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Anti arrhythmic agents

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Transcript

  • 1. Anti-Arrhythmic Agents
  • 2. Anatomy of a Heartbeat
  • 3. Normal Electrical Activity
  • 4. Cardiac Arrhythmias
    • Physiology
      • Normal Sinus rhythm
      • Abnormal rhythm
        • Disturbance of impulse formation
        • Disturbance of impulse conduction
    • Arrhythmias
      • Tachycardia, bradycardia
      • Atrial flutter, fibrillation
      • PVC, premature ventricular contraction
  • 5. Therapeutic Agents
    • Rational
    • Aim of therapy
    • MOA
      • Na+ channel block
      • SANS block on heart
      • Prolong refractory period
      • Ca+ block
  • 6. Class I Class III
    • Quinidine
      • Synchronism
    • Procainamide
    • Amiodarone
    • Lidocaine
    • Class II
      • Beta-blockers
        • propranolol
    • Bretylium (Bretylol)
    • Sotolol (Betapace)
    • Class IV
      • Ca+ Channel Blockers
        • Verapamil (Calan)
        • Diltiazem (Cardizem)
  • 7. Clinical Therapy
    • Evaluation
    • Risk versus Benefit
    • Non-Drug Therapy
    • CASE STUDY
  • 8.
    • DP is a slender, 45-year-old mother of three children all under the age of 15 years old. She presents to clinic with palpitations, sweating and hyperventilation. EKG reveals she is experiencing PVC’s every 10-12 beats. She is agitated and appears to be worried that her husband will be angry with her for getting sick.
    • BP 140/85 P 110 Temp 38.6 Wt 55 kg Ht 5’7”
    • Currently on no medications
  • 9. Points to Ponder
    • Evaluate this patient’s condition and possible etiologies.
    • Discuss the risks versus benefits of anti-arrhythmic therapy. Goals of therapy?
    • Is DP a candidate for drug treatment of her PVC’s?
    • Consider avenues of non-drug therapy.

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