Antiarrhythmic agent resident survival guide: Difference between revisions

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{{Family tree | | | | | B01 | | B02 | | B03 | | B04 | | B05 | | B06 | |B01='''[[Class IA]]''' |B02='''[[Class IB]]''' |B03='''[[Class IC]]''' |B04='''[[Class II]]'''|B05='''[[Class III]]''' |B06='''[[Class IV]]''' |B07= }}
{{Family tree | | | | | B01 | | B02 | | B03 | | B04 | | B05 | | B06 | |B01='''[[Class IA]]''' |B02='''[[Class IB]]''' |B03='''[[Class IC]]''' |B04='''[[Class II]]'''|B05='''[[Class III]]''' |B06='''[[Class IV]]''' |B07= }}
{{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}}
{{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}}
{{Family tree | C01 | | C02 | | C03 | | C04 | | C05 | | C06 | | C07 | |C01= '''Mechanism''' |C02= *Mainly predominant'''α1''' agonist (Vasoconstrictive) <br> *some β1 agonist (↑contractility) |C03= *Mainly predominant '''β1''' agonist (↑ cardiac contractility) <br> * some α1 agonist(Vasoconstrictive)|C04= *'''V<sub></sub>1''' receptor of GIT vasculatures <br> *Antidiuretic effects |C05= *'''Pure α1''' agonist(Vasoconstrictive) <br> *No β1 |C06= *Predominant '''β1''' agonist (↑contractility) <br> *β2 arterial smooth muscle (Hypotensive) |C07=  }}
{{Family tree | C01 | | C02 | | C03 | | C04 | | C05 | | C06 | | C07 | |C01= '''Mechanism''' |C02= *Mainly sodium channel blockade <br> *some potassium channel blockade|C03= *Mainly predominant '''β1''' agonist (↑ cardiac contractility) <br> * some α1 agonist(Vasoconstrictive)|C04= *'''V<sub></sub>1''' receptor of GIT vasculatures <br> *Antidiuretic effects |C05= *'''Pure α1''' agonist(Vasoconstrictive) <br> *No β1 |C06= *Predominant '''β1''' agonist (↑contractility) <br> *β2 arterial smooth muscle (Hypotensive) |C07=  }}
{{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}}
{{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | |}}
{{Family tree | D01 | | D02 | | D03 | | D04 | | D05 | | D06 | | D07 | |D01= '''Agents''' |D02= *'''1st''' line in : <br> *'''Septic shock''' <br> *'''Cardiogenic shock''' <br>*Undifferentiated shock |D03= 2nd line septic shock |D04= 2nd line septic shock |D05= '''1st''' line '''Neurogenic shock''' <BR> 3rd-4th line septic shock |D06= *1st line '''cardiogenic shock''' <BR>* low output septic shock |D07= }}
{{Family tree | D01 | | D02 | | D03 | | D04 | | D05 | | D06 | | D07 | |D01= '''Agents''' |D02= *'''1st''' line in : <br> *'''Septic shock''' <br> *'''Cardiogenic shock''' <br>*Undifferentiated shock |D03= 2nd line septic shock |D04= 2nd line septic shock |D05= '''1st''' line '''Neurogenic shock''' <BR> 3rd-4th line septic shock |D06= *1st line '''cardiogenic shock''' <BR>* low output septic shock |D07= }}

Revision as of 17:00, 12 December 2013

Template:Antiarrhythmic agent Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Definition

Causes

Life Threatening Causes

Common Causes

Prognosis

Vaughan-Williams classification of antiarrhythmic agents

 
 
 
 
 
 
 
 
 
 
 
 
Vaughan-Williams classification of antiarrhythmic agents
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Class IA
 
Class IB
 
Class IC
 
Class II
 
Class III
 
Class IV
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mechanism
 
*Mainly sodium channel blockade
*some potassium channel blockade
 
*Mainly predominant β1 agonist (↑ cardiac contractility)
* some α1 agonist(Vasoconstrictive)
 
*V1 receptor of GIT vasculatures
*Antidiuretic effects
 
*Pure α1 agonist(Vasoconstrictive)
*No β1
 
*Predominant β1 agonist (↑contractility)
*β2 arterial smooth muscle (Hypotensive)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Agents
 
*1st line in :
*Septic shock
*Cardiogenic shock
*Undifferentiated shock
 
2nd line septic shock
 
2nd line septic shock
 
1st line Neurogenic shock
3rd-4th line septic shock
 
*1st line cardiogenic shock
* low output septic shock
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Effect
 
1-30 mcg/min
0.01-0.3mcg/kg/min
 
2-20 mcg/min
 
0.03 unit/min
 
20-300 mcg/kg/min
 
2.5-20 mcg/kg/min
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Indications
 
Tachyarrhythmia {less β1 effect}
( less than Dopamine )
 
Arrhythmia (more β1)
 
*Coronary spasm
*Splanchnic vasoconstriction
 
Reflex bradycardia
(only α1)
 
Hypotension (β2)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Complications
 
Arrhythmia
 
*Not in cardiogenic shock
*Arrhythmia
*Ischemia induced cardiotoxicity
 
*Ischemic heart
*Gut ischemia
 
*Bradycardia
*Heart block
 
*Hypotension (add α1 agonist)
 
 

Do's

  • Assess the cause of shock
  • Always volume fluid resuscitation first
  • Norepinephrine in undifferentiated shock.
  • Titrate dobutamine according to clinical response slowly ( 2-20 ug/kg/min ) to avoid tachycardia (10% increase from the baseline). The benefit that dobutamine has as minimal effect on myocardial oxygen demand is lost if it is not well titrated.

Don'ts

  • Do not start with low dose Dopamine dose to perfuse the kidney.

References

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