Exam 7- Bahouth Objectives

What are the 3 primary indications for treatment of cardiac arrhythmias?

1. Abnormal Sinus Rhythm

2. Ectopic beats caused by changes in normal impulse formation

abnormal automaticity

3. Ectopic beats caused by alterations in impulse formation

reentry phenomena

What are the primary channel/receptor mechanisms of arrhythmic drugs?

Class I: Fast Sodium Channel Blockers

- Subdivided into A (moderate block), B (weak block), and C (pronounced block)

Class II: Beta-Blockers

Class III: Potassium Channel Blockers

Class IV: Calcium Channel Blockers

What are drugs are in each mechanism of action category?

Class I- A- Quinadine, procainide, and disopyramide, B- lidocaine and mexiletine, C- flecainide and profafenone

Class II- propranolol, metoprolol succinate, esmolol

Class III- Amiodarone, droneerone, sotolol, dofetolide, ibutilide

Class IV- Verapamil, diltiazem

How do Class I drugs increase ERP?

They prolong the action potential duration which prolongs the effective refractory period (ectopic beats cannot occur in ERP)

How do Class I drugs abolish reentrant arrhythmias?

What are the primary drugs used for acute treatment of AV node reentry?

What are the primary drugs for chronic treatment of AV node reentry?

Which drugs are used for reducing ventricular rate in patients with atrial tachyarrhythmias?

How do these drugs reduce ventricular rate in patients with atrial tachyarrhythmias?

How do class 1A drugs produce dangerous increases in Ventricular rate when used alone to treat atrial tachyarrhythmias?

Which drugs reduce the risk of sudden death and reinfarction after an MI?

What are the major side effects that limit the clinical use of antiarrhythmic drugs?

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