DRUGS AFFECTING ADRENERGIC TRANSMISSION

Enhances Norepinephrine Transmission

Exocytosis ENHANCER Tyramine

Ephedine

Amphetamine

Angiotensin II

Methamphetamine

Reuptake INHIBITOR Cocaine

Atomoxetine

Sibutamine

Metabolimsm INHIBITOR COMT Inhibitor “-capone”

Entacapone Tolcapone

MAO Inhibitor MAO A Selective Meclobemide

Nonselective MAO Phenelzine

Inh
Isocarboxazid

Tranylcypromine

MAO B Selective Selegiline

Reduces Norepinephrine Transmission

Synthesis INHIBITOR Metyrosine Blocks Tyrosine hydroxylase → low
DA

Storage INHIBITOR Reserpine Inhibits VMAT → DA not sequestered

in vesicle → DA metabolism → low
NE

Exocytosis INHIBITOR Guanethedine Binds to Dock proteins VAMPS and

SNAPS to displace NE
Guanadrel

Bretylium

DRUGS AFFECTING cholinergic TRANSMISSION

Enhances acetylcholine Transmission (cholinergic)

Anticholinesterase Block AChE enzyme Greater ACh in the cleft; greater binding

𝝰-latrotoxin ↑ Release of ACh

Reduces Acetylcholine Transmission (anti-cholinergic)

Hemicholinium Block active uptake of choline transporter Less synthesis of ACh → less transmission of
response

Vesamicol Block ACh storage Less ACh stored → Less transmission of response

Botulinum toxin Inhibitor of docking protein action. Blocks Less transmission

exocytosis of ACh

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 Sympathetic or Adrenergic Drugs
2° Msgr - EFFECT Drugs Therapeutic Uses / Notes
Location

Epinephrine B1, B2, A1 (no A2)

“Edi BB tA1”
B1: (+)
Non-
↑ Adenyl I/C/Dtropy, Selective Norepinephrine B1 and A1 (little B2)
cyclase, Tachycardia,↑
cAMP BP, β effect at low dose → 𝝰 effect
Vasoconstricti at higher dose
B1: Heart, on, ↑ Renin Dopamine B1, A1, D1
Kidneys; release “Dopa is a BAD 1”
B2: Smooth B2 Smooth:
Muscle (Lungs, Relaxation
Uterus),
Non- Isoproterenol / Rarely used; Bronchodilator; AV
B2 Skeletal: Selective B Isoprenaline block, acute HF, shock states
Skeletal
Muscle, Liver Contraction

B3: Fat B2 Liver:

Glycogenolysis &
Selective Pharmacologic stress test
Gluconeogenesis B1 Agonist Dobutamine Synthetically related to dopamine;
1st line for Cardiogenic shock,
acute HF

Albuterol
Selective
Selective B2 Agonist
B S Metaproterenol
Agonists A
S “Short
B
A
Pirbuterol
Bronchodilator for bronchospasm,

Y
AMPoTa” COPD, asthma
Terbutaline
“Long Tocolytic for preterm labor

M BIFS” Bambuterol Selectivity is lost at high

concentrations

P Direct
Acting
L
A
B
Indacaterol SQ

A A Formeterol
PO

T Salmeterol

H Isoxsuprine Tocolytics

O Ritodrine

M S PHenylephrine Two uses: Vasoconstrictors

I
y (systemic), Decongestants (local)
st
Selective e Methoxamine Not metabolized by COMT/MAO

M A1: ↑ IP3,
A1 Agonist m
ic Metaraminol
PO; Less potent; longer DOA

E
DAG - A1 Smooth: “PM MO si Diagnosis of Horner syndrome;
Smooth Contraction;
Mydriasis,↑ BP
EX” short term Hypotensive crisis,
Muscle & PR, ↓ IOP, L OxyMETazoline retinal exam (full opthalmoscopic

T A2: ↓ Adenyl
Cyclase,
A2: Inhibitory,
contraction
(muscle)
Selective
A Adreno-
o
c
al XyloMETazoline
view); Hayfever, rHinitis
May cause rhinitis

I
cAMP - Nerve, platelet medicaMENTosa
Platelet, aggregation, receptor
Pancreatic B hypeglycemia, Agonists

C
cells ↓ BP
Eye drops for red eyes
Tetrahydrozoline

L Selective
A2 Agonist
*Guanabenz Reduces sympathetic tone →
Reduces blood pressure

S
*Guanfacine Reduces IOP; antiglaucoma
“GG si
ClassMate *Clonidine 1: VConstriction → 2: VDilation
ni -dine”
*Presynapse
*Methyldopa Prodrug to A-methylnorepinephrine
(a false NT); safe for HTN in
Postsynapse Apraclonidine pregnancy; S/E: sedation
Clonidine: Post
→ Pre Brimonidine

Tyramine D/I with MAOIs → Hypertensive

crisis

Ephedrine Less potent than EPI; resistant to

MAO/COMT metabolism; long
DOA; Ephedrine found in Ma
Mephetermine Huang

↑ NE ↑ Relaxation Pseudoephedrine Isomer of ephedrine

Effect Indirect
Acting
Release Enhancers Amphetamine Alt for ADHD
Obesity (anorexiant effect)
Methamphetamine

Methylphenidate 1st line agent for ADHD

Phenmetrazine Anorexiant

Modafinil 1st line agent for narcolepsy

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 Reuptake Inhibitors Cocaine Local Anesthetic

Atomexetine Tx of ADHD

Sibutramine Tx of Obesity

Phenylpropanolamine Nasal congestion, hypotension

IA + DA
D1: Renal, Nonpolar; enters CNS readily*;
coronary, and Mephentermine Stimulation effect; S/E: Addiction
sphlanchnic
vessels, Mixed Acting
Smooth Metaraminol For Hypotension
muscle
Diagnosis of Horner syndrome
D2: Nerve Hydroxyamphetamine
endings

Noncompetitive, irreversible;
Phenoxybenzamine (𝝰 R)for Presurgical &
Non- inoperable tx of
Selective A ⊖ HAS Pheochromocytoma
Blocker
(H R)Mastocytosis
A1: ↓ IP3,
DAG - (5HT R) Carcinoid syndrome
Smooth A1 Smooth:
Muscle Relaxation; Alpha
Miosis, ↓ BP
Blockers Competitive, reversible
A2: ↑ & PR, Phentolamine
Glycogenesis,
Adenyl Gluconeogeno Direct Antidote in the tx of
Cyclase, lysis
Acting sympathomimetic (𝝰β
cAMP - A2:
Nerve, Excitatory oversimulation) poisoning;
Platelet, Vasodilators
Pancreatic B AntiHTN; Tx
cells of BPH for Pheochromocytoma;

for reversible peripheral

vasospasm (Reynaud

S
syndrome, erectile dysfunction)

A1 Prazosin
Y Selective
Blockers Doxazosin
Anti hypertensives

M
Taken HS
“-zosin” Terazosin For Urinary obstruction in BPH;

P Afluzosin
best drug
First dose phenomenon

A Tamsulosin (postural hypotension but no

reflex tachycardia unlike
Phentolamine)
T A2 Yohimbine

H Selective
Blockers Rauwolscine

O Nadolol Bronchoconstriction

L Non-
Selective B
Blocker
Sotalol Class III Antiarryhthmic
Antiglaucoma; angina pectoris
Y “Non-NSTP
Timolol
Prototype; Local anesthetic

T
” @Propranolol (Inderal) action; hyperthyroidism;
Beta migraine prophylaxis; stage
Blockers fright; angina pectoris; A/E:

I
↓ Adenyl B1: (-) sleep disturbances, depression,
cyclase, I/C/Dtropy,
sedation
cAMP Tachycardia,
↓ BP, Miosis AntiHTN;

C
Cardiac
B1: Heart, depressant Celiprolol
Kidneys; B2 Smooth:
Contraction Anti glaucoma
B2: Smooth *Bisoprolol, Betaxolol
Muscle, B2 B1
Skeletal: Selective Angina pectoris
Skeletal Esmolol
Muscle, Relaxation Blocker
Liver Arrhythmia
B2 Liver: “C
Glycogenesis Atenolol, Acebutolol
B3: Fat & B1BEAM” Shortest half life
Gluconeogeno
lysis *Metoprolol (succinate)

B2 Butoxamine No therapeutic application

Selective
Blocker
“Bubu (B2)”
Celiprolol
B Blocker Carteolol
with ISA
Labetalol
“ISAng Acebutolol
CCLAPP Penbutolol
naman jan” Pindolol
Pindolol
B Blocker Propranolol B1 blocker with local
with MSA Acebutolol anesthesia
Labetalol
“PPALM” Metoprolol Risk: Corneal injury

B Blocker Labetolol Local anesthetic action

with

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 A-Blocking *@Carvedilol
Capacity
“BALiC”

B Blocker Nebivolol Increase NO concentration →

with N2O vasodilatory
Increase Most cardioselective

NE Storage Reserpine
Inhibitor
NE
Peripher Neuronal Exocytosis Guanethidine
ally Blocker Inhibitor
Acting
Guanadrel
“GGB”
Bretylium

*for CHF: BaCa NaMan

For Arryhthmia
@For Hyperthyroidism

Parasympathetic or Cholinergic Drugs

2° GENERAL THERAPEUTIC USE / NOTES

Msgr - EFFECT DRUGS (Size: 8)
Loc

Non- Arecoline
Selective M
or N

M1: ↑ Acid & Pilocarpine Tx of open-angle glaucoma,

M1: Pepsin M Selective acute narrow angle
↑ IP3, Secretion Agonist glaucoma; Tx for Sjorgen
P
DAG - Alkaloids syndrome
GI Tract M2: ↓ HR (-)
I/C/Dtropy “Alam mo, Tx of GI atony

A via dilatory Choosy Mo

M2: effect, porket PiMus Muscarine
↓ Adenyl Bradycardia ka”
R Cyclase,
cAMP -
Heart
M3 Smooth:
Contraction N Selective Nicotine

A
(atria) Agonist
M3 Exocrine: Lobeline Smoking cessation aid
Enhanced Direct “Alam mo,
S M3:
↑ IP3,
DAG -
secretion
NM: Opens
Acting
(Receptor
Choosy si N
ng Ni LoV” Varenicline

Y Smooth
Muscle,
Exocrine
Na channel
→
Activated)
Non- Acetylcholine

M
Stimulation Selective M
Gland → muscle or N
contraction Choline Carbachol

P NM:
Neurom
NN:
Stimulation
Esters “Wag choosy
Choline kasi
ma-ACeM
Methacholine Diagnostic agent for pulmonary

A
uscular of EPI & NE; challenge test
junction Neurotrans ka” (bronchoconstrictor)
Mission

T NN:
Ganglion
A/E:
DUMBBELS
M Selective
Agonist
Bethanechol For Urinary retention, stimulate
smooth muscle motor activity,
H ; Adrenal
medulla
(contraction
/ wet) “Choosy Mo
PO or SC only; longer DOA; GI
S/E

O
Choline,
CaBet ka
naman”
M Amino Edrophonium Myasthenia gravis diagnosis;

I Alcohol (Tensilon)
Reversal of NMB Toxicity

M Short Acting

E IA for chronic open angle

glaucoma; combined with
Pilocarpine for acute
T Physostigmine /
Eserine angle-closure glaucoma;

I Reversible antidote for Anticholinergic

Indirect Carbamates (Atropine and Scopolamine)
⊖ AChE ↑ ACh Effect poisoning–central & peripheral
Acting “Reversibl
C e -ium” “-stigmine” for GI atony

S MOA:
Acetylcholi
nesterase
Intermediate to
Long Acting
Ambenonium Increase muscular strength for
Mysthenia gravis
Neostigmine GI and U Tract Atony
Inhibitors
Pyridostigmine Reversal of other anticholinergic

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 & NMB Toxicity

Demecarium IA for chronic open angle

glaucoma

Echothiophate IA for chronic open angle

glaucoma

Irreversible Organo Malathion Agricultural purposes only

Phosphate
Parathion
Very Long
Acting
Nerve Gas (Tabbun,
Sarin, Soman)

Tacrine
CNS
Acting Galantamine
For Alzheimer’s disease
“TrigGRD Rivastigmine
ang CNS”
Donepezil

2° GENERAL DRUGS THERAPEUTIC USE / NOTES

Msgr - EFFECT (Size: 8)
Loc

P Atropine Prototype; for symptomatic

bradycardia; suppress bronchial
secretion; only one with CNS

A Alkaloid effect:
Confusion, agitation, disorientation,
aute psychosis

R Muscarinic
Antagonist
Scopolamine Suppress bronchial secretion

A / Anti-
cholinergic Homatropine Refractive measurement; eye
exam

S M1: M1: ↓ Acid &

Dicyclomine

Y Stomach
M2:
Pepsin
Secretion Oxybutynin Symptomatic relief of urinary
urgency

M M3:
Heart M2: ↑ HR
M3 Smooth: Synthetic Tertiary Flavoxate

P Smooth
Muscle,
Exocrine
Relaxation /
Dilation
Compounds
Tolterodine

A
Gland M3 Exocrine:
Dryness Trihexyphenidyl

T
Anti-parkinsonism “PBB Trin’s”
Biperidin

H
Benztropine

Propantheline
O Methscopolamine

L Synthetic Quaternary Clidinium Bromide

Y Compounds
Mepenzolate

T Methantheline

I Glycopyrrolate

C Tricyclic Benzodiazepine Pirenzipine

Ganglionic Hexamethonium
Vasodilation, anticholinergic
Blocker
Trimethapan Rarely used
NM:
Neurom NN: Nicotinic Mecamylamine
uscular Depression
junction Antagonist
Relaxation IsOquinoline Neuromuscular blockade →
“-curium” relaxes immediately
NN: Neuromus- Non-
Ganglion
Mivacurium,
cular Depolarizing Atracurium , A/E: hypOtension
CNS C/I: Asthmatic, HTsives
Blocker / (reversible) tubocurarine
Skeletal A/E: Tachycardia
Muscle Steroidal

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 Relaxants “-curonium” D/I: General anesthetics esp
Pancuronium Isoflurane; Aminoglycosides

Depolarizing Succinylcholine Contracts the skeletal muscle

until muscle gets wornout →
(irreversible) relaxes
Postoperative muscle pain at
higher doses; hyPERKALemia
due to rhabdomyolysis;
Bradycardia, increased IOP;
prolonged paralysis; malignant
hyperthermia (Tx: Dantrolene)

CARDIOVASCULAR DRUGS
Drugs for hypertension
Drug Target Inhibits Reabsorption of:
PCT CAIs Na, HCO3
Thick Ascending Limb Loop Diuretics Na, K, Cl, Mg, Ca
Distal Convoluted Tubule Thiazide Diuretics Na, K, Cl
Collecting Duct K-Sparing Diuretics Na, K (secretion)
PCT & TDL (water-permeable membranes) Mannitol

Class - MOA Drug Examples Uses A/E

Notes
Carbonic ⊝ CA in the PCT → ↓ Acute mountain sickness Sulfa like
Anhydrase HCO3 and Na Acetazolamide
Inhibitor reabsorption Catamenial seizure Metabolic acidosis (due
shortlived anti-HTN Dorzolamide to ↓ HCO3 in the blood)
“-amide” Shortlived anti HTN
⊝ aqueous humor K wasting
production
Brinzolamide Antiglaucoma

N
C/I: COPD, hepatic
⊝Cerebrospinal fluid Acidic poisoning (urinary cirrhosis
production Dichlorphenamide alkalinizer)

A Metabolic alkalosis

T Sulfa like
Loop ⊝ NaKCl Co-transport Mgmt of CHF, Acute pulmonary
in the LoH → ↓ Na, K, Furosemide edema, ARF,
Diuretics Cl, Mg, Ca HyPO____emia
R “High-ceilin Bumetanide
Mgmt of HTN in px with
diminished renal function Hypotension

I g diuretics”
Torsemide
Mgmt of HyperCALcemia,
HYPERKALemia and Anion
hyperGLU

U
“emide /
D
Halide poisoning Ototoxicity
nide”
Ethacrynic Acid The only one with venodilating

I R Thiazide ⊝ NaCl Co-transporter Benzothiazide

effect
Most ototoxic
Sulfa like
E in the DCT → ↓ Na, Cl (True Chlorothiazide Anti-HTN for px with normal renal
U T
Diuretics but ↑ Ca
Limited effect: 2 weeks
Thiazide) function
1st line anti HTN
HyPO___emia
HyPERGLUC:
R I
“-one”
“-imide”
only → > 2 weeks:
Diuretic Breaking
Phenomenon
HCTZ
Metolazone
Adjuncts for HF
Glycemia
Lipidemia
Uricemia
E C Vasodilation: > 2 wks Thiazide-like Chlorthalidone
DOC for Nephrogenic DI
(paradoxical)
Calcemia

T S Indapimide
Mgt of Nephrolithiasis due to
idiopathic hypercalciuria

I Direct action
Mgmt of Meniere’s disease
diuretic of choice for px w/ Antiandrogen

C mineralocorticoid R Spironolactone Hepatic cirrhosis, mgt of PCOS

K-sparing antagonism → no HyPERKALemia
Aldosterone
Diuretics ENAC opening → ↓Na Antagonist Eplerenone Mgmt of HTN, CHF, Refractory

S “K SPAREd
reabsorption → K
saved
D
edema
Induction of diuresis in clinical
HyperCHLORemic MA
C/I: Px with renal
you a SEAT” setting associated with insufficiency
⊝ Na ion efflux ENaC hyperaldosteronism
Inhibitor Amiloride Renal stone formation

Triamterene

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 Osmotic Mannitol (IV) Dehydration
A Agents
Mannitol undergoes
rapid glomerular
Prophylaxis of acute Renal failure
HyPERNatremia
Tx of cerebral edema (to ↓ICP)
Q filtration (concentrates
in urine) → stays in Hypovolemia
U urine as it is
impermeable → water
Glycerin (PO) Ophthalmic use for corneal
damage
will undergo osmosis
A → diuresis Urea (IV) ↓ ICP and IOP
Hypertonic Saline
R Vasopressi For Diabetes Insipidus
E n Modifier
Vasopressin
Vasopressin Centrally Acting
Nonselective
or Analogues HYPERtension
T Desmopressin
Selective
For nocturnal enuresis
I
Demeclocyline For SIADH
C ADH
Antagonist Conivaptan Nonselective HYPOtension
S Tolvaptan Selective V2 Antagonist

S Beta Block B1 receptor → ↓ “olols”

Y Blocker I/C/Dtropy, ↓ BP
M Alpha Block A1 receptor → Smooth “-zosins” BPH Orthostatic
P Hypotension
Blocker muscle Relaxation → ↓ BP
A Alpha 2 Clonidine
T Safe for Pregnant women
Agonist Stimulate A2 receptor → Methyldopa
H Autoregulatory / inhibitory effect Guanabenz
O
Guanfacine
P
Nerve Block vesicular amine transporter Severe orthostatic
L Guanethedine HTN; sexual
E Terminals → depletes NT / displaces NT dysfunction
Guanadrel Rarely used for HTN
G Long DOA; psych
I Reserpine depression; GI
C disturbances
S Ganglionic Interferes with impulse Hexemethonium
Blocker transmission in the ganglia
Direct / Opening of K channel → Minoxidil Alternative for HTN crisis Hirsutism
Pure Hyperpolarization → ↓ BP Diazoxide HYPERGLYcemia
V Areteriolar
Inhibit insulin release
Mgt of Hypertensive emergency
A Dilators Release of Nitric oxide → ↑ Hydralazine in Pregnant women
S cGMP → ↓ contractile response Adjunct for CHF (combined with
ISDN) only effective to SLE
→ ↓ BP
O African-American Px
Fenoldopam Mgt in Hypertensive emergency &
D Activation of DA Receptor → postoperative Hypertension
I Renal Vasodilation
L Nonselecti
1st line in the mgmt of HTN Accumulation of CN →
ve Release of Nitric oxide → ↑ Sodium Nitroprusside emergency (must be freshly ⊖ Cytochrome oxidase
A Vasodilator cGMP → ↓ contractile response prepared) (Complex IV in ETC) →
ATP synthesis ⓧ
T s / Arterial → ↓ BP
O or Venous
Non- Increased risk of reflex
R Dihydropy- Verapamil Most cardioaselective tachycardia and
peripheral edema.
S Calcium - ridine Block L-Type Ca 50:50 selectivity** Administered in
Diltiazem** combination therapy
Channel Cardioselective Channels (found in Intrinsically SA
Blocker the heart) Intrisically LA except
Dihydropyri
-dipines (Lecarnidipine, Amlodipine, No need for
dine Lacidipine LAL) combination therapy
Vasoselective
Enthothelin blockade of potent “-sentan”
Antagonist vasoconstrictor
𝝰1 Blocker Block 𝝰1 → vasodilation “zosins”
A Inhibit ACE to convert “-pril” Mild to moderate HTN Angioedema
Dry cough
N ACE Inh inactive Ang 1 to Prodrugs except Captopril, Mgt of CHF
G active Ang 2 → Lisinopril, Enalaprilat HYPERkalemia
Mgt of CKD w/ or w/o DM
I ⊖Synthesis Vasodilation HYPOtension
O of Ang II
T Block Renin receptor Interstitial nephtritis
E Renin Inh → Ang 2 cannot bind Aliskiren
C/I: Preexisting
N to Renin R → Hyperkaemia, SB
<100mmHg,
S vasodilation Pregnancy (causes
IN Block Angiotensin Renal dysgenesis)
receptor → Ang 2 “-sartan”
⊖ ⊖Action of ARBs cannot bind to Ang Saralasin
Ang II receptor →
Vasodilation
Constipation - most common A/E for CCB

elainegt 🦭
 Drugs for CHRONIC HEART FAILURE

General Drug Class Drugs MOA Effect / Uses T/E

Effect

Digoxin Inhibit Therapeutic ATRIA: + Inotropy; ● Ventricular

Cardiac Digitalis lanata (white) Na-K-ATPase pump - Choronotropy tachycardia (esp
Increase Glycoside → ⓧ NCX → ⃠ Ca Dose: 0.5 - 1.5 ng/mL in HYPOK, Mg,
force of Digitoxin intrusion → ↑ O & HyperCa)
I myocardial Digitalis purpurea (purple) Intracellular Ca → Toxic VENTRICLES: + Inotropy; ● N&V (most
contractility ↑ Inotropy → ↑ + Chronotropy common)
N force of myocardial Dose: > 2 ng/mL ● Yellow-Green
Adjuncts contractility vision
O only
T Increase Cardiac output with
B1 Agonist Dobutamine β1 Activation → decrease in ventricular filling
R ⨁AC → ↑ cAMP → pressure
↑Inotropy,
O IV
Dopamine ↑Chronotropy
(+) Chronotropy (even at
therapeutic dose),
P Arrhythmogenic, Vasodilative

I IV only
C Inamrinone ⊖ enzyme PDE3 Only for acute HD or severe
PDE3 exacerbation of CHF
S Inhibitor /
(metabolizes cAMP
→ AMP) → ↑ For px who do not respond to
Bipyridine cAMP → ↑Inotropy, digitalis
Milrinone ↑Chronotropy
Effective for px with elevated
IV ventricular filling pressure

“-pril” ↓BV → ↓Preload Base treatment component

ACEIs & ↓ arterial resistance (afterload)
ARBs “-sartan” ↓SVR → ↓venous tension (preload)
↓SVR/Afterload ↓ aldosterone secretion
Ⓧ Cardiac & vascular
First line remodelling
agents
Loop Diuretics, Reduce venous A/E: Hypokalemia
Diuretics Thiazide Diuretics pressure and Spironolactone - safe taken with
ventricular preload; Digoxin (K-sparing)
Alter Decrease IVF &
neurohumoral Spironolactone
compensation
Cardiac preload
U mechanism →
ISDN (low dose: For px intolerant to ACEI
reduce
N afterload VEINS) + Only effective in
and/or Vasodilators ISDN + Hydralazine Hydralazine African-American px
L preload (arteries)
O Given in ISDN - ↓Preload
A Combination Hydralazine -
↓Afterload
D
Amlodipine + CCB + A1 Antagonist
E Prazosin
R
Nesiritide Brain natriuretic ↓ cardiac workload
S peptide (BNP)
analogue
↑ cGMP →
vasodilation;
Natriuresis, diuresis

Endot Bosentan
helin Potent vasoconstrictor
Antag Tezosentan
onist
“Endothela
ine Tan”

Beta Bisoprolol, Carvedilol, Block receptor in the Kidney: ⊖Renin → ⓧRAAS

Blocker Nebivolol, Metoprolol Pathway → ↓Afterload, ↓Preload
“BaCaNaMan succinate
CHieF”

elainegt 🦭
 Drugs for arrhythmia

CLASS MOA Drugs Uses / Notes

Disopyramide Anticholinergic effects greater than Quinidine (greater SE)

Class 1A Only for Ventricular arrhythmia
Prolong effective 1st anti-arrhythmic used
Moderate refractory period For atrial and ventricular arrhythmia
Quinidine
Blocker (EFR), For digitalis induced arrhythmia
repolarization, slow Induces Torsades de pointes arrhythmia; cinchonism
conduction
“A Double For atrial and ventricular arrhythmia
Quarter Second or third drug of choice for sustained ventricular tachycardia
Pounder”
Procainamide
associated with acute MI
Sodium S/E: Torsades de pointes arrhythmia; SLE; syncope
Channel
Tocainide
Blockade Class 1B

1 Weak
Blocker
Shortened
depolarization,
decrease action
Mexiletine

Lidocaine
Oral lidocaine derivative (congener of Lidocaine)
Tx of ventricular arrhythmia
Local anesthetic
potential duration, DOC for Digoxin-induced VT and prevention of ventricular
“Baby Too febrillation (IV)
Much Love shorten ERP
undergoes extensive FPE; least cardiotoxic
makes you
Pregnant”
S/E: Paresthesias, tremor, slurred speech
Phenytoin Anticonvulsant x Antiarrhythmic
Moricizine Withdrawn from the market
Class 1C Flecainide Block Na and K channel → slows conduction in all parts of heart
Suppress premature ventricular contraction
Strong May cause severe exacerbation
Blocker Slow conduction;
no effect on action Propafenone Weak beta blocker
“More Fries potential duration Blocks Ca channel
Please For supraventricular arrhythmia
Cheese” S/E: Metallic taste; constipation, arrhythmia excerbation
Encainide
Beta Penbutolol

2 Blockade Prolong AV conduction

Esmolol
Decrease HR and contractility
“BB PaMiNTa” Acebutolol
Bretylium
Ibulitide
Potassium Dofetilide
Channel

3
Prolong action potential, ERP Amiodarone Prolong action potential and delay K efflux
Blockade Delay repolarization First line agent for Ventricular tachycardia
Structurally similar to T4
"3 BIexual
DADS”
S/E: fatal pulmonary fibrosis, photodermatitis, corneal microdeposits,
Hyper/Hypothyroidism → via Wolf-Chaikoff Effect)
<10-14 days: HYPOthyroidism; > 14 days: HYPERthyroidism
Dronedarone Devoid of I2
Sotalol B blocker that is Class III
Calcium Verapamil For CHRONIC Paroxysmal Supraventricular Tachycardia

4 Channel
Blockade
Block Na channel too

Adenosine Mgt of ACUTE Paroxysmal Supraventricular Tachycardia

Others
Digoxin Control ventricular response in atrial flutter or fibrillation

MgSO4` 1st line for Torsades de pointes

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