Pharm of Anti-Arrhythmics Flashcards
AA use
- help maintain sinus rhythm after afib restored to sinus rhythm
- reduce freq of Vtachy/Vfib in pt w/ structural heart disease and ICD
90% of all arrhythmias are
reentry
danger of EAD
(torsades)
Ia (quinidine, procainamide)
III (sotalol, dofetilide)
non-dihydropyridine CCBs
diltiazem
verapamil
MOA: block AV node in SVTs
dihydropyridine CCBs
amlodipine
nicardipine
nifedipine
MOA: arterial vasodilator, HTN, chronic stable angina
Digoxin use
useful in control of ventricular response to afib when BP is low or when LV EF is significantly reduced
Adenosine use
give IV, blocks AV node conduction (terminates SVT that req AV node –> AVNRT or AVRT –> back to sinus rhythm)
rapid onset/offset
responsible for conversion of afib to aflutter
IC
promotion of BBB development
IC
rate control strategy –> reduce ventricular response
II
IV
digoxin
rhythm control strategy –>
AA therapy
normal heart –> IC
abnormal heart –> III
both rate control/rhythm control strategies should include
anti-coagulant therapy to prevent systemic thromboembolism
chronic SVT tx
ablation
medical therapy
-AV block
-BB or CCB
acute SVT tx
unstable –> synchronized cardioversion
stable –>
- vagal maneuvers
- adenosine IV
- CCB
- synchronized cardioversion
recurrent Vtachy tx
–> ICD –> correct ischemia/electrolytes/HF/advance beta blockers –> AA to prevent VT and reduce freq of ICD discharge (amiodarone or sotalol dec on HF)
