Class II Flashcards
What are the four drugs of Class II?
- Propanolol
- Acebutolol
- Esmolol
- Sotalol
What is the mechanism of Class II drugs?
- Decrease SA & AV nodal activity via decreasing cAMP, decreasing Ca++ currents
- Suppress normal pacemakers by decreasing slope of phase 4 (AV node particularly sensitive –> increased PR interval)
What are the cardiac effects of Propranolol?
-Decreases Conduction velocity through SA and AV node
What are the cardiac effects of Acebutolol?
-Decreases Conduction velocity through SA and AV node
What are the cardiac effects of Esmolol?
- Short acting selective Beta blocker (cardiac beta 1)
- Negative chronotrope and ionotrope
What are the cardiac effects of Sotalol?
- 2 isomers (L = beta blocker, D = Antiarrhythmic)
- Beta blockage at 25 mg, Antiarrhythmic at 160 mg
- Antiarrhythmetic effect lengthens repolarization or plateau phase of AP
What are the extra cardiac effects of Propranolol?
None
What are the extra cardiac effects of Acebutolol?
Beta blocker everywhere
What are the extra cardiac effects of Esmolol?
None
What are the extra cardiac effects of Sotalol?
None
What are the Pharmacokinetics of Propranolol?
- Complete oral absorption w/wide body distribution
- Metabolized by liver
What are the pharmacokinetics of Acebutolol?
- Well absorbed by GI
- Extensive first pass metabolism
What are the pharmacokinetics of Esmolol?
- Rapid onset and remission
- Renally excreted
What are the pharmacokinetics of Sotalol?
- Readily absorbed orally
- Peak plasma concentration @ 2.5-4 hours
- Renally excreted
What is the toxicity of Propranolol?
- Inhibits Bronchodilation
- Possible intensification of AV block, AV dissociation and AV conduction delays
What is the toxicity of Acebutolol?
- Avoid use in Patients with decompensated HF
- Possible decreased signs and Sx of hypoglycemia
What toxicity is associated with Esmolol?
-Hypotension, dizziness, diaphoresis, headache, somnolence, confusion, agitation, nausea
What toxicity is associated with Sotalol?
-Sinus bradycardia, chest pain, palpitations, hypotension, fatigue, dizziness, asthenia, lightheadedness, dyspnea, nausea & vomiting
What are the therapeutic uses of Propranolol?
- Preferred Tx for Stable, Narrow complex supreventrivcular tachycardias
- Tx for tachycardia during CV surgery
- Management of Supraventricular or ventricular tachycardia associated with glycoside toxicity w/out AV blok
What are the therapeutic uses of Acebutolol?
- Tx of frequent PVCs
- Tx of hypertension
What are the therapeutic uses of Esmolol?
- Supraventricular tachycardia
- Hypertension
- Acute MI
- Unstable Angina
- Non-ST elevation MI
What are the therapeutic uses of Sotalol?
-Ventricular arrhythmias & Supraventricular tachycardias
