Antiarrhythmic Therapy 沈阳药科大学药物化学教研室
沈阳药科大学药物化学教研室 Antiarrhythmic Therapy
Antiarrhythmic Therapy Empiric Pathophysiologic Arrhythmia Diagnosis Arrhythmia Diagnosis Known or suspected mechanisms BLACK BOX Critical components Vulnerable parameters Targeted subcellular units Interventions Interventions Clinical Outcomes Clinical outcomes
Antiarrhythmic Therapy Empiric Arrhythmia Diagnosis Interventions Clinical Outcomes Interventions Clinical Outcomes Pathophysiologic Arrhythmia Diagnosis Known or suspected mechanisms Critical components Vulnerable parameters Targeted subcellular units BLACK BOX
Antiarrhythmic Therapy Pathophysiologic AV node reentrant tachycardia Arrhythmia Diagnosis Known or suspected AV node reentry mechanisms Anatomical fast/slow Critical components pathway Vulnerable parameters Targeted subcellular units L-type Ca** channel Interventions Cat+ channel blocker B-blocker L→ Clinica| Outcomes Sinus rhythm
Antiarrhythmic Therapy Pathophysiologic Arrhythmia Diagnosis Interventions Clinical Outcomes Known or suspected mechanisms Critical components Vulnerable parameters Targeted subcellular units AV node reentrant tachycardia AV node reentry Anatomical fast/slow pathway AV node (slow conduction) AV nodal action potential L-type Ca++ channel Ca++ channel blocker -blocker Sinus rhythm
Vaughn-Williams Classification Based on cellular properties of normal His-Purkinje cells Classified on drug's ability to block specific ionic currents (i.e. Nat, K*+, Ca**) and beta-adrenergic receptors Advantages: Physiologically based Highlights beneficialldeleterious effects of specific drugs
Vaughn-Williams Classification • Based on cellular properties of normal His-Purkinje cells • Classified on drug’s ability to block specific ionic currents (i.e. Na+ , K+ , Ca++) and beta-adrenergic receptors • Advantages: – Physiologically based – Highlights beneficial/deleterious effects of specific drugs
Antiarrhythmic Therapy Empiric Goals Arrhythmia Diagnosis .dentify the type of dysrhythmia . Be familiar with more common BLACK BOX antiarrhythmics and their Vaughn-Williams Classification Interventions Clinical outcomes
Antiarrhythmic Therapy Empiric Arrhythmia Diagnosis Interventions Clinical Outcomes BLACK BOX Goals •Identify the type of dysrhythmia •Be familiar with more common antiarrhythmics and their Vaughn-Williams Classification