Tall me about it in a simple explanation way
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Here's a simple breakdown of everything in your notes ā these are antiarrhythmic drugs (medicines that fix abnormal heart rhythms):
š« Amiodarone (Class III)
Used for: Almost all arrhythmias ā except Torsades de Pointes (TdP)
Why it has so many side effects: It contains 40% iodine, and it accumulates in body tissues.
Use the mnemonic "The Periphery of My Lung Liver Cornea is Photosensitive" to remember side effects:
| Body Part | Side Effect |
|---|---|
| Thyroid | Hypo or Hyperthyroidism (from iodine) |
| Peripheral nerves | Peripheral neuropathy |
| Myocardium | Myocardial depression (weakens heart) |
| Lung | Lung fibrosis (scarring) |
| Liver | Liver toxicity |
| Cornea | Corneal deposits |
| Photosensitive | Rash in sunlight ā skin turns bluish = "Blue Man Syndrome" |
Dronedarone = Amiodarone without iodine ā fewer side effects, but less effective
Bretylium
- Old drug, was used for ventricular fibrillation (chaotic heart rhythm)
- Called a "pharmacological defibrillator" ā it chemically shocks the heart back to rhythm
Ibutilide & Dofetilide (Class III)
- Used for Atrial Fibrillation (AF)
- Special thing: they convert AF back to normal sinus rhythm (not just slow the rate)
- Other drugs (CCBs, beta blockers, digoxin) only control the ventricular rate ā they don't restore normal rhythm
Class IV ā L-Type Calcium Channel Blockers
Two main drugs:
- Verapamil
- Diltiazem
(DHPs like amlodipine are NOT used here ā they are peripheral calcium channel blockers)
Used for: Tachyarrhythmias (fast heart rhythms)
ā ļø Do NOT combine with beta blockers ā risk of severe bradycardia (very slow heart) and AV block (electrical block in heart)
Class V ā Others
| Drug | Use |
|---|---|
| Digoxin | Atrial Fibrillation in patients with Congestive Heart Failure (CHF) |
| Atropine | Drug of choice (DOC) for Bradycardia and AV Block |
Adenosine
- Shortest acting antiarrhythmic drug (half-life < 10 seconds ā gone from your body in seconds!)
- DOC for PSVT (Paroxysmal Supraventricular Tachycardia ā sudden fast heart rhythm)
- Given as rapid IV push into a central vein (must be given fast or it breaks down before reaching the heart)
Magnesium
- DOC for Long QT Syndrome / Torsades de Pointes (TdP)
- Torsades = a dangerous twisting ventricular arrhythmia caused by prolonged QT interval
Quick Summary Table
| Drug | Used For |
|---|---|
| Amiodarone | All arrhythmias except TdP |
| Ibutilide/Dofetilide | AF ā converts to normal rhythm |
| Verapamil/Diltiazem | Tachyarrhythmias |
| Digoxin | AF + heart failure |
| Atropine | Bradycardia, AV block |
| Adenosine | PSVT (fastest acting) |
| Magnesium | Torsades de Pointes / Long QT |
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