Pharmacology notes

Apr 15th, 2015
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CARDIAC ARRYHTHMIAS Not all ECG documented arrhythmias require treatment. The physician must consider the balance between the symptomatic andprognostic significance of the arrhythmia and the potential side effects of thetherapy. Arrhythmias may arise either from abnormal automaticity triggered afterdepolarization or from disorders of impulse conduction e.g. re-entryphenomenon. Examples of re-entry phenomenon include;o Atrial flutter and fibrillationo Supraventricular tachycardiao Ventricular tachycardiao Ventricular fibrillation Trigger activity is the likely basis for the arrhythmias of digitalis toxicity.Supraventricular Tachycardia(re-entry phenomenon)Supraventricular Tachycardia(re-entry phenomenon)VentricularTachycardia(re-entryPhenomenon)Normal Sinus rhythmAtrial FibrillationClassification of anti-arrhythmic drugs;(Vaughan Williams Classification)ClassDrugsI. Fast sodium channel inhibitorsIa; Quinidine, procainamide, disopyramideIb; Lidocaine, phenytoin, mexiletine, tocainideIc; Flecainide, propafenoneII. Antisympathetic agentsBeta-blockers; e.g. atenolol, propranolol,metoprololIII. Prolongation of action potentialAmiodarone, bretylium, sotaloldurationIV. Slow calcium channel antagonistsVerapamil, diltiazemNot ClassifiedDigoxin, adenosineCardiac Action PotentialClass I action; Also referred to as fast sodium channel inhibitors Agents with class I activity block sodium channels a

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