Antiarrhythmic Drugs

Department of Therapy

Presented by: Mohamed Fazneen LatheefGroup no:17

6th Year

Antiarrhythmic Drugs

04/07/23 Free Template from www.brainybetty.com 2

INTRODUCTIONDrugs that modify the rhythm and

conduction of the heart are used to prevent cardiac arrhythmias.

All such drugs may aggravate or produce arrhythmias and they may also depress ventricular contractility.

04/07/23 Free Template from www.brainybetty.com 3

Vaughan Williams classificationClass 1a

Class 1b

Class 1c

Class 2

Quinidine, Procainamide, Disopyramide

Lidocaine, Mexiletine, Tocainide

Flecainide,Propafanone

Beta adrenergic blocking agents

04/07/23 Free Template from www.brainybetty.com 4

Vaughan Williams classificationClass 3

Class 4

Others

Amiadarone, Sotalol, Bretylium, Ibutilide,Dofetilide

Verapamil, Diltiazem

Adenosine, Digoxin

04/07/23 Free Template from www.brainybetty.com 5

Class 1 Drugs• These are membrane depressant

drugs.• They reduce the rate of entry of

sodium into the cell• They may slow conduction,delay

recovery or reduce the spontaneous discharge of myocardial cells

04/07/23 Free Template from www.brainybetty.com 6

Class 2 Drugs• These anti-sympathetic drugs

prevent the effects of catecholamines on the action potential.

• Most are beta adrenergic antagonists• Cardioselective beta blockers

include,metoprolo,atenalol,acebutalol

04/07/23 Free Template from www.brainybetty.com 7

Class 3 Drugs• These prolong the action potential

and do not effect sodium transport through the membrane.

• Two major classes: Amiadarone and Sotalol(Beta blocker)

04/07/23 Free Template from www.brainybetty.com 8

Class 4 Drugs• The non-dihydropyridine calcium

antagonists that reduce the plateau phase of the action potential and particularly effective at slowing conduction in the nodal tissue.

• Verapamil n Diltiazem are the most important drugs in this group

04/07/23 Free Template from www.brainybetty.com 9

QuinidineClassDaily doseProtein bindingHalf lifePlasma therapeuticIndication

1a250-500mg orally75%6hours2-5microgram/mlAFPSVTVTVPBWPW

04/07/23 Free Template from www.brainybetty.com 10

Side effects of Quinidine• Nausea• Diarrhoea• Blood Dyscrasia• Rash• Fever• Cinchonism• Syncope

04/07/23 Free Template from www.brainybetty.com 11

DisopyramideClassDaily doseProtein bindingHalf lifePlasma therapeuticIndication

1a100-250mg thrice oral40-90%5hours3-6microgram/mlAFPSVTVTVPBWPW

04/07/23 Free Template from www.brainybetty.com 12

Disopyramide SE• Hypotension• Anticholinergic effects• Dry mouth• Urinary hesitancy• Blurred vision• Heart failure

04/07/23 Free Template from www.brainybetty.com 13

LidocaineClassDaily doseProtein bindingHalf lifePlasma therapeuticIndication

1b1-4mg/min50-80%1.5-2hours2-6microgram/mlVT/VFMIVPB

04/07/23 Free Template from www.brainybetty.com 14

Lidocaine SE• Confusion• Convulsion

04/07/23 Free Template from www.brainybetty.com 15

MexiletineClassDaily doseProtein bindingHalf lifePlasma therapeuticIndication

1b400-800mg orally70%15hours0.5-2microgram/mlVTMI

04/07/23 Free Template from www.brainybetty.com 16

Mexiletine SE• Confusion• Tremor• Bradycardia• Hypotension

04/07/23 Free Template from www.brainybetty.com 17

FlecainideClassDaily doseProtein bindingHalf lifePlasma therapeuticIndication

1c100mg twice orally50%18hours0.2-0.8microgram/mlVTPSVTWPW

04/07/23 Free Template from www.brainybetty.com 18

Flecainide SE• Dizziness• Visual disturbance• Arrhythmogenesis

04/07/23 Free Template from www.brainybetty.com 19

PropafenoneClassDaily doseProtein bindingHalf lifePlasma therapeuticIndication

1c150mg thrice85%6hours0.2-1.5microgram/mlVT/VFPSVTWPW

04/07/23 Free Template from www.brainybetty.com 20

Propafenone SE• Light headedness• Unusual taste• Headache• Constipation• Arrhythmogenesis

04/07/23 Free Template from www.brainybetty.com 21

AmiodaroneClassDaily doseProtein bindingHalf lifePlasma therapeuticIndication

3200mg twice orally98%50days plus0.2-5micrograms/mlVT/VFWPWPSVTAF

04/07/23 Free Template from www.brainybetty.com 22

Amiodarone SE• Corneal deposits• Photosensitivity• Skin pigmentation• Thyroid disturbance• Pulmonary alveolitis• Nightmares• Liver disease• Neurological

04/07/23 Free Template from www.brainybetty.com 23

SotalolClassDaily doseProtein bindingHalf lifePlasma therapeuticIndication

2/380-160mg thrice orally<10%24hours0.3-1.5micrograms/mlVTWPWPSVT

04/07/23 Free Template from www.brainybetty.com 24

Sotalol SE• Ventricular arrhythmias• Bradycardia• Heart failure• Bronchospasm• Hypotension

04/07/23 Free Template from www.brainybetty.com 25

VerapamilClassDaily doseProtein bindingHalf lifePlasma therapeuticIndication

40.1mg/kg IV90%6hours0.1-0.3micrograms/

mlPSVT

04/07/23 Free Template from www.brainybetty.com 26

Verapamil SE• Nausea• Vomiting• Constipation• Flushing• Headache• Bradycardia• Fluid retention• Hypotension

04/07/23 Free Template from www.brainybetty.com 27

DiltiazemClassDaily doseProtein bindingHalf lifePlasma therapeuticIndication

460-120mg thrice

orally80%2-8hours0.02-0.16microgm/mlPSVT

04/07/23 Free Template from www.brainybetty.com 28

Diltiazem SE• Nausea• Vomiting• Constipation• Flushing• Headache• Bradycardia• Fluid retention• Hypotension

04/07/23 Free Template from www.brainybetty.com 29

DigoxinClassDaily doseProtein bindingHalf lifePlasma therapeuticIndication

N/A0.25mg once orally25%36hours1.3-2.6millimol/LAF/AFLPSVT

04/07/23 Free Template from www.brainybetty.com 30

Digoxin SE• Nausea• Anorexia• Vomiting• Visual disturbances• Bradycardia• Gynaecomastia