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> with some 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 | 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 arrhythmias (may reverse with sodium lactate or sodium bicarbonate).
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.

References

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