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    Disease Mechanism of Action Note

    Uploaded by

    amoody95
    This document discusses various types of arrhythmias and treatments. It describes tachyarrhythmias as a heart rate over 100 beats per minute that lasts more than 5 consecutive beats (tachycardia), and can be paroxysmal (starting and stopping abruptly) or incessant (occurring most of the time). It then discusses drug treatments including Class I-IV antiarrhythmic drugs that work by different mechanisms like blocking sodium or calcium channels to affect conduction velocity or action potential duration. Side effects of various drugs are also noted. Genetic conditions like Long QT syndrome and Brugada syndrome that can cause life-threatening arrhythmias are described along with their treatments.

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    Disease Mechanism of Action Note

    Uploaded by

    amoody95
    74 views3 pages
    This document discusses various types of arrhythmias and treatments. It describes tachyarrhythmias as a heart rate over 100 beats per minute that lasts more than 5 consecutive beats (tachycardia), and can be paroxysmal (starting and stopping abruptly) or incessant (occurring most of the time). It then discusses drug treatments including Class I-IV antiarrhythmic drugs that work by different mechanisms like blocking sodium or calcium channels to affect conduction velocity or action potential duration. Side effects of various drugs are also noted. Genetic conditions like Long QT syndrome and Brugada syndrome that can cause life-threatening arrhythmias are described along with their treatments.

    Original Description:

    Drugs, Phatmacology

    Original Title

    Anti Arrythmias

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    This document discusses various types of arrhythmias and treatments. It describes tachyarrhythmias as a heart rate over 100 beats per minute that lasts more than 5 consecutive beats (tachycardia), and can be paroxysmal (starting and stopping abruptly) or incessant (occurring most of the time). It then discusses drug treatments including Class I-IV antiarrhythmic drugs that work by different mechanisms like blocking sodium or calcium channels to affect conduction velocity or action potential duration. Side effects of various drugs are also noted. Genetic conditions like Long QT syndrome and Brugada syndrome that can cause life-threatening arrhythmias are described along with their treatments.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    74 views3 pages

    Disease Mechanism of Action Note

    Uploaded by

    amoody95
    This document discusses various types of arrhythmias and treatments. It describes tachyarrhythmias as a heart rate over 100 beats per minute that lasts more than 5 consecutive beats (tachycardia), and can be paroxysmal (starting and stopping abruptly) or incessant (occurring most of the time). It then discusses drug treatments including Class I-IV antiarrhythmic drugs that work by different mechanisms like blocking sodium or calcium channels to affect conduction velocity or action potential duration. Side effects of various drugs are also noted. Genetic conditions like Long QT syndrome and Brugada syndrome that can cause life-threatening arrhythmias are described along with their treatments.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 3

    DISEASE

    Arrythmias CVR33
    Tachyarrhythmia=HR greater than
    conventional number of 100 beats/min
    If this occurs for more than 5 consecutive
    beats it is
    tachycardia=sustained when it lasts for
    more than 30 seconds
    Paroxysmal tachy: when it starts and stops
    abruptly
    Incessant tachy: when it occurs most of
    the time
    **Classic, Ventricular vs Supra-Ventricular
    (e.g. by WPW syndrome)
    **Electropysiology, wide vs narrow QRS

    DRUGS/TRE
    ATMENT
    Class Ia:
    Disopyramid
    e, Quinidine,
    Procainamide

    MECHANISM OF ACTION

    NOTE

    Ventricular arrhythmias and SVT


    Reduce the rate of rise of the action
    potential upstroke (phase 0) and prolong
    action potential
    Kinetics of onset and offset in blocking
    the Na+ channel are of intermediate
    rapidity (< 5 seconds)
    Acts on atrial, ventricular muscle
    cells,purkinje fibres and AV node

    Class Ib:
    Lignocaine,
    Mexiletine

    Block the Na channels


    Treatment for Ventricular arrhythmias
    Lignocaine: Administered IV only
    Rapidly metabolized /Half life = 30 min
    Side effects: High plasma levels cause
    drowsiness, paresthesia and seizure
    activity
    Mexiletine, oral treatment of ventricula
    Arrhythmia
    Phenytoin, treatment of seizure
    disorders.
    Used to treat atrial and ventricular
    arrhythmias induced by digoxin
    Block the fast Na channel (like other
    class 1)
    No effect on action potential duration
    Treatment for both SVT and Ventricular
    arrhythmias
    Flecanide n propafenone:
    Use in life threatening VT and in SVT

    SE:
    *Quinidine: administered orally, GI side effects.
    Cinchonism CNS S/E tinnitus, hearing loss,
    visual disturbances, confusion and psychosis.
    Antibody induced thrombocytopenia
    *Disopyramide: Anticholinergic effects: Nausea,
    vomiting, dry mouth, urinary retention
    * Procainamide: Given PO, IV or IM. Associated
    with N+V, Rash, Arthralgia
    -Lupus like syndrome occurs more frequently
    and earlier in patients who are slow acetylators of
    procainamide
    Main SE and given IV is CNS toxicity

    Mech of DZ:
    Usually associated with structural
    abnormality of myocardium
    Ischaemia
    Heart failure
    Hypertrophic Obstructive
    Cardiomyopathy
    Premature beats: cause of irregular
    response
    Atrial fibrillation: most common type

    Class Ic:
    Propafenone,
    Flecainide

    Flecanide:
    SE Proarrythmic, given by
    Electrophysiologist
    Propafenone:
    SE: Exacerbation of lung disease due to partial
    beta blocking action

    Given orally
    Class II: Beta
    blockers
    (propranolol,
    atenolol )

    Class III:
    Amiodarone,
    Bretylium,
    Sotalol

    Adrenaline and Noradrenaline act on the


    beta receptors in the heart
    *Heart 1, lungs and blood vessels 2.
    *Have a membrane stabilising effect on
    beta receptors
    *Act on SA and AV nodes predominantly
    *Treat SVT and Ventricular arrhythmias
    Act by slowing repolarisation (phase 3),
    prolonging the action potential duration.
    Amiodarone mainly effects the purkinje
    fibres
    and ventricular muscle cells.
    Rx: Both SVT and Ventricular
    arrhythmias
    Used in life threatening cases, iv load
    followed by oral rx

    S.Es: Bronchoconstriction, Heart block, Heart


    failure

    S.Es: Thyroid disorders, photosensitivity, liver


    damage and pulmonary alveolitis
    Bretylium:SE: Hypotension main side effect
    Sotalol: SE prolong QT interval, beta
    blocker SE

    Bretylium:used in ICU setting in


    patients with recurrent and
    refractory ventricular tachyarrythmias

    Class IV:
    Calcium
    Channel
    Blockers

    Sotalol: Non-specific beta blocker


    without prolonging repolarisation
    *Exerts negative inotropic effect only
    thru -blocking action
    *Used to treat ventricular arrhythmias
    Verapamil and Diltiazem
    Block the L subtype of Ca++ channels
    Act on AV node (NB: Ca++ influx only
    Treatment of SVT only.

    S.Es: CCF, interacts with beta


    Blockers

    Long QT syndrome
    *Inherited arrhythmogenic disease
    characterised by life threatening
    ventricular arrhythmia
    *Autosomal Dominant; Romano-Ward
    Recessive assoc with deafness; Jervell
    Lange-Nielsen
    Brugada Syndrome
    Autosomal Dominant Inherited
    Structurally normal heart
    ST segment elevation in right heart
    leads
    Susceptible to ventricular tachycardia

    Rx with beta blocker, left cardiac


    sympathetic denervation or ICD
    Implantable Cardiac Defibrillator

    Treat with ICD

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