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ANTIARRHYTHMIC DRUGS-II
Class II antiarrhythmics: ß blockers 00:00:18

Bblockers block Av node and SA node.

tis used for
Long term management of arrhuythmia : Oral metoprolol.
emergency management: V esmolol.
They are the Doc for:
ldiopathic ventricular tachucardia.
ventricular premature beats.
Atrial Fibrillation/ Putter Rate control.
Congenital long QT sundrome : Long term management.
Catecholamine induced arrhuthmia (Exercise, emotional,
Halothane, Cyclopropane).
V esmolol mau be used for acute attack of sVT/ PSVT.

Class III : Potassium channel blockers 00:04:51

Potassium channel blockers cause a

delay in repolarisation,
hence QT prolongation (Seen with Class la and I1).
Torsades has: maximum risk with lbutilide.
minimum risk with Amiodarone.
Amiodarone
High volume of distribution Requires loading dose.
avinteshpvk98@gmail.com
Inhibitor of P glucoprotein pump.
Haf-He: 53 daus Longest acting
antiarrhythmic).
Amiodarone is the drug of choice in:
Atrial Abrillation Hutter: Rhuthm control
ventricular tachyeardia/ ventricular Abrillation
caused by mi or Digoxin toxicity: Lidocaine is
preterred
tbiocKs potassium channels, sodium channels, calcum
channels and Breceptors
t also blocks a receptors.
Amiodarone has least risk of Torsades.
t contains lodine uhich results in toxicituy,
Side effects of Amiodarone:
Auimonary Abrosis (Tupe 1 pneumocyte damage)
Orug of choice is Prednisoone.
Corneal microdeposits in whori like pattern (vortex
keratopatthy or Cornea verticillato).
elue-greyskin: Cerukoderma.
myocarditis
Granulomas in liver.

Hypotension due to oa blockade.

Photosensitivity
Thyroid toxicity
euthyroid region: Hypothyroidism (more commo.
endemic iodine detcient region: Hyperthyroidism
oronedarone is an Amiodarone derivative
does not contain Iodine but is less eticacious.
used in case of Amiodarone intolerance.
Halflife: a4 hours.
Contraindications: Pregnancu, lactation, heart
failure.

butilide: shortest acting Potassium channel blocker.

Route: IntravenousS.
used in Acute attack of atrial Abrllation utter.

vernakalant: multi-ion channel blocker: Potassium, sodium

and calcium channel blocker.
No QT proonaation (Due to calcum chanmel
blockade and ventricular sparing)
used for Atrial Abrillation.
Dofetilide uses are similar to Amiodarone and lbutilide.

6027e146aa8ded353b86a751
Sotalol: Belongs to both Class Il and I.
used for Atrial lbrillation/ Sutter and ventricular
tachycardia/ Abrilation
eretylium (medical deibrilator): may be used for
ventricular tbrillation.
Class IV: Calcium channel blockers 00:24:04

Calcum chamel blocKers

Nlon Dihudropyridines : Used in arrhythmias.
They aso delay calcium channel recovery ater
blockade.
elocking effect on SAN and AvN (DecreaSed heart rate
and conduction block).

DHPS:more potent vasodilatation more potent

Relex tachucardia.
Drugs: Amlodipine, Nlifedipine, Clevidipine.
OHPs may be used in stable angina but with blocker
Cover.
Non DHPs :
Used in SvT and PSVT.
verapamil (more potent) and Ditiazem:
Produce vasodilation with normal heart rate (No
increase in muocardial 0, demand)
Can be used as monotherapy in Stable angina
Class V antiarrhythmic drugs: Miscellaneous 00:31:50

Adenosine:
mechanism of action: Stimulates adenosine
receptors:
Adenosine IReceptor G): AV node
block and
eronchoconstriction.
Adenosine a Receptor (): Vasodilation.
Adenosine (nucleoside) is rapidly taken
up by Adenosine
uptake protein in cells.
Half ife: 1S seconds Shortest
acting antiarrhuthmic dru
t1s the
drug of choice for aaaubecabinteoof SvT/ PSVT.
Route: Rapid
intravenous push.
mg AdenosineNo response 1 a mg Adenosine.

Adenosine is used to maintain controlled

hupotension during
SArgery
tis used for
diagnosis of coronary artery disease.
Side etects of Adenosine

Hupotension.
 Flushing and dysproea m/).
Risk of atrial flbrillation (Opens channels leads to
Eary repolarisation)
Adenosine is not used in atrial Hbrillation.

Adenosine is contraindicated in
.COPD and eronchial asthma.
V Verapamil is drug of choice for PsVT in this cose.
a. Transplanted heart due to denervation hupersensitivitu

magnesium sulphate
mechanism of action: Blocks cacium channel, leads to

early repolarisation.
used in acute attack of long qT syndrome
management of long QT syndrome
Acute attack Torsades (Acquired/ Congenital
Drug of choice: magnesium sulphate.
Alternative: Isopreraline.
Longterm management
Congenital: ß blockers are drug of choice
Treatment of choice: Pacing.
Acquired Avoid druas causing QT prolonoation.

Atropine: 6027e146aa8ded353b86a751
tis an anticholinergicdrug: Increases heart rate and
AV conduction.
t is the drug of choice for eradyarrhuthmias:
Sinus arrest.
Sinus bradycardia.
Interior wall mi associated braduarrhuthmia
tis the druq of choice for Av block
xample:Digoxin toxicity).
Digoxin:Poarasumpathomimetic eftect AV node block
uses: Preterred when sVT/ PSVT is present with chronic CHF