abhi01
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in chronic stable AF, if we decide to chemically cardiovert after proper anticoagulation, then which is the best antiarrhythmic to use?
class I
class III
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| wyvern
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class 3?
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| AAAAA
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What is class I and class 3 ?
Class 3 is amiodarone !
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| guayoman
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Amiodarone is class I and class III
For symptomatic Afib synchronized cardioversion. Dig, Betablockers, Verapamil. for short term ventrticular rate. But the antiarrythmics are class IA Procainamide, Quinidine
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| karusmle
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answer plz
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| wyvern
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Class 3 ibutilide is used for chemical cardioversion for af of short duration
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| abhi01
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i am not sure of the answer.
usmle world just mentions that the drug of choice is class III
though in case of chemical cardioversion of chronic stable artial flutter, the drug of choice is clearly mentioned as ibutilide.
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| guayoman
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Cardioversion may be achieved with drugs that stabilise the atrial myocardium, for example:
- quinidine - 200 to 400 mg/6-8 h PO; or
- amiodarone:
load with 200 mg/8 h PO for 1 week then 200 mg/12 h for 1 week then maintenance 100 to 200 mg/24 h
Probably UW says class III, because Amiodarone is considered to be more class III like AAAAAa stated.
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| jvo_md
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Class 3
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| guayoman
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I just researched Amiodarone. It's actually class Ia, II, III, and IV !!!!!!!!! How about them apples!
Can it be cosidered class III for practical purposes?
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| AAAAA
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Amiodarone in
real life medicine
is Class III
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| AAAAA
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Class I a PQP
Class I c PFS Flecainide, Propafenone, Sotalol
Class 3 Amiodarone
The drug most commonly used in May 2006 is amiodarone !
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| AAAAA
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Amiodarone is class III !
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| AAAAA
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There are many, many drugs you can used. It is true, FPS, AD, DPQ
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| guayoman
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OK just don't raise your voice!
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| AAAAA
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- Class I antiarrhythmic medicines are sodium-channel blockers, which slow electrical conduction in the heart. Quinidine, procainamide, disopyramide, flecainide, propafenone, tocainide, and mexiletine are examples of class I medicines. Class II antiarrhythmic medicines are beta-blockers, which work by blocking the impulses that may cause an irregular heart rhythm and by interfering with hormonal influences (such as adrenaline) on the heart's cells. By doing this, they also reduce blood pressure and heart rate. Propranolol, metoprolol, and atenolol are examples of class II medicines. Class III antiarrhythmic medicines slow the electrical impulses in the heart by blocking the heart's potassium channels. Amiodarone, sotalol, and dofetilide are examples of class III medicines. Class IV antiarrhythmic medicines work like class II medicines but act by blocking the calcium channels in the heart. Diltiazem and verapamil are examples of class IV medicines.
Digoxin is another example of a medicine that can be used as an antiarrhythmic, although it is not included in the above categories.
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| AAAAA
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Home href="http://www.fpnotebook.com/cmplin.htm">Links Index Education Doctor Tools Editor's Choice Advertisement. Cardiovascular Medicine Pharmacology Arrhythmia Antiarrhythmic href="http://www.fpnotebook.com/CV192.htm">Procainamide Quinidine Lidocaine Flecainide Propafenone Amiodarone Bretylium Ibutilide Sotalol Pacemaker Coronary Artery Disease Nitroglycerin Nitroglycerin Drip Long Acting Nitroglycerin Short Acting Nitroglycerin EKG Prolonged QT Interval due to Medication Hypertension Herbals Affecting Blood Pressure ACE Inhibitor Angiotensin 2 Receptor Blocking Agent ACE Inhibitor in CHF Central Adrenergic Agonist Alpha Adrenergic Antagonist Peripheral Acting Adrenergic Antagonist Beta Blocker href="http://www.fpnotebook.com/CV216.htm">Carvedilol Esmolol Hydrochloride Metoprolol Propranolol Calcium Channel Blocker Dihydropyridine Nifedipine Diltiazem Mibefradil Verapamil Diuretics Acetazolamide Loop Diuretic Potassium-Sparing Diuretic Selective Aldosterone Receptor Antagonist Spironolactone Thiazide Diuretic Intravenous Antihypertensive Direct Acting Vasodilator Nitroprusside Hyperlipidemia Ezetimibe Fibric Acid derivative Plant Sterol Niacin Bile Binding Resin HMG-CoA Reductase Inhibitor Assorted Pages Amrinone Digoxin Digoxin Toxicity Dobutamine Dopamine Epinephrine Epinephrine Home Injectable Devices Isoproterenol Obstetrics Chapter Cardiovascular Medicine IndexArrhythmiaCoronary Artery DiseaseCongestive Heart FailureEKGEndocrinologyExaminationOphthalmologyGeriatric MedicineHypertensionInfectious DiseaseLaboratoryGeneralHyperlipidemiaPulmonologyMyocardiumNeurologyNeonato logyObstetricsPediatricsPericardiumPharmacologyPreventionProcedureRadiology Sports MedicineSurgerySymptom EvaluationValvular DiseaseVessel Page Pharmacology IndexArrhythmiaArrhythmia AdenosineArrhythmia Ia ProcainamideArrhythmia Ia QuinidineArrhythmia Ib LidocaineArrhythmia Ic FlecainideArrhythmia Ic PropafenoneArrhythmia III AmiodaroneArrhythmia III BretyliumArrhythmia III IbutilideArrhythmia III SotalolArrhythmia Pacemaker AVCAD Angina NitroglycerinCAD Angina Nitroglycerin IVCAD Angina Nitroglycerin Long ActingCAD Angina Nitroglycerin Short ActingEKG QTHtn AdverseHtn ACE Inhibitor IHtn ACE Inhibitor IIHtn ACE Inhibitor for CHFHtn Alpha Agonist CentralHtn Alpha AntagonistHtn Alpha Antagonist PeripheralHtn Beta AntagonistHtn Beta Antagonist PerioperativeHtn Beta Antagonist CarvedilolHtn Beta Antagonist EsmololHtn Beta Antagonist MetoprololHtn Beta Antagonist PropranololHtn CalciumHtn Calcium DihydropyridineHtn Calcium Dihydropyridine NifedipineHtn Calcium DiltiazemHtn Calcium MibefradilHtn Calcium VerapamilHtn DiureticHtn Diuretic AcetazolamideHtn Diuretic LoopHtn Diuretic SparingHtn Diuretic Sparing EplerenoneHtn Diuretic Sparing SpironolactoneHtn Diuretic ThiazideHtn IntravenousHtn VasodilatorHtn Vasodilator NitroprussideInotrope AmrinoneInotrope DigoxinInotrope Digoxin ToxicityInotrope DobutamineInotrope DopamineInotrope EpinephrineInotrope Epinephrine HomeInotrope IsoproterenolInotrope NorepinephrineLipid Absorption InhibitorLipid Fibric AcidLipid Herbal SterolLipid NiacinLipid ResinsLipid Statins
Class I: Sodium Channel Blockade Class Ia: Lengthens action potential duration Quinidine href="http://www.fpnotebook.com/CV192.htm">Pronestyl) Disopyramide (Norpace) Imipramine (MAO inhibitor) Amiodarone (also Class II, III, IV) Class Ib: No effect on action potential Lidocaine (Xylocaine) Tocainide (Tonocard) Mexiletine (Mexitil) Phenytoin (Dilantin) Class Ic: Greater sodium current depression Flecainide (Tambocor) Encainide (Enkaid) Propafenone
Class II: Beta Blocker Esmolol (Brevibloc) Sotalol (also Class III) Amiodarone (also Class Ia, III, IV)
Class III: Prolong Refractory period via action potential Bretylium (Bretylol) Sotalol Amiodarone (also Class Ia, II, IV)
Class IV: Calcium Channel Blocker Verapamil (Calan) Diltiazem (Cardizem) Amiodarone (also Class Ia, II, III)
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| AAAAA
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- Mechanism
- Class IA Antiarrhythmic High affinity for inactive sodium channels Most effective in tissue with long action potentials
Class II href="http://www.fpnotebook.com/CV214.htm">Beta-Blocker Class III Antiarrhythmic Prolongs refractory period via action potential Class IV Antiarrhythmic Weak Calcium Channel Blocker
- Pharmacokinetics
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| AAAAA
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Amirodarone is a Ia, II, III, IV but the action of antiarrhythmia is predominately Class III by prolonging refractory period by increasing the action potential.
I am sorry but the main action is to prolong the refractory period although it can be classified as Ia, II, III, IV but its main action is classified as Class III by prolonging its refractory period !
Thanks
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| AAAAA
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Amiordarone used for atrial fibrillation conversion
Atrial Fibrillation Cardioversion
Time to Cardioversion: 8-24 hours Conversion Rate: 43-68% Chronic Efficacy: 55-65%
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| AAAAA
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Atrial Fibrillation Cardioversion for Amiordaone Time to Cardioversion: 8-24 hours
Conversion Rate: 43-68% Chronic Efficacy: 55-65%
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| AAAAA
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Class I: Sodium Channel Blockade Class Ia: Lengthens action potential duration Quinidine href="http://www.fpnotebook.com/CV192.htm">Pronestyl) Disopyramide (Norpace) Imipramine (MAO inhibitor) Amiodarone (also Class II, III, IV) Class Ib: No effect on action potential Lidocaine (Xylocaine) Tocainide (Tonocard) Mexiletine (Mexitil) Phenytoin (Dilantin) Class Ic: Greater sodium current depression Flecainide (Tambocor) Encainide (Enkaid) Propafenone
Class II: Beta Blocker Esmolol (Brevibloc) Sotalol (also Class III) Amiodarone (also Class Ia, III, IV)
Class III: Prolong Refractory period via action potential Bretylium (Bretylol) Sotalol Amiodarone (also Class Ia, II, IV)
Class IV:
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