Antiarrhythmic Overview Pharmacological Treatments

Question 1

What are the Class Ia drugs used for afib and VT?

Answer 1

Procainamide, Quinidine, Disopyramide

Question 2

What are procainamide adverse events and clincial pearls?

Answer 2

Adverse events: Drug induced SLE (lupus), agranulocytosis, and QT prolongations
Clinical pearls: Active metabolite = NAPA; monitor for renal disease

Question 3

What are quinidine adverse events and clinical pearls?

Answer 3

Adverse events: QT prolongation, diarrhea (can include fever) [common AE], vision changes
Clinical pearls: Paradoxical increase in HR and Afib
ONLY Ia class of drug that is indicated for malaria!!

Question 4

What are the Class Ib drugs used for VT?

Answer 4

Lidocaine and Mexiletine

Question 5

What are lidocaine adverse events and clinical pearls?

Answer 5

Adverse events: Hypotension and seizures at HIGH doses
Clinical pearls: IV is ONLY metabolized in liver (reduce dose)
ONLY Ib class of drug that is indicated for VF!!

Question 6

What are the Class Ic drugs used for VT or PSVT?

Answer 6

Flecainide and Propafenone

Question 7

What are flecainide adverse events and clinical pearls?

Answer 7

Adverse events: QT prolongation, heart block, and new/worsened arrythmias
Clinical pearls: PO only, needs renal adjustment, and worsens HF (mostly systolic)

Question 8

What are the Class II drugs for arrhythmias?

Answer 8

Beta blockers

Question 9

What are the Class III drugs for arrhythmias?

Answer 9

Dofetilide, Ibutilide, Sotalol, Amiodarone, and Dronedarone

Question 10

What are the Class IV drugs for arrhythmias?

Answer 10

Ca channel blockers

Question 11

What are the miscellaneous drugs for arrhythmias?

Answer 11

Adenosine and Digoxin