```Common side effects of class 1b
no prolonged QT, mostly CNS effects (drowsiness, agitation, muscle twitch, seizures, paresthesias)
```Common side effects of class 1c
prolonged QT, TdP not for use in HF
```Common SE of Dofentilide
Ventricular arrhythmias, TdP, avoid other agents known to prolong QT interval. Drugs that inhibit metabolism in liver: dilt, verapamil, amio, sotalol, TCA, phenothiazines and diuretics.
Liver 80%, Kidney 20%
Liver 30%, Kidney 70%
Liver 75%, Kidney 25%
```What are the indications of quinidine?
Effective in the tx of chronic and supraventricular arrhythmias. Often given to slow atrial rate in the presence of atrial fibrillation.
```What are the major S.E. of procainamide?
hypotension with rapid IV admin agranulocytosis, SLE, prolong QT, may cause agranulocytosis.
```What are the major drug interactions associated with procainamide?
Increased effect of skeletal muscle relaxants, lidocaine, and neuromuscular blockers (succinylcholine), increased plasma/Napa levels with cimetidine, rantidine, BBs, and amiodarone, increased NAPA levels with trimethoprim.
```Explain the indications for disopyramide.
Suppresses atrial and ventricular arrhythmias.
```What are the major precautions for disopyramide?
has significant negative inotropic effects which can worsen CHF, anticholinergic SEs,
```What are the major precautions for propafenone?
Should be avoided in patients with CAD, bronchospastic disorders, uncontrolled CHF, or conduction disorders (AV block or SSS), and bradycardia.
```What are the major precautions of sotalol?
not for patients with HF or heart block, renal dysfunction, may cause TdP
```What are the major precautions for ibutilide?
stop drugs which may prolong the QT interval at least 5 half lives before starting hold at least 4 hours after.
primarily excreted in urine, only partially in the liver
***MOA of K sparing diuretics
- direct action on renal tubular x-port mechanism on distal convoluted tubule - increased excretion of Na+, Cl, HCO3, urinary pH - N increase in K excretion
```where do thiazide diuretics work?
1st in cortical portions of the loop, ascending portion of the loop of Henle, proximal and distal renal tubules. Increases urinary excretion of Na, Cl-, HCO3-.
```where do loop diuretics work?
inhibit reabsorption Na+, Cl- primarily in the medullary portions of ascending limbs of the loop of Henle
```common SE of quinidine
diarrhea, conchonism, very increased dig, TdP, atrial/ventricular arrythmias
primarily excreted in urine