Class Ic is a ____ Na-channel blocker.
potent
It takes Class Ic drugs ____ seconds to recover
10
What class does Fleccainide belong to?
Class Ic drug
What is the brand name for Flecainide?
Tambocor
Flecainide blocks K and L-type Ca channels ___.
to a lesser extent
Flecainide works better in ______ than ____ and works in normal HR
fast HR
slow HR
_____ can prolong QRS and QT interval
Flecainide
Flecainide is eliminated through _____
hepatic and renal systems
Flecainide is metabolized by _____
CYP2D6 and CYP1A2
Adverse effects of Flecainide
proarrhythmic, CHF exacerbation, and heart block
Contraindications of Flecainide
secondary/tertiary AV block or right bundle branch block
What is the brand name of Propafenone
Rythmol
Propafenone is a part of the _____ class.
Ic
Propafenone is very efficient in maintaining _____ rhythm.
sinus
Propafenone has moderate efficacy in___.
ventricular arrhythmias
Propafenone is structurally ____.
racemic
____ is also a beta-adrenergic blocker
S+propafenone
At normal HR, propafenone prolongs ____.
PR, QRS intervals
Propafenone is eliminated by ___.
H
Propafenone is metabolized by ___.
CYP2D6
Main adverse effect of Propafenone is ____.
proarrhythmic (ventricles), bradycardia and bronchospasm due to the beta-blocking
Contraindications for use of Propafenone is ____.
any heart conditions
Dysopyramide is part of which class?
Ia
The brand name for Dysopyramide is ____.
Norpace
Class Ia have ____
intermediate recovery time ranging from 1-10 seconds
Dysopyramide blocks _____
Na and Ca channels
When Dysopyramide blocks Na channels, it ____.
increases threshold potential and decreased automaticity
When Dysopyramide blocks K channels, it ____.
prolongates the action potential (especially seen in slow HR)
Dysopyramide also inhibits the _____.
vagal nerve
Dysopyramide is eliminated through ____.
H/R (50%)
Dysopyramide is metabolized by ____
CYP3A4
Adverse effects of Dysopyramide include: ___
proarrhythmic effects (TDP), and anticholinergic effects (dry mouth, constipation, urinary retention, precipitation of glaucoma)
Contraindications for Dysopyramide:
secondary/tertiary AV block
Lidocaine is a ____
class Ib antiarrhythmic
Class Ib has ____ of recovery time.
<1s
Lidocaine is considered to have ____ potency and not useful for _____.
weak
atrial arrhythmias
Effects of Lidocaine are seen in ___ HR and ____ (ischemic) tissues
fast
depolarized
Lidocaine increases the ____.
threshold potential
Lidocaine is also seen reducing the _____.
Phase 4 slope
Lidocaine doesn't usually change ____
PR and QRS intervals, but may shorten QT interval
Lidocaine's brand name is:
Xylocaine
Lidocaine is eliminated through ____
H/R
Lidocaine is metabolized by ____.
CYP3A4
Lidocaine can cross the ____
BBB and placenta
Adverse effects from Lidocaine
seizures (large, rapid IV doses), tremor, dysarthria, nystagmus (involuntary jerking of the eye => early sign of toxicity)
Use lidocaine cautiously in ___
liver/heart failure, AV conduction deficit
Mexiletine is a ____.
class Ib drug
The brand name of Mexiletine is ____
Mexitil
Mexiletine is also a ___ Na-channel blocker and has a very short recovery time.
weak
Mexiletine is _____ used in ventricular arrhythmias.
rarely
Mexiletine is structurally similar to ____ and suitable for chronic oral therapy due to less FPM.
lidocaine
Mexiletine is eliminated through ____.
H/R (10%)
Use mexiletine cautiously in ____
H/R patients
Mexiletine is metabolized by ____.
CYP1A2 and CYP2D6
Main adverse effects of Mexiletine ____.
proarrhythmic effects, exacerbation of HF, upper GI distress (may mean toxicity), lightheadedness, tremor, and coordination difficulties