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Antiarrhythmic Drugs

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Amiodarone

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Class: Class III, Mechanism of action: Potassium channel blocker, also blocks sodium and calcium channels and has alpha- and beta-blocking properties, Indications: Life-threatening ventricular arrhythmias, atrial fibrillation

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Lidocaine

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Class: Class Ib, Mechanism of action: Sodium channel blocker, primarily affecting ventricular cells, Indications: Acute ventricular arrhythmias especially post-MI

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Propranolol

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Class: Class II, Mechanism of action: Non-selective beta-blocker, Indications: Supraventricular and ventricular arrhythmias, prevention of MI recurrence

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Quinidine

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Class: Class Ia, Mechanism of action: Sodium channel blocker with anticholinergic activity, Indications: Supraventricular and ventricular arrhythmias

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Flecainide

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Class: Class Ic, Mechanism of action: Sodium channel blocker with little effect on AP duration, Indications: Supraventricular arrhythmias, atrial fibrillation/flutter

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Sotalol

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Class: Class III, Mechanism of action: Beta-blocker with potassium channel blocking properties, Indications: Atrial fibrillation/flutter, ventricular arrhythmias

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Dofetilide

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Class: Class III, Mechanism of action: Selective potassium channel blocker, Indications: Atrial fibrillation/flutter conversion and maintenance of sinus rhythm

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Procainamide

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Class: Class Ia, Mechanism of action: Sodium channel blocker with some potassium channel effects, Indications: Acute ventricular arrhythmias, atrial fibrillation

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Diltiazem

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Class: Class IV, Mechanism of action: Calcium channel blocker with both vascular and cardiac effects, Indications: Supraventricular tachycardia, rate control in atrial fibrillation/flutter

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Digoxin

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Class: Cardiac glycoside, Mechanism of action: Inhibition of Na+/K+ ATPase leading to increased intracellular calcium, Indications: Atrial fibrillation, heart failure

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Disopyramide

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Class: Class Ia, Mechanism of action: Sodium channel blocker, Indications: Ventricular tachycardia, certain forms of supraventricular tachycardia

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Adenosine

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Class: Unassigned, Mechanism of action: Activates adenosine receptors, leading to hyperpolarization and conductance decrease in AV node, Indications: Paroxysmal Supraventricular Tachycardia (PSVT)

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Verapamil

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Class: Class IV, Mechanism of action: Calcium channel blocker, Indications: Supraventricular arrhythmias, rate control in atrial fibrillation/flutter

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Atenolol

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Class: Class II, Mechanism of action: Selective beta1-blocker, Indications: Supraventricular and ventricular arrhythmias, hypertension, post-MI

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Esmolol

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Class: Class II, Mechanism of action: Short-acting selective beta1-blocker, Indications: Supraventricular tachycardias, intraoperative and perioperative tachycardia

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Nadolol

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Class: Class II, Mechanism of action: Non-selective beta-blocker, Indications: Supraventricular and ventricular arrhythmias, angina pectoris

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Propafenone

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Class: Class Ic, Mechanism of action: Sodium channel blocker, Indications: Supraventricular and ventricular arrhythmias, atrial fibrillation/flutter prevention

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Ibutilide

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Class: Class III, Mechanism of action: Potassium channel blocker, Indications: Conversion of recent-onset atrial fibrillation and flutter

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Mexiletine

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Class: Class Ib, Mechanism of action: Sodium channel blocker similar to Lidocaine, Indications: Ventricular tachycardia, prevention of ventricular arrhythmias

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Dronedarone

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Class: Class III, Mechanism of action: Similar to amiodarone but with less thyroid and lung side effects, Indications: Atrial fibrillation/flutter to reduce hospitalization

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