Antiarrhythmics beta-blockers

Codeine, dextromethorphan, haloperidol, thioridazine, perphenazine, nortriptyline, desipramine, fluoxetine, norfluoxetine, TCAs (hydroxylation), beta-blockers such as timolol and metoprolol, type 1C antiarrhythmics encainide, flecainide TCAs (desmethylation), triazolam, alprazolam, midazolam, carbamazepine, terfenadine, quinidine, lidocaine, erythromycin, cyclosporin... 

Antiarrhythmics encainide, flecainide, mexiletine Beta-blockers alprenolol, metoprolol, propranolol, timolol Opiates codeine, dextromethorphan, ethylmorphine... 

Drugs that may affect procainamide include amiodarone, anticholinergics, antiarrhythmics, beta-blockers, ethanol, histamine H2antagonists, propranolol,... 

Drugs that may affect disopyramide include antiarrhythmics, beta blockers, cisapride, clarithromycin, erythromycin, fluoroquinolones, hydantoins, quinidine, thioridazine, rifampin, verapamil, and ziprasidone. Drugs that may be affected by disopyramide include quinidine, anticoagulants, and digoxin. 

Drugs that may increase the effects or side effects of bupropion include levodopa, MAOIs, ritonavir, antidepressants, antipsychotics, beta blockers, type 1C antiarrhythmics. 

Sotalol (Betapace) [Antiarrhythmic, Antihypertensive/Beta Blocker] WARNING Monitor pts for 1st 3 d of Rx to 4- risks of arrhythmia Uses Ventricular arrhythmias, AF Action p-Adrenergic blocking agent Dose Adults. 80 mg PO bid may be T to 240-320 mg/d Peds. Neonates 9 mg/m tid... 

On the basis of two large randomized trials aimed at suppressing premature ventricular complexes after MI, so-called warning arrhythmias, it was discovered that many common antiarrhythmic medications actually increase the risk of mortality [20, 21]. Amiodarone also has been shown to have no definitive effect on mortality in patients after an MI, including in the recent SCD-HeFT trial [22-24]. In fact, of all antiarrhythmic medications, only beta blockers have been clearly shown to prevent SCD after MI [25], particularly among those with depressed LV function [11]. 

A significant mortality benefit of ICD therapy was shown in the largest of the three studies, the AVID study. In this study, over 1,000 patients with ischemic cardiomyopathy and an EF < 40% who were resuscitated from VF or from symptomatic, sustained VT were randomized to antiarrhythmic medications (>90% amiodarone) or ICD implantation. The trial was stopped early because the ICD showed a significant survival benefit with an 11.3% absolute and 31.5% RR reduction for all-cause mortality over 3 years. Persistent benefit with the ICD was seen even after adjustment for age, beta blocker use, and baseline EF. 

Beta blockers -olol Metoprolol, propranolol Antihypertensive (21), antianginal (22), antiarrhythmic (23), congestive heart failure (24)... 

Therapeutic Function Beta-adrenergic blocker, Antiarrhythmic... 

Quinidine overdose should be treated with symptomatic and supportive therapy. Quinidine should be used with caution when coadministering with calcium channel blockers, diuretics, beta-blockers, antibacterials, antifungals, and antiarrhythmics.97... 

Exner, D., Reiffel, J., Epstein, A., Ledingham, R., Reiter, M., Yao, Q., Duff, H., Follmann, D., Schron, E., Greene, H., Carlson, M., Brodsky, M., Akiyama, T., Baessler, C., and Anderson, J., Beta-blocker use and survival in patients with ventricular fibrillation or symptomatic ventricular tachycardia The Antiarrhythmics Versus Implantable Defibrillators (AVID) trial, Journal of American College of Cardiology, Vol. 34, No. 2, 1999, pp. 325-333. 

Sotalol is a beta-blocker that also has class III antiarrhythmic effects, It causes prolongation of the Q-T interval and is recommended solely as an antiarrhythmic. It is included in this section because it is subject to interactions from its betablocking properties as well as its Q-T prolongation... 

PROPAFENONE I. ANTIARRHYTHMICS - disopyra-mide, procainamide 2. ANTIBIOTICS - macrolides (especially azithromycin, clarithromycin, parenteral erythromycin, telithromycin), quinolones (especially moxifloxacin), quinupristin/ dalfopristin 3. ANTICANCER AND IMMUNOMODULATING DRUGS -arsenic trioxide 4. ANTIDEPRESSANTS - TCAs, venlafaxine 5. ANTIEMETICS-dolasetron 6. ANTIFUNGALS-fluconazole, posaconazole, voriconazole 7. ANTIHISTAMINES - terfenadine, hydroxyzine, mizolastine 8. ANTI-M ALARIALS - artemether with lumefantrine, chloroquine, hydroxychloroquine, mefloquine, quinine 9. ANTIPROTOZOALS - pentamidine isetionate 10. ANTIPSYCHOTICS-atypicals, phenothiazines, pimozide II. BETA-BLOCKERS - sotalol 12. BRONCHODILATORS -parenteral bronchodilators 13. CNS STIMULANTS - atomoxetine Risk of ventricular arrhythmias, particularly torsades de pointes Additive effect these drugs prolong the Q-T interval. Also, amitriptyline, clomipramine and desipramine levels may be t by propafenone. Amitriptyline and clomipramine may t propafenone levels. Propafenone and these TCAs inhibit CYP2D6-mediated metabolism of each other Avoid co-administration... 

---