Drugs Indication Special considerations

Class IA AF Monitor widening QRS,

Disopyramide VT prolonged QT
Procainamide A flutter
Quinidine PAT

Class IB VT Potentiates effects of other

Lidocaine VF antiarrhythmics
Mexlitine
Tocainide

Class IC VT Correct electrolyte imbalance

Flecainide VF Monitor QRS widening,
Moricizine SVT prolonged QT
Propafenone

Class II AF MonitorHR and BP

Beta blockers A flutter Abrupt stoppage exacerbate
PAT angina and precipitate MI
Monitor PR
Cautious in reactive airway ds
May mask features of shock
and hypoglycemia

Class III Life threateningarrhythmias BP, HR, rhythm

Amiodarone resistant to other drug Amiodarone increases digoxin
Dofetilide toxicity
Ibutilide Signs of pulmonary toxicities
Sotalol Prolonged QT with sotalol,

Class IV SVT Monitor HR, rhythm, BP when

Diltiazem initiating and increasing
Verapamil Calcium supplements reduce
effectiveness

Class V PSVT Short acting

Adenosine Saline flush following i.v. use
Record rhythm strip

Atropine Symptomatic SB Monitor HR ,rhythm

AV block Cautious in IHD
Asystole Paradoxical slowering in dose
PEA <0.5mg

Epinephrine Pulseless VT,VF Monitor HR ,rhythm

Asystole Cautious in IHD
PEA Hypersensitivity reaction