ICU Advantage - Antiarrhythmic Medications Lecture

Introduction

• Continuation of Part two covering antiarrhythmic medications
• Previous lesson covered foundational information
• Current lesson focuses on different classes of antiarrhythmic medications

Antiarrhythmic Medication Classes

• Class 1: Sodium Channel Blockers

  • Subdivided into 1A, 1B, 1C
  • Class 1A: Prolongs action potential; used for AFib, AFlutter, SVT, VTAC
    • Example: Procainamide (IV)
  • Class 1B: Shortens action potential; used for VTAC
    • Example: Lidocaine (IV)
  • Class 1C: Strongest sodium channel blockers; used for life-threatening SVT, VTAC
    • Examples: Flecainide, Propafenone

• Class 2: Beta Blockers

  • Antagonize beta receptors, affecting sodium channels
  • Increase AV node refractory period
  • Important to monitor for bradycardia, hypotension, etc.
  • Non-selective: Affect beta-1 and beta-2 receptors
  • Selective: Primarily affect beta-1 receptors
  • Example: Esmolol (IV)

• Class 3: Potassium Channel Blockers

  • Prolong phase 3 repolarization
  • Common medication: Amiodarone (IV)
  • Used for VTAC, V-fib, A-fib, A-flutter

• Class 4: Calcium Channel Blockers

  • Inhibit calcium channels in SA and AV nodes
  • Affect conduction and refractory period
  • Examples: Verapamil, Diltiazem

• Class 5/Other Agents

  • Varying effects on SA and AV nodes
  • Examples: Adenosine, Atropine, Digoxin
  • Magnesium and potassium supplementation important for electrolyte balance

Monitoring and Indications

• ECG monitoring crucial for all classes
• Monitor PR interval, QRS complex, QT interval, and arrhythmia frequency

Conclusion

• Understanding of how different antiarrhythmic medications work and their indications
• Importance of monitoring ECG and specific drug effects
• Stay tuned for more lessons on ICU drips

---

• Subscribe and engage with the ICU Advantage channel for more educational content.