Antiarrhythmic drugs

• amiodarone (Cordarone, Pacerone)
• flecainide (Tambocor)
• ibutilide (Corvert), which can only be given through IV.
• lidocaine (Xylocaine), which can only be given through IV.
• procainamide (Procan, Procanbid)
• propafenone (Rythmol)
• quinidine (many brand names)
• tocainide (Tonocarid)

How do you choose antiarrhythmic?

What dose should I choose? When choosing the initial dose of an antiarrhythmic drug, generally, the lowest possibly effective dose is chosen first, followed by dose escalation if needed in response to AF recurrence patterns following attainment of the steady state of the previous dose.

What is the best antiarrhythmic drug?

Amiodarone is considered the most potent antiarrhythmic agent. The adverse event profile with amiodarone can be intolerable, with gastrointestinal effects the most common side effect.

What antiarrhythmic is used for heart failure?

Although the evidence on efficacy is still controversial, amiodarone is the only antiarrhythmic drug whose use is acceptable to treat symptomatic ventricular arrhythmias in patients with heart failure, particularly if the patients are survivors of myocardial infarction.

In which type of arrhythmia it is a preferred treatment?

Radiofrequency catheter ablation can offer a permanent cure for some types of arrhythmias, and is often a preferred method for conditions causing rapid heart rates, such as atrial fibrillation and ventricular tachycardia.

Pharmacology - ANTIARRHYTHMIC DRUGS (MADE EASY)

25 related questions found

What is the most effective treatment for atrial fibrillation?

Heart rate controlling medicines, such as beta-blockers that include Coreg (Carvedilol) and Lopressor and Toprol (Metoprolol), is the best way to treat AFib. These medications can control or slow the rapid heart rate so that the heart can function in a better way.

What is the best beta blocker for AFib?

Bisoprolol* or metoprolol succinate are first-choice beta-blockers for patients with atrial fibrillation as they are prescribed once-daily and do not require dose adjustment in patients with renal impairment. Bisoprolol is preferred as it is more cardioselective than metoprolol and may cause more bradycardia.

Is amlodipine an antiarrhythmic?

Dihydropyridines, like amlodipine, nicardipine, and nifedipine, are highly selective for calcium channels on the vascular smooth muscle tissue; so they're primarily used to treat hypertension. On the other hand, non-dihydropyridines are the class IV antiarrhythmics and they include verapamil and diltiazem.

Why is amiodarone preferred in heart failure?

Because of its superior efficacy and probable beneficial impact on survival, amiodarone is currently the initial drug of choice for sinus rhythm maintenance in patients with CHF. The use of amiodarone in CHF patients with AF is not without risk.

What is the most common arrhythmia in heart failure?

Atrial fibrillation (AF) is one of the most common arrhythmias. AF and congestive heart failure (CHF) are frequent co-morbidity in the geriatric population. The probability that AF precedes CHF or vice versa is similar. They can deteriorate each other and make the therapy more difficult.

What are the 4 classes of antiarrhythmic drugs?

Antiarrhythmic drug classes:

• Class I - Sodium-channel blockers.
• Class II - Beta-blockers.
• Class III - Potassium-channel blockers.
• Class IV - Calcium-channel blockers.
• Miscellaneous - adenosine. - electrolyte supplement (magnesium and potassium salts) - digitalis compounds (cardiac glycosides)

Is atropine an antiarrhythmic?

Atropine. Atropine is an anticholinergic agent that is used to inhibit the effects of excessive vagal activity on the heart. Vagal reactions usually manifest as bradycardia, atrioventricular (AV) block, and hypotension.

What is the safest antiarrhythmic medication?

Dronedarone was the best tolerated of the antiarrhythmic drugs, with the lowest rates of severe adverse events and a significant reduction in the risk of stroke. It is our practice to use propafenone, flecainide, sotalol, and dronedarone as first-line therapies in patients without structural heart disease (Table 4).

Is flecainide bad for kidneys?

Too much of the drug in your body can be toxic. Kidney problems: Severe kidney disease: 100 mg taken once per day (or 50 mg taken twice per day). The levels of flecainide in your body must be monitored before any dose changes.

Is amiodarone an AV nodal blocker?

Cardiac toxicity. Amiodarone by blocking the calcium channel activity can cause sinus bradycardia and AV nodal block in 5% of patients. Hypotension may occur when concentrated Amiodarone hydrochloride injection is given by the intravenous route.

What is the success rate of Tikosyn?

In total, 148 patients treated with TIKOSYN (59%) and 86 patients treated with placebo (34%) were restored successfully to NSR (either pharmacologically or by direct current cardioversion).

When is amiodarone contraindicated?

Amiodarone therapy is contraindicated in patients with second- or third-degree heart block who do not have a pacemaker. Intravenously administered amiodarone causes heart block or bradycardia in 4.9 percent of patients and hypotension in 16 percent.

Can you use amiodarone in heart failure?

Asymptomatic ventricular arrhythmias in patients with congestive heart failure are associated with increased rates of overall mortality and sudden death. Amiodarone is now used widely to prevent ventricular tachycardia and fibrillation.

Does amiodarone help heart failure?

In conclusion amiodarone is an effective antiarrhythmic agent in patients with heart failure. It has been shown to suppress ventricular ectopy with an acceptable frequency of adverse effects when administered in lower doses.

Is Amlodipine a dihydropyridine calcium channel blocker?

Dihydropyridines — The dihydropyridines, including nifedipine, isradipine, felodipine, nicardipine, nisoldipine, lacidipine, amlodipine, and levamlodipine are potent vasodilators that have little or no negative effect clinically upon cardiac contractility or conduction.

Which calcium channel blocker is used in arrhythmia?

Verapamil is the prototype calcium antagonist and has the most clearly defined antiarrhythmic properties. Other agents in the class include D-600 (gallopamil), tiapamil, nifedipine, and diltiazem.

Are calcium channel blockers antiarrhythmic?

Calcium channel blockers (CCBs) are useful antiarrhythmic agents in the management of certain arrhythmias, primarily supraventricular tachyarrhythmias [1-3]. They have diverse electrophysiologic properties and are therefore of variable antiarrhythmic efficacy.

Which is better propranolol or metoprolol?

Comparing the effects of treatment, labetalol lowered sitting diastolic pressure significantly more than propranolol and standing diastolic pressure than both propranolol and metoprolol. Metoprolol and propranolol were more effective in reducing heart rate.

What is the first drug of choice for atrial fibrillation?

Beta-blockers and calcium channel blockers are first-line agents for rate control in AF. These drugs can be administered either intravenously or orally. They are effective at rest and with exertion. Intravenous diltiazem or metoprolol are commonly used for AF with a rapid ventricular response.

Which is better atenolol or metoprolol?

Metoprolol showed a more significant reduction in risk of cardiovascular mortality as compared to atenolol. Metoprolol also showed a decreased trend for all-cause mortality and coronary heart disease. When evaluated for a decrease in risk of stroke, metoprolol proved to be superior to atenolol as well.