Antiarrhythmic agent resident survival guide: Difference between revisions
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{{Family tree | E01 | | E02 | | E03 | | E04 | | E05 | | E06 | | E07 | |E01= '''Effect''' |E02= Slows conduction, & prolongs repolarization |E03= Slow conduction in diseased tissues, shorten repolarization |E04= 0.03 unit/min |E05= 20-300 mcg/kg/min |E06= 2.5-20 mcg/kg/min |E07=}} | {{Family tree | E01 | | E02 | | E03 | | E04 | | E05 | | E06 | | E07 | |E01= '''Effect''' |E02= Slows conduction, & prolongs repolarization |E03= Slow conduction in diseased tissues, shorten repolarization |E04= 0.03 unit/min |E05= 20-300 mcg/kg/min |E06= 2.5-20 mcg/kg/min |E07=}} | ||
{{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | {{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | ||
{{Family tree | F01 | | F02 | | F03 | | F04 | | F05 | | F06 | | F07| |F01= '''Indications''' |F02= Pre-excited [[atrial arrhythmias]] <br> [[PSVT]], [[Ventricular tachycardia]] |F03= | {{Family tree | F01 | | F02 | | F03 | | F04 | | F05 | | F06 | | F07| |F01= '''Indications''' |F02= Pre-excited [[atrial arrhythmias]] <br> [[PSVT]], [[Ventricular tachycardia]] |F03= [[Ventricular arrhythmia]] |F04= *Coronary spasm<br>*Splanchnic vasoconstriction|F05= Reflex bradycardia <br>(only α1) |F06= Hypotension (β2) |F07=}} | ||
{{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | {{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | ||
{{Family tree | G01 | | G02 | | G03 | | G04 | | G05 | | G06 | | G07 | |G01= '''Complications''' |G02= | {{Family tree | G01 | | G02 | | G03 | | G04 | | G05 | | G06 | | G07 | |G01= '''Complications''' |G02= | ||
Revision as of 18:56, 12 December 2013
Template:Antiarrhythmic agent Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Definition
Causes
Life Threatening Causes
Common Causes
Prognosis
Vaughan-Williams classification of antiarrhythmic agents
| Vaughan-Williams classification of antiarrhythmic agents | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Class IA | Class IB | Class IC | Class II | Class III | Class IV | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mechanism | Predominantly sodium channel blocker with some potassium channel blocking activity | Sodium channel blocking activity | *V1 receptor of GIT vasculatures *Antidiuretic effects | *Pure α1 agonist(Vasoconstrictive) *No β1 | *Predominant β1 agonist (↑contractility) *β2 arterial smooth muscle (Hypotensive) | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Agents | Quinidine, procainamide, disopyramide | Lidocaine, mexiletine, phenytoin | 2nd line septic shock | 1st line Neurogenic shock 3rd-4th line septic shock | *1st line cardiogenic shock * low output septic shock | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Effect | Slows conduction, & prolongs repolarization | Slow conduction in diseased tissues, shorten repolarization | 0.03 unit/min | 20-300 mcg/kg/min | 2.5-20 mcg/kg/min | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Indications | Pre-excited atrial arrhythmias PSVT, Ventricular tachycardia | Ventricular arrhythmia | *Coronary spasm *Splanchnic vasoconstriction | Reflex bradycardia (only α1) | Hypotension (β2) | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Complications | Abdominal cramping, diarrhea, rash, cinchonism (hearing decrease, tinnitus, and blurred vision), thrombocytopenia, hemolytic anemia, lupus syndrome , granulomatous hepatitis, QRS widening and ventricular arrhythmias. | *Not in cardiogenic shock *Arrhythmia *Ischemia induced cardiotoxicity | *Ischemic heart *Gut ischemia | *Bradycardia *Heart block | *Hypotension (add α1 agonist) | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Do's
- Toxic levels of quinidine cause severe QRS widening and ventricular arrhythmias. (may reverse with the infusion of sodium lactate or sodium bicarbonate).
Don'ts
- Do not start with low dose Dopamine dose to perfuse the kidney.