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Drugs in this class include:
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- Amiodarone
- Sotalol
- Disopyramide
- Digoxin
- Procainamide
- Quinidine
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There are many different classes of antiarrhythmics and their uses are tailored toward the specific arrhythmia being treated.
Digoxin is a very commonly used antiarrhythmic. Digoxin has a slowing effect on the heart rate and for this reason is used in the treatment of atrial fibrillation and atrial flutter, arrythmias which characteristically are associated with rapid and erratic heart rates. Digoxin does not suppress or prevent these arrhythmias but only works to slow them down and relieve the symptoms of palpitations, or “heart pounding.” Digoxin also helps a weakened heart muscle to pump more efficiently and is used in the treatment of congestive heart failure. Digoxin is cleared from the body by the kidneys. Therefore, its levels must be closely monitored in patients with kidney disease.
Amiodarone and sotalol are antiarrhythmics that are used to treat atrial arrhythmias (atrial fibrillation and atrial flutter) as well as ventricular arrhythmias (ventricular fibrillation). These drugs are very effective in suppressing arrhythmia. Amiodarone and sotalol are very potent and may themselves cause various rhythm disturbances and may interact with other drugs. These drugs are monitored very closely and are usually prescribed only by a cardiologist. Sotalol also has beta blocker activity. Amiodarone has several potential toxicities, including liver, lung, and thyroid toxicity.
Procainamide, quinidine, and disopyramide are frequently used to treat atrial arrhythmias. Procainamide also is effective in ventricular arrhythmias.
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