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Anti-Arrhythmic (Class III
Slow repolarisation (increasing action…
Anti-Arrhythmic
Class III
- Slow repolarisation (increasing action potential duration)
- Treatment of SVT + ventricular arrhythmia
Amioderone
- Mainly effect purkinje fibres + ventricular muscle cells
- After absorption slow distribution
- Lipid soluble (adipose tissue)
- Slow elimination (6 mo.)
Dronedarone
- Similar to amioderone
- Reduced lipophilicity
- Reduced accumulation + half-life
Bretylium
- Recurrent + ventricular tachyarrhythmia
Sotalol
- Non-specific b-blocker
- Negative inotropic effect
- Treatment of ventricular arrhythmia
- Prolong QT
- Mixed between Class III and Class II
Class Ia
- Na+ channel interference
- Pro-arrhythmic drugs
- Prolong QT interval
- By depressing conduction may promote re-entry
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Class Ib
Lignocaine
- Standard treatment for ventricular arrythmia's
- Acts preferentially on ischaemic myocardium
- IV
- T 1/2 = 30mins
Mexiletine
- Ventricular arrhythmia
- Oral
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Class Ic
- Block fast Na+ channels
- No effect on action potential duration
- Treatment of SVT + ventricular arrhythmia
Flecanide
- Life threatening SVT + VT
- Oral
- Proarrhythmic
- Given by electrophysiologist
Propafenone
- Life threatening arrythmia
- Oral
- Exacerbation of lung disease (partial beta-blocker action)
Class IV
(Ca2+ Channel Blockers)
- Block L-type Ca2+ channels
- AV node only
- Treatment of SVT only
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Class II
(Beta-blockers)
- Act on SA + AV node predominantly
- Treatment of SVT + ventricular arrhythmia