Pharm3-12-6-05

Antiarrhythmic Drugs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Learning Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object]

Arrhythmias (Dysrhythmias) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ECGs of Normal and Arrhythmic Hearts (from Goodman & Gilman)

History of Antiarrhythmic Drug Therapy ,[object Object],[object Object],[object Object],[object Object]

Cardiovascular Drug Section from the 1st edition of Goodman & Gilman (1941)

Antiarrhythmic Drug Action ,[object Object],[object Object],[object Object],[object Object]

Ion Fluxes in Cardiac Myoctes (from Katzung)

Luo-Rudy Model of the Cardiac Myocyte ,[object Object]

Time course of myocyte ion fluxes (from G&G, Figure 34-3) Sodium channel blockers Calcium channel blockers Potassium channel blockers Cardiac glycosides

Electrical Activity in the Normal Heart (from Katzung) ,[object Object],[object Object]

Arrhythmogenic Mechanisms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Automaticity: Mechanisms for Slowing Pacemaker Rate (from Goodman & Gilman, 34-10)  - Adrenergic blockers Na + and Ca ++ channel blockers Adenosine and muscarinic blockers K + channel blockers Drugs that Inhibit Automaticity

Afterdepolarizations and Triggered Automaticity (from Goodman & Gilman, 34-6) ,[object Object],[object Object]

Reentry ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Reentrant Mechanisms: AV Nodal Reentry ,[object Object],[object Object],[object Object],[object Object]

Animations of Reentrant Arrhythmias (can be found at NetPharmacology)

Classification of Antiarrhythmic Drugs ,[object Object],[object Object]

Singh-Vaughan Williams Classification ,[object Object],[object Object],[object Object],[object Object],[object Object]

Singh-Vaughan Williams Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Singh-Vaughan Williams Classification ,[object Object],[object Object]

Advantages of the Vaughn Williams Antiarrhythmic Drug Classification System ,[object Object],[object Object],[object Object],[object Object]

Class Toxicities of Antiarrhythmic Drugs (adapted from Woosley, 1991)

Relative Efficacies of Antiarrhythmic Drugs (adapted from Melmon and Morelli, 3rd ed.)

Drugs of Choice for Major Arrhythmias (Based on G&G 11th ed., Table 34-2) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Drawbacks of the Singh-Vaughn Williams Antiarrhythmic Drug Classification System ,[object Object],[object Object],[object Object],[object Object]

Sicilian Gambit Classification ,[object Object],[object Object],[object Object],[object Object],[object Object]

Actions of Antiarrhythmic Drugs (adapted from Hurst’s the Heart, 10th ed.)

Lidocaine and mexiletine (Class IB) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Procainamide (Class IA) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Disopyramide (Class IA) ,[object Object],[object Object]

Quinidine (Class IA) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Propafenone (Class IC) ,[object Object],[object Object]

Flecainide (Class IC) ,[object Object],[object Object],[object Object]

Verapamil and diltiazem (Class IV) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ibutilide (Class III) ,[object Object],[object Object],[object Object],[object Object]

Sotalol (Class III and II) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Amiodarone (Class III/other) ,[object Object],[object Object],[object Object],[object Object]

Amiodarone (cont.) ,[object Object],[object Object],[object Object]

Amiodarone (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Digoxin (Misc.) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Adenosine (Misc.) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Proarrhythmias ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Torsades de Pointes ("twisting of the points") ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ECG of Patient with Prolonged QT Interval and Torsades de Pointes (From Katzung)

CAST Proarrhythmia ,[object Object],[object Object]

Use(Rate)-Dependent Channel Blockade ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Affinity of Channel Blocker Drugs for Different Channel States (from Katzung) ,[object Object],[object Object]

Possible Mechanisms for Differential Affinity of Channel Blocking Drugs for Different Channel States (from Katzung) ,[object Object],[object Object]

Examples of Channel Blockers Showing Use-Dependent Blockade ,[object Object],[object Object],[object Object],[object Object],[object Object]

Therapeutic Considerations and Challenges ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Optimizing Antiarrhythmic Drug Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Optimizing Antiarrhythmic Drug Therapy: Genetic considerations ,[object Object],[object Object],[object Object],[object Object],[object Object]

Non-Drug Antiarrhythmic Therapies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Antiarrhythmic Therapy (Singh & Breithardt, 1997, Am J Cardiol) ,[object Object],[object Object],[object Object],[object Object]

Pharm3-12-6-05

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