2. RHYTM
OF HEART
• RHYTM OF HEART:-Heart rhythm is the steady,
rhythmic sequence of the pumping of the
heart to draw blood into its chambers and push
the same out to the arteries.
3. ARRHYTHMIA
• ARRHYTHMIA- The term "arrhythmia" refers to any change from the normal sequence of electrical impulses. The electrical
impulses may happen too fast, too slowly, or erratically – causing the heart to beat too fast, too slowly, or erratically. When the
heart doesn't beat properly, it can't pump blood effectively. When the heart doesn't pump blood effectively, the lungs, brain and
all other organs can't work properly and may shut down or be damaged.
❖ Types of Arrhythmias
• Atrial Fibrillation = upper heart chambers contract irregularly
• Bradycardia = slow heart rate
• Conduction Disorders = heart does not beat normally
• Premature contraction = early heart beat
• Tachycardia = very fast heart rate
• Ventricular Fibrillation = disorganized contraction of the lower chambers of the heart
4. • Other Rhythm Disorders- Adams-Stokes Disease also called Stokes-Adams
disease, refers to a heart block that can slow the heart rate considerably, causing
fainting (syncope) or convulsions. It’s caused when the heart’s electrical signals are
interrupted as they pass from the upper (atria) to the lower (ventricles) chambers.
• Arrhythmia in Children- In children lower chambers of the heart (ventricles) take
too long to contract and release. The gap of time needed to complete a cycle can
be measured and compared to normal averages for children.
5. CLASSIFICATION OF ANTIARRYTHMIC
DRUGS
• The five main classes of antiarrhythmic agents are:
Class I agents- interfere with the sodium (Na+) channel.
Class II agents- are anti-sympathetic nervous system agents. Most agents in this class are beta blockers.
Class III agents- affect potassium (K+) efflux.
Class IV agents- affect calcium channels and the AV node.
Class V agents- work by other or unknown mechanisms.
6. QUINIDINE SULPAHTE-
• It is a class I antiarrhythmic drug
• It extracted from the bark of the CHINCHONA tree and similar plant species.
• This alkaloid lowers the excitability of cardiac and skeletal muscles by blocking
sodium and potassium currents across cellular membranes.
• It prolongs cellular ACTION POTENTIALS and decreases automaticity.
Chemical name and structure
5-ethenyl-1-azabicyclo[2.2.2]octan-2-yl]-(6-methoxyquinolin-4-
yl)methanol;sulfuric acid
7. QUINIDINE
SULPAHTE-
• Uses-
• used to treat or prevent many types of irregular heartbeats like atrial
fibrillation decrease the number of irregular heartbeats It also has anti
malarial properties
➢ Storage and stability
• Should be stored at 20-25oC
• Protect from moisture
• Store in light resistant container
➢ Formulation
• Tablets
• Capsule
➢ Brands name
• Quinora
• Cardioquin
• Quinidine sulphate, Natcardin, Duraquin
8. PROCAINAMIDE HYDROCHLORIDE
Procainamide Hydrochloride is the
hydrochloride salt form of procainamide, It is a
class 1A antiarrhythmic property and analog of
procaine. Procainamide hydrochloride
reversibly binds to and blocks activated (open)
voltage-gated sodium channels, thereby blocks
the influx of sodium ions into the cell, which
leads to an increase in threshold for excitation
and inhibit depolarization.
➢ Chemical name and structure:-4-amino-N-[2
(diethylamino)ethyl]benzamide;hydrochloride
9. PROCAINAMIDE
HYDROCHLORIDE
• Uses :-
• It used to manage and treat Ventricular
arrhythmias Supraventricular arrhythmias
Atrial flutter/fibrillation Wolf-Parkinson-White
syndrome- an extra signaling pathway between
the heart's upper and lower chambers causes a
fast heartbeat (tachycardia). This condition
present at birth (congenital heart defect). It is
fairly rare.
• ➢ Stability and storage Should be stored at 20-
25oC Protect from moisture Store in light
resistant container
• ➢ Formulation:-Capsule Injection
• ➢ Brands name Procanbid Procan SR
Pronesty
10. VERAPAMIL
• Verapamil, sold under various trade
names It is a calcium channel blocker
medication used for the treatment of
high blood pressure, angina (chest pain
from not enough blood flow to the
heart), and supraventricular tachycardia.
It may also be used for the prevention of
migraines.It is given by mouth or by
injection into a vein.
• ➢ Chemical name and structure2-(3,4-
dimethoxyphenyl)-5-[2-(3,4-
dimethoxyphenyl)ethyl-methylamino]-2-
propan-2-ylpentanenitrile
11. VERAPAMIL
• Uses:-It is used to treat High Blood
pressure To control angina (chest pain).
To prevent and treat irregular
heartbeats.
• ➢ Stability and storage
• Should be stored at 20-25oC Protect
from moisture
• Store in light resistant container
• ➢ Formulation Tablet Capsule Solution
• ➢ Brands name:-Zavera, Calaptin,
Veracen
12. PHENYTOI
N SODIUM
• Phenytoin (PHT), sold under the brand
name Dilantin among others. • it is an anti-
seizure medication. It is useful for the
prevention of tonic-clonic seizures (also
known as grand mal seizures) and focal
seizures, but not absence seizures. It may
also be used for certain heart arrhythmias
or neuropathic pain. It can be taken
intravenously or by mouth. The intravenous
form generally begins working within 30
minutes and is effective for 24 hours.
• ➢ Chemical name and structure5,5-
diphenylimidazolidin-3-ide-2,4-dione
14. PHENYTOI
N SODIUM
• Uses:-
• It is used to treat i) Ventricular
tachycardia ii) Atrial tachycardia
➢ Stability and storage • Should be
stored at 20-25oC.Protect from
moisture .Store in light resistant
container
➢ Formulation • Capsule • injection
➢ Brands name Dialntin Epicent
Episol
15. LIDOCAINE
HYDROCHLORIDE
• A local anesthetic and cardiac
depressant used as an antiarrhythmia
agent. Lidocaine, also known as
lignocaine. It is a sodium channel
blocker antiarrhythmic drug. It is also
used to treat ventricular tachycardia.
• Chemical name and structure2-
(diethylamino)-N-(2,6-
dimethylphenyl)acetamide;hydrochlo
ride
16. LIDOCAINE
HYDROCHLORIDE
• Uses :-It is used to treat Premature
ventricular contraction Ventricular
tachycardia Wolff-Parkinson-white
syndrome
• ➢ Stability and storage Should be
stored at 20-25oC • Protect from
moisture Store in light resistant
container
• ➢ Formulation:-Tablets
• ➢ Brands name :-Carvidon Lidocam
17. LORCAINIDE
HYDROCHLORIDE
• Lorcainide (Lorcainide
hydrochloride) is a Class 1c
antiarrhythmic agent • It is used to
restore normal heart rhythm and
conduction in patients with
premature ventricular
contractions, ventricular
tachycardiac and Wolff-Parkinson-
White syndrome. ➢ Chemical
name and structureN-(4-
chlorophenyl)-2-phenyl-N-(1-
propan-2-ylpiperidin-4-
yl)acetamide;hydrochloride
18. LORCAINIDE
HYDROCHLORIDE
• Uses It is used • To restore normal
heart rhythm and conduction •
Premature ventricular contractions
• Ventricular tachycardiac • Wolff-
Parkinson-White syndrome ➢
Stability and storage • Should be
stored at 20-25oC • Protect from
moisture • Store in light resistant
container ➢ Formulation Tablets
➢ Brands • Lerka • Larpin •
Landip
19. AMIODARON
E
activities. • It is a class III
antiarrhythmic agent. • It blocks the
myocardial calcium, potassium and
sodium channels in cardiac tissue,
resulting in prolongation of the
cardiac action potential. •
Amiodarone is an antiarrhythmic
medication used to treat and prevent
a number of types of cardiac
dysrhythmias. • This includes
ventricular tachycardia (VT),
ventricular fibrillation (VF), and wide
complex tachycardia, as well as
atrial fibrillation and paroxysmal
supraventricular tachycardia. • It can
be given by mouth, intravenously, or
20. AMIODARON
E
• Uses used to treat and prevent a
number of types of cardiac
dysrhythmias • Ventricular
tachycardia (VT), • Ventricular
fibrillation (VF), • Wide complex
tachycardia, • Atrial fibrillation •
Paroxysmal supraventricular
tachycardia ➢ Stability and
storage • Should be stored at 20-
25oC • Protect from moisture •
Store in light resistant container ➢
Formulation • Tablets • Injection ➢
Brands • Amidrone • Cardarone •
Pacerone
21. SOTALOL
• Sotalol is a nonselective beta-
adrenergic blocker used largely in the
therapy cardiac arrhythmias. o
Sotalol, sold under the brand name
Betapace.
• It is used to treat and prevent
abnormal heart rhythms. o It is taken
by mouth or injection into a vein.
• ➢ Chemical name and structureN-[4-
[1-hydroxy-2-(propan-2-
ylamino)ethyl]phenyl]methanesulfon
amide
22. SOTALOL
• Uses It's used to treat Atrial
fibrillation Other conditions that
cause an irregular heartbeat
(arrhythmia).
• ➢ Stability and disorder Should be
stored at 20-25oC Protect from
moisture Store in light resistant
container
• ➢ Formulation Solution Tablets
• ➢ Brands name Betapace Betapace
AF Sorine Sotylize
