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EDUCATION IN HEART VOL 1 - PART 7

EVects bất lợi lâm sàng quan trọng khác phổi ï ¬ brosis nhạy giác mạc microdeposits xơ thần kinh Co thắt phế quản Hạ huyết áp (IV) bị biến đổi phản ứng với táo bón Hạ huyết áp hạ đường huyết (verapamil) Loạn nhịp tim mentation | EDUCATIONIN HEART Table 23.2 Important side effects of antiarrhythmic drugs Mortality post-MI Exacerbation of sustained VT Atrial flutter with 1 1 AV conduction Torsades de pointes Brady-arrrhythmia Exacerbation of heart failure Other clinically important adverse effects Adenosine Amiodarone ị Rare transient Pulmonary brosis 152 â Blockers ịị acute Photosensitivity Corneal microdeposits Cirrhosis Neuropathy Hypotension IV Bronchospasm Altered response to hypoglycaemia Bretylium Hypotension Calcium channel blockers f f Constipation verapamil verapamil diltiazem Digitalis Arrhythmias Altered mentation vision Nausea Disopyramide f Constipation Urinary retention Glaucoma Dry mouth Dofetilide Flecainide Ibutilide Lidocaine TT J f Altered mentation Seizures Mexiletine T Nausea Tremor Moricizine TT Procainamide T Drug induced lupus arthritis rash occasional pericarditis Nausea Hypotension IV Marrow aplasia Propafenone T f Occasional f Bronchospasm especially in PMs Quinidine 2 y Diarrhea Nausea Sotalol Bronchospasm Tocainide Nausea Marrow aplasia PM poor metabolisers. IV intravenous. For example it is increasingly recognised that altered intracellular calcium homeostasis may play an important role in arrhythmias in settings such as heart failure. Drugs targeting the molecular events that make altered intracellular calcium homeostasis arrhythmogenic might therefore attack the vulnerable parameter in this situation. Differential drug effects in atrial flutter versus atrial fibrillation was an interesting and it turns out incorrect prediction of the initial publication of the Sicilian Gambit. It was postulated that atrial fibrillation should respond particularly well to drugs that prolong atrial refractoriness while atrial flutter would respond especially well to drugs that slow conduction. In fact clinical studies have demonstrated that the exact opposite occurs. Drugs with predominant QT prolonging effects dofetilide ibutilide are more effective in atrial flutter than in .