Antiarrhythmic agent resident survival guide: Difference between revisions
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{{Family tree | | | | | B01 | | B02 | | B03 | | B04 | | B05 | | B06 | |B01='''[[Class IA]]''' |B02='''[[Class IB]]''' |B03='''[[Class IC]]''' |B04='''[[Class II]]'''|B05='''[[Class III]]''' |B06='''[[Class IV]]''' |B07= }} | {{Family tree | | | | | B01 | | B02 | | B03 | | B04 | | B05 | | B06 | |B01='''[[Class IA]]''' |B02='''[[Class IB]]''' |B03='''[[Class IC]]''' |B04='''[[Class II]]'''|B05='''[[Class III]]''' |B06='''[[Class IV]]''' |B07= }} | ||
{{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | {{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | ||
{{Family tree | C01 | | C02 | | C03 | | C04 | | C05 | | C06 | | C07 | |C01= '''Mechanism''' |C02= Predominantly sodium channel blocker <br> | {{Family tree | C01 | | C02 | | C03 | | C04 | | C05 | | C06 | | C07 | |C01= '''Mechanism''' |C02= Predominantly sodium <br> channel blocker with some <br> potassium channel blocking activity|C03= *Mainly predominant '''β1''' agonist (↑ cardiac contractility) <br> * some α1 agonist(Vasoconstrictive)|C04= *'''V<sub></sub>1''' receptor of GIT vasculatures <br> *Antidiuretic effects |C05= *'''Pure α1''' agonist(Vasoconstrictive) <br> *No β1 |C06= *Predominant '''β1''' agonist (↑contractility) <br> *β2 arterial smooth muscle (Hypotensive) |C07= }} | ||
{{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | {{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | ||
{{Family tree | D01 | | D02 | | D03 | | D04 | | D05 | | D06 | | D07 | |D01= '''Agents''' |D02= [[Quinidine]], [[procainamide]], [[disopyramide]] |D03= 2nd line septic shock |D04= 2nd line septic shock |D05= '''1st''' line '''Neurogenic shock''' <BR> 3rd-4th line septic shock |D06= *1st line '''cardiogenic shock''' <BR>* low output septic shock |D07= }} | {{Family tree | D01 | | D02 | | D03 | | D04 | | D05 | | D06 | | D07 | |D01= '''Agents''' |D02= [[Quinidine]], [[procainamide]], [[disopyramide]] |D03= 2nd line septic shock |D04= 2nd line septic shock |D05= '''1st''' line '''Neurogenic shock''' <BR> 3rd-4th line septic shock |D06= *1st line '''cardiogenic shock''' <BR>* low output septic shock |D07= }} | ||
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{{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= | ||
abdominal cramping, diarrhea, rash cinchonism (hearing decrease, tinnitus, and blurred vision, thrombocytopenia, hemolytic anemia, lupus syndrome , granulomatous hepatitis, QRS widening and ventricular | abdominal cramping, [[diarrhea]], rash, [[cinchonism]] (hearing decrease, [[tinnitus]], and [[blurred vision]], [[thrombocytopenia]], [[hemolytic anemia]], [[lupus syndrome]] , [[granulomatous hepatitis]], QRS widening and [[ventricular arrhythmia]]s. | ||
|G03= *'''Not in cardiogenic shock''' <br>*Arrhythmia <br> *Ischemia induced cardiotoxicity|G04= *Ischemic heart <br> *Gut ischemia |G05= *Bradycardia <br> *Heart block |G06= *Hypotension (add α1 agonist) |G07=}} | |G03= *'''Not in cardiogenic shock''' <br>*Arrhythmia <br> *Ischemia induced cardiotoxicity|G04= *Ischemic heart <br> *Gut ischemia |G05= *Bradycardia <br> *Heart block |G06= *Hypotension (add α1 agonist) |G07=}} |
Revision as of 17:26, 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 | *Mainly predominant β1 agonist (↑ cardiac contractility) * some α1 agonist(Vasoconstrictive) | *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 | 2nd line septic shock | 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 | 2-20 mcg/min | 0.03 unit/min | 20-300 mcg/kg/min | 2.5-20 mcg/kg/min | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Indications | Pre-excited atrial arrhythmias PSVT, Ventricular tachycardia | Arrhythmia (more β1) | *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.