CLASS 1 SODIUM CHANNEL BLOCKERS

Wednesday, February 16, 2011 12:14 PM

Slow impulse conduction in the atria, ventricles, and HisPurkinje system BECAUSE NS CHANNELS IN ALL CARDIAC MYOCYTES SO CLASS 1B ACCELERATES REPOLARIZATION IA also delays repolarization Quinidine, Procainamide, Disopyramide IB also accelerates repolarization Lidocaine, Phenytoin, Mexiletine IC also delays repolarization Flecainide, Propafenone Other Moricizine

CLASS 1B - LIDOCAINE Only for Ventricular dysrhythmias.

Blocks sodium channels Slows conduction in the atria, ventricles, and His-Purkinje system Reduces automaticity in the ventricles and His-Purkinje system Accelerates Repolarization Shortens action potential duration and effective refractory period IV, SubQ, IM, Topical IF I ACCELERATE REPOLARIZATION- SHORTENING THE TIMEFRAME OF REPOLARIZATION OF ECG COMPLEX BY DOING SO - SHORTEN THE ACTION POTENTIAL- DURATION IS SHORTER EFFECTIVE REFRACTORY PERIOD COULDN'T INITIATE WHILE ANOTHER IS OCCURING; ADVERSE EFFECTS OF LIDOCAINE CNS effects High therapeutic doses: drowsiness, confusion, paresthesias Toxic doses: convulsions, respiratory arrest

CLASS 1- PROCAINAMIDE Blocks sodium channels, slows impulse conduction, and delays repolarization Active against atrial, ventricular, and His-Purkinje dysrhythmias PO, IV, IM

ADVERSE EFFECTS Blood dyscrasias May be fatal Cardiotoxicity Hypotension Weakly anticholinergic Although unlikely, may cause ventricular tachycardia

CLASS 1C-FLECAINIDE- DON'T FOCUS TOO MUCH ON THIS

Atrial and ventricular dysrhythmias Decreases cardiac conduction and increases effective refractory period (EFR) Prolongation of PRI and widening of QRS Reserved only when other, safer, drugs have not worked PO

ADVERSE EFFECTS OF FLECAINIDE

Prodysrhythmic Decreases myocardial contractility Exacerbation of HF

TEST 5 Page 1