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    Anti Arrhythmics Drugs

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    Saima Parveen

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    © All Rights Reserved
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    Anti Arrhythmics Drugs

    Uploaded by

    Saima Parveen
    5 views16 pages

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    5 views16 pages

    Anti Arrhythmics Drugs

    Uploaded by

    Saima Parveen

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 16

    Anti arrhythmics drugs

    Cont.. drug
    anti arrhythmic

     An arrhythmia is an abnormality of the heart


    rate, cardiac rhythm, site of origin of the
    cardiac impulse or an abnormality in the
    impulse conduction.
    They may be classified as tachy arrhythmias in
    which the heart rate is increased or brady
    arrhythmias, in which the heart rate is
    decreased.
    Arrhythmia occur due to disturbance in
    impulse formation and conduction.
    Cont..
    Anti arrhythmics drugs are used to treat
    abnormal electrical activity of the heart.
    These are the drugs used to prevent or treat
    irregularities of cardiac rhythm caused by
    ischemia, mechanical injury, stretching, drug
    influence, electrolyte and pH imbalance.
    Cont..
    MOA:

    Anti arrhythmic drugs used to treat, suppress or


    prevent three major mechanisms of
    arrhythmias, i.e.decreased automaticity,
    decreased conductivity and re-entry. They
    limit cardiac electrical activity to normal
    conduction pathways and decrease
    abnormally fast heart rate by following
    mechanisms:
    Cont..
    1. Decrease self-activation:
     Many of the dysrhythmias and premature
    beats are due to the ability of cardiac cells to
    fire an impulse (self-activation or auto-
    maticity).
    2. Decrease re-entry phenomena: Myocardial
    tissue has the ability to reactivate for the
    second time by the same impulse.
    3.
    Cont..
    3. Decrease conduction: By blocking sodium
    channels in myocardial cells that results in
    slow heart rate.
     Accelerate repolrization by stabiling the cell
    membrane.
    4. Decrease ischemia: By decreasing heart rate
    and oxygen demand.
    5. Decrease conduction rate: By blocking
    calcium influx into the myocardial cells.
    Cont..
    Classification:
    1. Class IA: The drug are: a. procainamide , b. quinidine ,
    c. disopyramide.

     Action: this class control arrhythmia by altering


    myocardial cell membrane and interfering with
    autonomic nervous system.
     Dose: a. procainamide( tab pronestyl ) loading dose
    15-18 mg slowly over 25-30 min,100mg available)
     b. quinidine( brand name: natcardine) : 200 - 300mg
    tab,p/o, 6 hourly for atrial fibrillation, for PSVT 400-
    600MG ,P/O BD.
     c. disopyramide: 150mg,p/o, 6 hourly.
    Cont..
    Indication : atrial fibrillation
    paroxysmal atrial tachycardia
    premature ventricular contraction.
    Contraindication :
    myasthenia gravis
    Hypersensitivity
    severe heart block
    Hypotension
    Lactation
    Cont..
    Class IB : lidocaine .
     Mexi letine
     Tocaina mide

    Dose: lido caine(slow IV 1-1.5 mg/kg


     Mexi letine (capsule mexitil) loading dose 400mg then
    200mg after 8 hr )
     Tocaina mide

    Action: these class of drug work by blocking the rapid influx of


    sodium ions during the depolarization phase of heart
    depolarization.

    Indication: ventricular tachycardia, during cardiac surgery.


    Cont.
    Contraindication:
    hypersensitivity
    cardiogenic shock
    pregnancy
    lactation
    liver disease
    myasthenia gravis.
    Class IC: moricizine
    flecainide
    Cont..
    Dose: moricizine( 200mg orally very 8 hrly)
    brand name: ethmozine.

    Flecainide ( 50mg ,p/o, BD )brand name:


    tambocor.

    Action: it primarly slow conduction along heart


    conducting system.
    it depress the depolarization rate.
    Cont.
    Indication: used to treat certain ventricular
    arrhythmia.

    Side effect:
    blurred vision
    disturbed colour vision
     hearing loss
     vomiting
    Hepatotoxicity
    hypotension,
    Bradycardia
    Cont..
     Swelling
     hemolytic anaemia
     Respiratory depression
     Skin rash
     Syncope
     Irritability
     Thrombocytopenia
    Pharmacokinetics: orally onset of action1/2 hr.
    Peak concentration 5-6 hr, duration of action 8 hr ,
    metabolizd in liver and excreted through urine.
    Cont..
    Role of nurse:
     To monitor blood pressure 6 hourly to observe
    fluctuations To assess cinchonism(headache,
    vomiting, nausea, vertigo hearing loss) if occurs
    discontinue drug.
     To assess, dyspnea , respiratory depression,
    increased pulse if occurs discontinue drug.
     there is no improvement with drug after 10
    days, then discontinue drug.In emergency
    quinidine may be given intravenously with
    extreme care.To assess confusion, psychosis,
    convulsions if occurs drug may be discontinued.
    Cont..
     administer dose (loading dose) with food to
    decrease nausea vomiting .
    Monitor ECG, to determine dose of
    amiodarone effectiveness.
     To assess chest pain, pulse rate, respiration
    rate rhythm.
    Advice patient not to break and chew the
    drug.
    To advice patient not to take other medicine
    unless prescribe.
    Cont..
    Drug interection : increased anticoagulant
    effect with warfarin.
    Smoking decrease the action of drug.

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