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Verapamil is used for controlling ventricular rate in supraventricular tachycardia (SVT) and migraine headache prevention. [17]Verapamil is also used for the treatment of angina (chronic stable, vasospastic or Prinzmetal variant), unstable angina (crescendo, preinfarction), and for the prevention of paroxysmal supraventricular tachycardia (PSVT).
Sotalol is indicated for the treatment of atrial or ventricular tachyarrhythmias, and AV re-entrant arrhythmias. Ibutilide is the only antiarrhythmic agent currently approved by the Food and Drug Administration for acute conversion of atrial fibrillation to sinus rhythm. Azimilide; Bretylium; Clofilium; E-4031; Nifekalant [6] Tedisamil; Sematilide
Prevent paroxysmal atrial fibrillation [7] and haemodynamically stable ventricular tachycardia [8] (amiodarone) Treat atrial flutter and atrial fibrillation (ibutilide) Treat ventricular tachycardia and atrial fibrillation (sotalol) Treat Wolff-Parkinson-White syndrome; IV Calcium channel blockers Diltiazem; Verapamil; Ca 2+ channel blocker
Atrial fibrillation is associated with an increased risk of heart failure, dementia, and stroke. [3] [12] It is a type of supraventricular tachycardia. [14] Atrial fibrillation frequently results from bursts of tachycardia that originate in muscle bundles extending from the atrium to the pulmonary veins. [15]
The most common adverse effects in studies were dysgeusia (taste disturbance, in 18% of patients), sneezing (13%) and paraesthesia (abnormal skin sensations, 7%); they were transient and rarely led to an abortion of the treatment. Potentially serious side effects included low blood pressure and conversion of the heart rhythm to atrial flutter ...
Cardiovascular agents generally have narrow therapeutic indices, implying that small differences in dose or blood concentration may give rise to adverse drug reactions. [45] Serious acute toxicity may result from accidental, intentional or iatrogenic overdose. [46] Therefore, patients need to be aware of any unusual and serious side effects.
Medications to treat the toxic effects include: intravenous fluids, calcium gluconate, glucagon, high dose insulin, vasopressors and lipid emulsion. [1] [2] Extracorporeal membrane oxygenation may also be an option. [1] More than ten thousand cases of calcium channel blocker toxicity were reported in the United States in 2010. [2]
Ibutilide is a Class III antiarrhythmic agent that is indicated for acute cardioconversion of atrial fibrillation and atrial flutter of a recent onset to sinus rhythm. It exerts its antiarrhythmic effect by induction of slow inward sodium current, which prolongs action potential and refractory period of myocardial cells.