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To which class of drugs does flecainide belong?
Na+ channel blockers (Class 1C).
What indications are associated with flecainide?
Arrhythmia (supraventricular arrhythmia)
Which Class I aniarrhythmic has the strongest effect on action potential depolarization (prolongation)?
Which Class I aniarrhythmic has a moderate effect on action potential depolarization (prolongation)?
Which Class I aniarrhythmic has a weak effect on action potential depolarization (prolongation)?
What determines the "strength" with which Na+ channel blockers prolong action potential depolarization?
The duration of time that they linger at their site of action.
True or false?
The reason that flecainide lingers so long at its site of action (and hence greatly prolongs action potential depolarization) is because it is a pseudoirreversible inhibitor of Na+ channels.
It lingers because it is the most lipid soluble of the class I drugs. (Log P's 4.6, 2.1, 1.3).
True or false?
All class I antiarrhythmics slow the rate of depolarization.
It appears to be true.
Which class I drug causes an increase in ERP?
Class 1A - procainamide
Which class I drug causes a decrease in ERP?
Class 1B - lidocaine
Which class I drug causes no change in ERP?
Class 1C - flecainide
What is the target MOA of flecainide?
- Blocks Na+ channels, and also some K+ channels.
- Decreases the rate of depolarization without increasing ERP (duration).
As per flecainie's MOA, what effects does it have on myocardial tissue?
- Suppression of premature ventricular contraction.
- Only slight prolongation of ERP.
- Increased threshold of ventricle, perkinje-His system.
- Moderate (-) inotropic effects.
What are some adverse effects associated with flecainide?
Exacerbation of arrhythmia (CAST trial).
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