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
|
|
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
