生命應該如此 不倦不休 細水長流 有些東西是值得為它堅持一生的...

※ Class Ia :
  * Quinidine
     -> Inh. vagolytic
     -> Anticholinergic
     -> Cinchonism
     -> thrombocytopenia

  * Procainamide
     -> Met. way:N-acetylation => SLE
     -> Active Met.:NAPA

  * Disopyramide
     -> Anticholinergic(atropine like)


※ Class Ib :
  * Lidocaine
     -> Met.:MEGX => Induce epilepsy
     -> Non PO effect
     -> Digoxin overdose antidote

  * Phenytoin
     -> Elimination order:LD:1 ; HD:0
     -> Tx digitalis-induced tachyarrhythmias
     -> Antiepilepsy

  * Tocainide
     -> SE: Epilepsy inducer
     -> Only this "-cainide" is Class Ib

  * Mexiletine
     -> SE: Epilepsy inducer


※ Class Ic :
  * Flecainide
     -> Mechanism: Na.K.Ca blocker => Not pure
     -> SE: Overlay CHF

  * Propafenone
     -> Mechanism: Na.K blocker
     -> Met.: Hepatic & Renal
     -> SE: Bronchospasm => Asthma CI


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※ Class II
  * Propranolol
     -> SE: CHF , bronchospasm
     -> Cannot use with Verapamil => Overlay CHF

  ** Sotalol
     -> Two types: Nonselective beta blocker => Class II
　　　　　　　 K channel blocker => Class III
     -> Met.: Renal


※ Class III
  * Bretylium
     -> Mechanism: Inh. NE reuptake
     -> Tx: Tachycardia , Ventricular fibrillation

  * Amiodarone
     -> I => SE: Gray man syndrome
     -> Nonspecific: Na,K,Ca & alpha,beta blocker & Muscarinic
     -> SE: Gray man syndrome , Pulmonary fibrosis
     -> Higt lipophilic => Half life: 3 month
     -> Broad antirrhythmic drugs
     -> Amiodarone is CYP inhibitor => Inh. other drugs met.

  * Ibutilide, Dofetilide
     -> Pure Class III drug
     -> SE: Torsade de pointes
     -> CI: Sulfanamide hypersensitive

  ** Sotalol


※ Class IV
  * Verapamil
     -> Papaverine indivate
     -> Mechanism: L-type CCB
     -> SE: Overlay CHF , A-V block(Antidote:Atropine,Ca,Beta agonist)
     -> Tx: PSVT , Reentrant PSVT , Cancer(Block P170 glycoprotein)

  * Diltiazem

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※ Others:
  * Adenosine
     -> Mechanism: Active adenosine receptor => prolong conduction
　　　　　　　 Active K channel => Cause Hyperpolarization
     -> SE: Dyspnea, Hypotension, Chest pain
     -> Half life: 30 sec.
     -> Met. Enzyme: Adenosine deaminase => Inh. other drug met.
     -> Tx: PSVT, Reentrant PSVT, AV nodal reentry tachycardia

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Only "Class Ia & Class III" cause QT prolong, inducing Torsade de pointes.