VAUGHAN WILLIAMS CLASSIFICATION

CLASS EXAMPLE S/E

Ia
Reduce rate of rise of upstroke.(0) &
prolong action potential
Act on atria, ventricular muscle cell,
AV nodes, Purkinje fibres
reat !V & v"arr#$t#mia
%isop$ramide
Antic#olinergic effects & 'ausea, vomiting, dr$
mout#, urinar$ retention
(uinidine Administer orall$
)* !"+ & cinc#onism ,'!
!"+ & titanus, #earing loss, visual disturbance,
confusion, ps$c#osis
Procainamide
Administer P-,*V,*.
Associated /it# nausea, ras#, vominting,
art#algia (joint pain)
0upus like s$ndrome occurs more
fre1uentl$ & earlier in patient /#o are slo/
acet#$lators of procainamide
Ib
Administered orall$
2lock 'a c#annel
Rapidl$ metabolised & 30 mins
reat ventricular arr#$tmia
0ignocaine,
.e4iletine
5ig# plasma levels cause dro/siness, parest#esia
(abnormal skin sensation) and sei6ures activit$
P#en$toin & treat sei6ures
7 given *V
7 !+ & ,'! to4icit$
Ic
2lock 'A fast c#annel
'o effect on AP duration
Administer orall$
Propafenone
7 t#reatening
V
+4aceration of lung due to partial beta blocking
action
8lecainide
7 V"!V
Proarr#$t#mic , given b$ electrop#$siologist
II
2eta receptor antagonist
(5eart, 9
:
lung & blood vessels 9
;)
Act on !A & AV predominantl$
2ot# !V & v"arr#$t#mia
2eta blockers
(Propranolol,
Atenolol)
2ronc#oconstriction
5eart block
5eart failure
III
!lo/ing do/n repolarisation (p#ase
3)
Prolong AP duration
2ot# !V and v"arr$t#mia
<sed in life t#reatening cases, *V
oral r4
Amiodarone
.ainl$ affect Purkinje fibre & ventricular
muscle
!"+ &
#$roid disorders
P#otosensitivit$
0iver damage
Pulmonar$ alveolitis
2ret$lium
<sed in *,< setting 7 treat recurrent"refractor$
arr#$t#mia
5$potension
!otalol
'on specific beta blocker
+4erts =ve ionotrop#ic effect
.ain !"+ & prolong ( interval
*V
2lock 0 subt$pe of calcium c#annel
Act on AV nodes onl$ ,a;>influ4
Verapamil
%iltia6em
Reduce contractilit$ of t#e #eart not for 58
patient
reatment for !V onl$