1. type IA
1.1. MOA: produce a moderate blockade on fast Na channels ->
1.1.1. increase threshold needed to generate AP and slows phase 0, decreases conduction velocity and lengthens AP
1.2. Quinidine
1.2.1. for conversion of afib/flutter to NSR; prevention of SVT from preexcitation syndromes; prevent recurrent vent arrhymias
1.2.2. AE: diarrhea; antimuscarinic effects, increased rate and AV conduction-> good for WPW; cinchonism (HA, tinnitus); interacts w/digoxin; QT prolongation
1.2.3. CI: caution: prolongation of AP, QT; triggers torsades de pointes and other arrhythmias
1.3. procainamide
1.3.1. short 1/2 life, requires freq dosing; FOR vent tachycardia
1.3.2. AE: hypotention and slowed conduction; drug induced lupus; nausea; torsades de pointes; no antimuscarinic effects
1.4. disopyramide
1.4.1. for vent arrhythmias
1.4.2. AE: prominent anticholinergic activity (constipaiton, dry mouth, worsening glaucoma, urinary retractions); may worsen HF (neg inotropic effects)
1.4.3. CI: LVH and HF
2. block fast Na+ channels responsible for phase 0 in non-pacemaker cells; sodium channel blockade
3. TYPE IB
3.1. MOA: mild na channel blockade and also blocks small sodium currents throughout AP -> shorter AP
3.2. Lidocaine
3.2.1. acute therapy vent arrhythmia; IV admin d/t extensive first pass
3.2.2. AE: most neuro; seizures in high doses; hypotention, av blocks, and other arrhythmias; tremor, dysarthria and altered levels consciousness
3.3. mexilitine
3.3.1. alone or in combo to prevent vent arrhythmias
3.3.2. AE: tremor, nausea, drymouth/GI
3.4. tocainide
3.4.1. rarely used d/t pulm fibrosis and potentially fatal myelosuppresion
4. Type IC
4.1. MOA: post potent Na channel blockers
4.1.1. decrease phase 0 , decrease conduction velocity in atrial and ventricular fibers so prolonged conduction time in atria and ventricles
4.2. propafenone
4.2.1. blocks Na and K blocker and beta blocking activity; SVTs and afib refractory vent arrhythmias
4.2.2. AE: exacerbated HF, increased vent tachy, BB effects
4.3. Flecainide
4.3.1. blocks Na and slows K currents and prolongs AP in atrial tissue
4.3.2. AE: vent arrhythmias; blurred vision; may cuase heart block in pts w/conduction system probs