STEP TO PG-MD/MS - DR.AKIF A.B

ANTI-ARRHYTHMICS

STEP TO PG-MD/MS - DR.AKIF A.B

STEP TO PG-MD/MS - DR.AKIF A.B

Na+ channel blockage Decreases slope of Phase 0

K+ channel blockage Increases duration of action potential

K+ channel opener Decrease duration of action potential

STEP TO PG-MD/MS - DR.AKIF A.B

--- a) Na+ channel blockage

--- b) K+ channel blockage

--- c) K+ channel opener

a)

b)

c)

Phase 0Phase 2

Phase 1

Phase 3

Phase 4Phase 4

STEP TO PG-MD/MS - DR.AKIF A.B

NORMAL ECGAction potential difference = QT interval

K+ channel blockers

K+ channel blockage

Increases duration of action potential

K+ channel opener

Decrease duration of action potential

STEP TO PG-MD/MS - DR.AKIF A.B

Na+ channel = Depolarisation(QRS wave)

Na+ channel blockage = Increases QRS duration

K+ channel = Repolarisation(QT interval)

K+ channel Blockage = Prolongs QT interval

K+channel Opener = Shortens QT interval

STEP TO PG-MD/MS - DR.AKIF A.B

ANTI ARRHYTHMICSClass I Na+ channel blockerClass II Beta blockersClass III K+ channel blockerClass IV Calcium channel

blockerClass V Others

STEP TO PG-MD/MS - DR.AKIF A.B

CLASS-I ANTI ARRHYTHMICS

Ia Ib IcNa+ channel blockage

Na+ channel blockage

Na+ channel blockage

K+ Channel blockage K+ channel opener No effect on K+ channel

QuinidineProcainamide (S/E:SLE)

LignocainePhenytoinTocainide

Encainide FlecainidePropafenone

Queen – QuinidinePrincess - Procainamide

Used only for ventricular Arrhythmias

STEP TO PG-MD/MS - DR.AKIF A.B

STEP TO PG-MD/MS - DR.AKIF A.B

 PROPRANOLOL

METOPROLOL

CLASS-II ANTI ARRHYTHMICS

BETA BLOCKERS

STEP TO PG-MD/MS - DR.AKIF A.B

CLASS-IIIANTI ARRHYTHMICSB – Bretylium

I – Ibutilide

N – No

D – Dofetilide

A – Amiodarone

S - Sotalol

STEP TO PG-MD/MS - DR.AKIF A.B

AMIODARONE-Metabolised by microsomal enzymes

-Have all the 4 mechanisms : Na+ #

K+ #

Beta #

Ca #

-Longest acting (T1/2 = >3wks)

-Used for all Arrhytmias except Torsades De pointes ( Since it prolongs QT interval)

-

STEP TO PG-MD/MS - DR.AKIF A.B

AMIODARONES/E

The = Thyroid (Hypo or Hyper)

Periphery of = Peripheral Neuropathy

My = Myocardial Depression

Lung & = Lung fibrosis

Cornea is = Corneal deposits

Photosensitive = Photosensitivity

STEP TO PG-MD/MS - DR.AKIF A.B

AMIODARONES/E

STEP TO PG-MD/MS - DR.AKIF A.B

CLASS-IVANTI ARRHYTHMICS

Calcium Channel Blockers

-Verapamil

-Diltiazem

- Dipines do not act on heart.

STEP TO PG-MD/MS - DR.AKIF A.B

CLASS-V ANTI ARRHYTHMICS

Digitalis DOC for Atrial fibrillation + CHF

Atropine Used for Bradyarrhythmias

- DOC for AV blockAdenosine Shortest acting Anti-

Arrhythmias (T1/2 < 10sec)

- DOC for PSVTMgSO4 DOC for Torsades De

Pointes

STEP TO PG-MD/MS - DR.AKIF A.B

DOCAtrial fibrillation and flutter -Acute attack = I.V Ibutilide

-Rhythm control = Amiodarone

-Rate control = Beta blockersAnticoagulation in Atrial Fibrillation

Noval Oral Anticoagulants-Dabigatran-Apixaban

PSVT Treatment = I.V Adenosine

Prophylaxis = Verapamil or Beta Blockers

SVT Treatment and Prophylaxis = Verapamil> Beta blockers

- Associated with CHF = Digoxin

STEP TO PG-MD/MS - DR.AKIF A.B

DOCTorsades De Pointes Magnesium sulphate

Ventricular extrasystole Beta Blockers

Ventricular fibrillation Amiodarone

Digitoxin Toxicity Lidocaine

Ventricular Tachycardia in M.I Lidocaine

WPW Sx Procainamide

STEP TO PG-MD/MS - DR.AKIF A.B

STEP TO PG-MD/MS - DR.AKIF A.B