potassium
Class 5
Decrease resting potential depolarizing action
Increase membrane potential stabilizing action
Hypokalemia increase risk of EAD & DAD, ectopic pacemaker activity
Digoxin
Class 5
Increase RP
Increase ERP, conduction
強心
Treat
Atrial flutter & fibrillation
Side effect
Ectopic ventricular beats (ventricular tachycardia & fibrillation —用 lidocaine 治）
心室性 DAD
