Arrhythmia Flashcards
How do anti-arrhythmic drugs generally work?
By affecting either specialized ion channels or sympathetic tone
What are the three main I-a class drugs? (Double Quarter Pounder)
Disopyramide
Quinidine
Procainamide
What is the MOA of class I-a drugs?
Moderate block of both open Na+ and K+ channels
- slow phase 0 depolarization
- prolong action potential and slow conduction
What conditions do class I-a drugs treat?
Ventricular tachyarrhythmias
Paroxysmal recurrent afib
Wolff-Parkinson-White syn. (procainamide)
What are the three I-b drugs? (Lettuce Pickles Mayo)
Lidocaine
Phenytoin
Mexiletine
What is the MOA for class I-b drugs?
Mild blocking or inactivating Na+ channels
- shorten phase 3 repolarization
- decrease the duration of the action potential
What conditions do class I-b drugs treat?
Ventricular tachycardias
What are the two I-c drugs? (Fries Please)
Flecainide
Propafenone
What is the MOA for class I-c drugs?
Block open Na+ channels
-markedly slow phase 0 depolarization
What conditions do class I-c drugs treat?
Paroxysmal atrial fibrilation
What is the class II drug?
Propranolol
What is the MOA of Propranolol (II)?
Block catecholamines at the AV node
- decrease slope of phase 4 depolarization
- prolong repolarization in AV node > block reentry
What conditions does Propranolol (II) treat?
Tachyarrhythmia
Supraventricular
What are the five class III drugs?
Amiodarone Sotalol Ibutilide Dofetilide Dronedarone
What is the MOA of Class III drugs?
Blocking IKr (rapid K+ delayed reaction, outflow) -prolong phase 3 repolarization without altering phase 0
What conditions do class III drugs treat?
Wolff-Parkingons-White syn. (sotalol)
Ventricular arrhythmias
Atrial tachyarrhythmias
What makes Amiodarone different from other Class III drugs?
It blocks like other classes
Has a two month half-life
Treats atrial flutter, afib, vtach, vflutter, SVT
What are the class IV drugs?
Non-dihydropyridine CCBs
Verapamil
Diltiazem
What is the MOA of class IV drugs?
Block L-type Ca++ channels, decrease AV node conduction and increase refractory period -similar to class II but does not block the adrenergic system
What conditions do the class IV drugs treat?
Prevent recurrence of paroxysmal supraventricular tachycardias
Control ventricular rate in afib
What treatments control rate?
Class II, IV, digoxin
What treatments control rhythm?
Class I-a, I-c, III
What are two nonpharmacologic treatments for rate and rhythm control?
Ablation and pacing
What are the drug interactions or contraindications for Quinidine?
Warfarin and digoxin