Let's Keep it Classy/MOA
Reduce β Adrenergic Activity
Class II
AAD for acute termination of PSVT
IV Adenosine
This AAD can cause Hypo/hyperthyroidism, pulmonary fibrosis, retinopathy, and photosensitivity.
Amiodarone
Quinidine, Procainamide, and Disopyramide belong to this class.
Class Ia
First-line treatment of VT/VF arrest refractory to shock (Class IIb).
Amiodarone and Lidocaine
This AAD can cause flushing, headache, chest pain, asystole, atrial fibrillation, and bronchospasm
Adenosine
This AAD class has a reverse use-dependence property (Greater drug effect at slower HR)
Class III: Sotalol, Dofetilide
Treatment of sustained monomorphic VT (with pulse)
Toxicity with this AAD can cause N/V, visual disturbance, CNS toxicity, and proarrhythmic effect.
Digoxin (proarrhythmia examples: AF or AT with AV block, bidirectional VT, VF)
This AAD class has a use-dependence property (Greater drug effect at faster HR).
Class Ic sodium channel blockers: Flecainide, propafenone.
Best AAD for prevention of ICD shocks.
Amiodarone
(then >sotalol> beta-blocker alone)
(Mexiletine used as second-line agent)
This AAD can cause lupus-like syndrome, TdP, and agranulocytosis
Procainamide
This AAD class may bring out latent Brugada pattern.
Class I AAD (Na-channel blockers).
These AAD decrease defibrillation threshold (DFT)
Sotalol and Dofetilide
Contraindicated AADs in pregnancy
Atenolol, Amiodarone, and Dronedarone