DR Medhat MRCP

Flecainide :
Class : class Ic antiarrhythmic drugs.
Mechanism of action : Na + channel blocker
Uses :
1) AF (without underlying structural heart disease e.g MI)
2) SVT associated with accessory pathway e.g WPW.
Adverse effects :
1) –ve inotrope.
2) Bradycardia.
3) Pro-arrhythmic.
4) Oral parathesia
5) Visual disturbance
Contraindication : Post MI ( flecainide mortality post MI).
Beta – blockers :
slowing of AP (long P-R & wide QRS).
Class : II antiarrythmic drugs.
Action: decrease the HR (delay A-V conduction )& cardiac work leading to decrease
cardiac O2 demands leading to relief of the symptoms.
Commonly used BB:
o Atenolol (Tenormine):
o Metoprolol (lopressor)
o Bisoprolol :
10 mg OD
50-100 mg/day . (OD or BD)
SR (start with 25 mg BD then up to maximum
tolerated dose 100mg TDS according to HR & BP).
modified release ( up to 200 mg OD).
Adverse effects:
1. Fatigue (the earliest SE felt by the patient, within 2 hrs, sp. with atenolol).
2. Sexual dysfunction (impotence, decrease libido).
3. Worsening of PVD symptoms (cold extremities,parathesia,numbness).
4. Bronchospasm (specially with non-selective BB).
5. Bradycardia
6. Hypotension
7. Masking of hypoglycemic symptoms (tremors , tachycardia)
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