Anti-arrhythmia drugs

Can you name the Anti-arrhythmia drugs?

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HintAnswer
Sotolol
Preferential for ectopic arryhythmias and ventricular arrhythmias d/t increased automaticity and reentry
MOA: non-selective beta blockade
Class IB drug with pulmonary fibrosis as a side effect
Contraindicated in WPW
Blocks K channels
SE: more pronounced SA and AV block, lupus erythmatosus like syndrome, ganglion blockade
SE: profound anti-muscarinic effects, dry mouth, urinary retention, blurred vision, constipation, confusion, convulsions, etc.
Class II drug used in surgery and acute arrhythmias
SE: least toxic for cardiac arrhythmias, CNS, drowsiness, slurred speech, paresthesia, agitation, convulsions
Disopyramide is excreted by the....
Procainamide is excrexted by the....
Class IB drugs
MOA: blockade of open and inactivated sodium channels -> no effect on AP duration, slows phase 0 depolarization, decreases conduction velocity
Used in supraventricular and ventricular tachy-arrhythmias, paroxsymal A fib
IV only class 1B drug with a wide therapeutic window
Other antiarrhythmias
Need to monitor PFTs, LFTs, and TFTs
Class II Drugs
Class IA drug that also blocks N-R
Bretylium
Class III drugs with high affinity for inactive channels
Class IA drug that also blocks alpha-R
SE: torsades de pointes
MOA: beta-1 selective beta blockade
Amiodarone
MOA: decrease phase 4 spontaneous depolarization, slows conduction in cells dependent on Ca current. Also vasodilates
HintAnswer
Other: Used in digitalis associated arrhythmias, torsades de pointes, and acute MI
SE: arrythmias, N/V, diarrhea, cinchonism, displaces digoxin from tissue binding site, thrombocytopenia, hepatitis, angioneurotic edema
Used to maintain SR after cardioversion of A fib and A flutter
Class IC drugs
Class III IV only
Ibutilide
DOC for paroxsymal supraventricular tachycardia and V tach
Used in rate control for supraventricular arrythmias including A fib, A flutter
Other: Used in SV arrhythmias, Afib, Aflutter, controls ventricular response rate
Class IC drug with weak beta blocking activity
Used in life threatening ventricular arrhythmias when lidocaine and cardioconversion have failed
Used in conversion in a fib and a flutter
Quidine is metabolized by the .....
Class IA Drugs
MOA: blockade of open and inactivated sodium channels -> shortened AP, decreased slope of repolarization, and shortened phase 3 repolarization
MOA: partial beta agonist
Na channel blocker
Class IV drugs
DOC for ventricular arrhythmias, esp. post-MI and cardioversion
Decreases sudden death MI for sustained ventricular tachycardia
SE: safe, flushing, SOB, hypotension, transient asystole
Dofetilide
SE pulmonary fibrosis, liver tox, hypothyroid, photosensitivty, corneal discoloration, blue skin
Caution in CHF, asthmas, COPD, MAOI, eldery, depressed, PVD
MOA: high affinity for blockade of open Na channels and also K channels -->decrease phase 0 depolarizing slope, prolong AP, decrease phase 4 spontaneous depolarization
Used in refractory ventricular arrythmias and some SVT -- oral with long half life

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