EM Podcasts: Difference between revisions

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Revision as of 01:31, 10 January 2012

Overview table

Class Known as Examples Mechanism Clinical uses
Ia fast-channel blockers-Affect QRS complex
  • Quinidine
  • Procainamide
  • Disopyramide
(Na+) channel block (intermediate association/dissociation)
  • Ventricular arrhythmias
  • prevention of paroxysmal Recurrent atrial fibrillation (triggered by Vagus nerve overactivity)
  • procainamide in Wolf Parkinson White (WPW)
Ib- Do not affect QRS complex
  • Lidocaine
  • Phenytoin
  • Mexiletine
  • Tocainide
(Na+) channel block (fast association/dissociation)
  • treatment and prevention during and immediately after Myocardial infarction, though this practice is now discouraged given the increased risk of Asystole
  • Ventricular tachycardia
  • Atrial fibrillation
Ic
  • Flecainide
  • Propafenone
  • Moricizine
(Na+) channel block (slow association/dissociation)
  • prevents Paroxysmal atrial fibrillation
  • treats Recurrent tachyarrhythmias of abnormal conduction system.
  • contraindicated immediately post-myocardial infarction.
II Beta-blockers
  • Propranolol
  • Esmolol
  • Timolol
  • Metoprolol
  • Atenolol
  • Bisoprolol
beta blocking
Propranolol also shows some class I action
  • decrease Myocardial infarction mortality
  • prevent recurrence of Tachyarrhythmias
III
  • Amiodarone
  • Sotalol
  • Ibutilide
  • Dofetilide
  • Dronedarone
  • E-4031

K+ channel blocker

Sotalol is also a beta blocker

Amiodarone has Class I, II, and III activity

IV slow-channel blockers
  • Verapamil
  • Diltiazem
Ca2+ channel blocker
  • prevent recurrence of Paroxysmal supraventricular tachycardia
  • reduce Ventricular rate in patients with Atrial fibrillation
V
  • Adenosine
  • Digoxin
  • Magnesium Sulfate
Work by other or unknown mechanisms (Direct nodal inhibition).

Used in supraventricular arrhythmias,

Or in the case of Magnesium Sulfate, used in Torsade de Pointe.

Source

UpToDate

Katzung & Trevor's Pharmacology