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    AntiArrythmtic Drug

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    SHANJIDA ALI RIA
    Cardiac arrhythmia occurs when the heart's normal rhythm is disrupted. The conduction system is responsible for generating and coordinating the heart's electrical signals. Cardiac arrhythmias are abnormalities in impulse formation and conduction that are common and can be asymptomatic. They are treated through medications, ablation, surgery, or lifestyle changes. Antiarrhythmic drugs modify impulse generation and conduction through various mechanisms like sodium channel blockade.

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    AntiArrythmtic Drug

    Uploaded by

    SHANJIDA ALI RIA
    24 views17 pages
    Cardiac arrhythmia occurs when the heart's normal rhythm is disrupted. The conduction system is responsible for generating and coordinating the heart's electrical signals. Cardiac arrhythmias are abnormalities in impulse formation and conduction that are common and can be asymptomatic. They are treated through medications, ablation, surgery, or lifestyle changes. Antiarrhythmic drugs modify impulse generation and conduction through various mechanisms like sodium channel blockade.

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    Cardiac arrhythmia occurs when the heart's normal rhythm is disrupted. The conduction system is responsible for generating and coordinating the heart's electrical signals. Cardiac arrhythmias are abnormalities in impulse formation and conduction that are common and can be asymptomatic. They are treated through medications, ablation, surgery, or lifestyle changes. Antiarrhythmic drugs modify impulse generation and conduction through various mechanisms like sodium channel blockade.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    24 views17 pages

    AntiArrythmtic Drug

    Uploaded by

    SHANJIDA ALI RIA
    Cardiac arrhythmia occurs when the heart's normal rhythm is disrupted. The conduction system is responsible for generating and coordinating the heart's electrical signals. Cardiac arrhythmias are abnormalities in impulse formation and conduction that are common and can be asymptomatic. They are treated through medications, ablation, surgery, or lifestyle changes. Antiarrhythmic drugs modify impulse generation and conduction through various mechanisms like sodium channel blockade.

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    Cardiac arrhythmia

    Cardiac arrhythmia is the condition in which


    the heart’s normal rhythm (75beats/minute)
    is disrupted.
    The Conduction System

    Bundle of His

    Purkinje fibre
    The Conduction System

    Electrical impulses from your heart muscle (the myocardium) cause


    your heart to beat (contract). This electrical signal begins in the
    sinoatrial (SA) node, located at the top of the right atrium. The SA
    node is sometimes called the heart's "natural pacemaker." When an
    electrical impulse is released from this natural pacemaker, it causes
    the atria to contract. The signal then passes through the
    atrioventricular (AV) node. The AV node checks the signal and sends it
    through the muscle fibers of the ventricles, causing them to contract.
    The SA node sends electrical impulses at a certain rate, but your heart
    rate may still change depending on physical demands, stress, or
    hormonal factors.
    ARRHYTHMIAS

    DEFINITION
    Abnormal heart rhythm that is abnormalities in impulse
    formation and conduction in the myocardium.
    It is the disorder in rate and rhythm of cardiac contraction
    due to myocardial damage is called cardiac arrhythmia.

    Types.

    Bradycardia
    Heart rate < 60 bpm; impulse originates in SA node

    Tachycardia
    Heart rate >100-160 bpm; impulse does not originate in SA
    node
    Signs & symptoms

    - irregular heartbeat
    - Palpitations
    - Chest discomfort
    - Shortness of breath
    - Dizziness
    - Weakness
    - Nausea

    Fever
    fatigue
    Aetiology / risk factors
    • Coronary artery disease
    • High blood pressure
    • Congenital heart disease
    • Thyroid problems
    • Obesity
    • Uncontrolled diabetes
    • Electrolyte imbalance
    • Air pollution
    PREVALENCE OF CARDIAC ARRHYTHMIAS

    • Cardiac arrhythmias are common.


    • Statistics from the centers for Disease control and prevention
    (CDC) has estimated sudden cardiac death rates at more than
    600,000 per year worldwide.
    • Up to 50% of patients have sudden death as the first
    manifestation of cardiac disease .
    • Cardiac arrhythmias are common in the elderly and are often
    asymptomatic.
    • Approximately 2.2 million individuals in US have CA and
    approximate 4.5million individuals in European union have CA.
    Management/Treatment
    • Anticoagulant medication to reduce the risk
    of blood clots and stroke.
    • Cardiac ablation/Surgery
    • Antiarrhythmic drugs medications.
    •
    PREVENTION
    • Treat or when possible eliminate risk factors
    • Making healthy lifestyle choices
    • Exercising regularly
    • Eating a healthy, low fat diet with plenty of vegetables,
    fruits for healthy heart
    • Maintaining a healthy weight
    • Avoid or stop smoking
    • Avoiding unnecessary stress such as anger, anxiety or fear
    • Having regular physical exams and reporting unusual
    symptoms to physician.
    • Treat underlying medical condition that may contribute to
    arrhythmia.
    Antiarrhythmic drugs
    Class I (Na+ channel blocker)
    • Quinidine
    • Lidocaine
    • Procainamide
    The antiarrhythmic drugs can
    • Propafenone
    Class II (β-adrenoceptor blockers) modify impulse generation
    • Propranolol and conduction
    • Metoprolol
    • Pindolol
    Class III (K+ channel blockers)
    • Amiodarone
    • Sotalol
    Class IV (Ca2+ channel blockers)
    • Verapamil
    • Diltiazem
    Other anti-arrhythmic drugs
    • Adenosin
    • Digoxin
    Cardiac Electro-Physiology
    • Phase 0: Rapid depolarisation of the cell membrane and it is associated with
    the inflow of the Na+ ions.

    • Phase 1: A short initial phase of rapid repolarisation due to activation of a


    Cl- current (inflow). K+ channel rapidly open and close causing a transient outward
    current.
    • Phase 2: Action potential plateau. A period of more gradual repolarisation in which
    there is a movement of Ca2+ ion into the cell.
    • Phase 3: Final repolarisation. A second period of rapid repolarisaion during which
    K+ move out of the cell.
    • Phase 4: A fully repolarised state during which K+ channel opens. K+ move into
    and Na+ out of the cell again to enable the next cycle to begin.

    1 2
    3
    0
    4 4

    Anti-arrhythmic drugs act at different points in cardiac action potential cycle.


    M/A of Quinidine

    Quinidine

    Membrane stabilizing action


    Prolongs refractory period
    (blocks the activation of Na+
    channel)

    Suppress of SA node Prevent re-entry rhythm


    Prevent ectopic beats
    AV conduction block

    ↓ Automaticity
    ↓ Excitability and conductivity

    Anti-arrhythmic effect
    Quinidine

    Pharmacological effect Adverse Effect


    On Cardiac tissue:
    ↓ Automaticity
    CVS:
    ↓ Conductivity
    • Heart block
    Prolong refractory period • Sinus arrest
    • Myocardial depression
    Other action: • Q-T prolongation
    Anti-malarial effect CNS: Headache, Blurred vision
    Anti-pyretic effect GIT: Nausea, vomiting, dirrhoea.
    Vasodilation (hypotension) Allergic: Rash, fever.

    Therapeutic uses
    • Arrhythmia
    • Malaria
    • Pyrexia (fever)
    M/A of Lidocain

    Lidocaine

    Membrane stabilizing action


    Shorten refractory period
    (blocks the activation of Na+
    Shorten action potential
    channel)

    Suppress of SA node Make the rhythm uniform


    Prevent ectopic beats

    Anti-arrhythmic effect
    M/A of Lidocain

    Therapeutic uses

    • Ventricular arrhythmia
    • Local anaesthesia

    Adverse effects

    • Bradycardia
    • Hypotension
    • Dizzinesws
    • Blurred vision
    • Confusion
    • Convulsion
    M/A of Propranolol

    Direct membrane stabilizing effect

    ↓ Automaticity

    ↓ Conduction velocity

    ↑ Refractory period

    Anti-arrhythmia
    Propranolol

    Therapeutic uses

    • Anti-arrhythmia
    • Hypertension
    • Angina

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