Antiarrhythmic Pharmacology

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  • Опубликовано: 3 авг 2019
  • ​​SUPPORT/JOIN THE CHANNEL: / @dirtymedicine
    My goal is to reduce educational disparities by making education FREE.
    These videos help you score extra points on medical school exams (USMLE, COMLEX, etc.)
    For educational purposes only; NOT medical or other advice.
    Some videos contain mild profanity and hyperbole solely used to assist with memorization. Viewer discretion advised.
    Opinions are entirely my own.

Комментарии • 183

  • @DirtyMedicine
    @DirtyMedicine  4 года назад +232

    Full disclosure: this is a brutal topic to learn. I did my best to simplify it. Remember to pay special attention to:
    1. Cardiac action potential changes
    2. Main adverse drug reaction (ADR)
    3. Classification (Class 1A, 1B, 1C, II, III, and IV)

    • @tiagobeirao5979
      @tiagobeirao5979 4 года назад +2

      Thank you so so much. This is really hard!

    • @sililly1379
      @sililly1379 4 года назад

      What time zone will you be airing this topic?

    • @yogeshbhusal8945
      @yogeshbhusal8945 4 года назад +3

      How about antidiabetic drugs?

    • @yogeshbhusal8945
      @yogeshbhusal8945 4 года назад +1

      How about anti diabetic drug?

    • @Drhamzaasad
      @Drhamzaasad 4 года назад +1

      I can’t believe my eyes! Thank you so much dirty. Thank you so much!! You’re the BEST!!

  • @xayisnaliemartinez9999
    @xayisnaliemartinez9999 4 года назад +345

    Very Very important that Amiodarone messes with your TSH (it can cause hypo or hyperthyroidism). Appears in the questions every time

    • @angryrantmansneighbours8470
      @angryrantmansneighbours8470 3 года назад +4

      He mentioned it here with TFTs. Thanks for the reminder again tho

    • @SaiRam-nz9sy
      @SaiRam-nz9sy 3 года назад +1

      Hypo and hyper
      Double track drifting

    • @mathiasmacson4782
      @mathiasmacson4782 2 года назад +7

      I had this exact question on my exam yesterday, thank you so much 🥰🥰

  • @gulzarbabarg
    @gulzarbabarg 3 года назад +117

    Amiodarone = Am(iod)arone = iodine = Thyroid Problems.
    Dronedarone = No “iod” so = No thyroid issues.

  • @TheAcvivek
    @TheAcvivek 3 года назад +80

    My mnemonic for
    class IA :queen(quinidine) die(disopyramide) fast after doing cocaine(procainamide)
    Class III : LOL(sotalol) till I die(ibu-til-ide, dofe-til-ide) Amigo (amiodarone)
    Both class mnemonic has dying part :D so they can cause torsades de points by increasing the effective refractory period (ERP) -->> QT prolongation (Action potential prolongation)
    For class IC: proper(propa-fenone) cane(fle-cain-ide) slaps the sodium channel the hardest but stabilizes ERP.

    • @purple.rainbow
      @purple.rainbow 2 месяца назад

      Did you make it up by yourselves?

    • @purple.rainbow
      @purple.rainbow 2 месяца назад

      Do share if it was from some website

  • @droopingsnoot2761
    @droopingsnoot2761 4 года назад +108

    You could remember that beta-blockers are class II by thinking of beta being the second letter in the Greek alphabet

    • @Ruqaya_pearl
      @Ruqaya_pearl 4 года назад +2

      So logic, I guess i will never forget it 👍

    • @MedicineGod
      @MedicineGod 2 месяца назад +1

      or B the second letter in our alphabet

    • @Jimbo292
      @Jimbo292 2 месяца назад

      @@MedicineGod no is it really???

    • @iamasavageproductions2618
      @iamasavageproductions2618 2 месяца назад

      @@Jimbo292yess!!! i’m glad ur up to date now !

  • @DannyMercer1993
    @DannyMercer1993 3 года назад +62

    Christ imagine if medicine were taught like this. It might even be possible to do it in three years and be HAPPY?!

    • @masterimbecile
      @masterimbecile 3 года назад +8

      I've realized that it's not our faculty's job to keep us happy. They just have to have presented the info at least once, so that when they test you on it you can't say you didn't "learn" it in class; how that info manages to stick in your brain is all on you.

    • @felipepubillones2768
      @felipepubillones2768 2 года назад +5

      @@masterimbecile don't know about you, but our faculty figured out food = happy. Every event had food lol

  • @yukyunglee4706
    @yukyunglee4706 3 года назад +60

    Calcium channel blockers and beta-blockers work on the nodal action potential, so the shape of the original AP curves should be different. Thank you for another great video!

    • @zeinaahmad3783
      @zeinaahmad3783 Год назад +6

      I was looking for this comment... you don't need to memorize 0,3,4 for class 4 because you already know there are no phases 1 and 2 in nodal action potential .. I guess he's just trying to simplify and avoid the physiology 🤷‍♀️

    • @sahityabk
      @sahityabk Год назад +2

      Saaaaame thought omg

  • @faisalalabdally2975
    @faisalalabdally2975 3 года назад +11

    Na Channel blocker pneumonic for class 1 drugs...
    Class 1A: DQP; Double Quarter Pounder
    Class 1B: ML; Mayo Lettuce
    Class 1C: FP; Fries Please

  • @xaaboopinkly
    @xaaboopinkly 3 года назад +51

    I studied this on Uworld and it took me an entire day to master it, but you’re simplifying it into just 20 minutes, huge thanks sir!

  • @professorcensored3647
    @professorcensored3647 2 года назад +14

    My med school professors are terrible and it's exhausting as a learner. I binge-watch Dirty Medicine after every topic we cover to actually understand the material. Thank you for helping my mental health stay afloat.

  • @sililly1379
    @sililly1379 4 года назад +15

    It's so impressive how easy you and palatable you've made this topic. Thanks again

  • @riyadhatrah
    @riyadhatrah 4 года назад +13

    please, keep making these videos man. This is gold. This and the other videos as well.

  • @junaidmushtaq9421
    @junaidmushtaq9421 4 года назад +18

    POLICE DEPARTMENT QUESTIONED THE LITTLE MAN FOR PUSHING ENCAINIDE
    this help u to remember Class 1A 1B 1C

  • @LaoevanSVU
    @LaoevanSVU 3 года назад +5

    Thank you for not brute forcing this and actually teaching the info!

  • @mattcoleman946
    @mattcoleman946 3 года назад +36

    The reason you give glucagon in a beta blocker overdose is not because of the hypoglycemic masking. Glucagon stimulates cardiac ionotropy via a separate mechanism than beta blockers.

  • @fireandce
    @fireandce 4 года назад +36

    Did that help? YES! That was beautiful. You are a gem, seriously. I learn way more from you than I did in my two years of med school. Any chance you could do some more drugs with us? I'd love any obgyn/repro stuff you feel like doing too. Thanks!

  • @mongorians22
    @mongorians22 2 года назад +4

    I remember the mechanism of each of the classes though the phrase, "Never BET the Kitchen Counter". Type I, II, III, IV = Na, BETa, K, and Ca.

  • @thepacemaker8165
    @thepacemaker8165 4 года назад +6

    Your effort is so greatly appreciated!

  • @anonmikey
    @anonmikey 2 года назад +1

    this has to be the most helpful and actually efficient way to read pharmacology omg thanks

  • @michaelmakarchuk8662
    @michaelmakarchuk8662 4 года назад +9

    some block potassium channels - sodium (I), beta (II), potassium (III), calcium (IV)

  • @komaldiptianandmaisuriya4301
    @komaldiptianandmaisuriya4301 3 года назад +1

    Ty so much . Best video ,easy understanding and great pneumonics.

  • @monzilachowdhury6590
    @monzilachowdhury6590 2 года назад +9

    I love your lectures. Thank you:) The way I remember Beta blockers are class II by remembering that B is the 2nd letter of alphabet.

  • @Michael75557
    @Michael75557 Год назад +3

    Additional UWorld facts:
    1) Amiodaron has partial Class 1,2 and 4 effects too. It also has an homogenous effect on K channel hence lowest risk of TdP among Class 3 agents.
    2) Sotalol has partial B-cloker effect
    3) B-Blockers reduce PR interval (obviously)
    4) Adenosine acts on A1 receptors---->Potassium outflow--->Nodal conduction delay

  • @hujaimaarab3474
    @hujaimaarab3474 2 года назад +2

    You are very hard working teacher - Respect!
    I really hope u make more videos on pathology amd pharmacology pleaseeee

  • @sililly1379
    @sililly1379 4 года назад +14

    Thank you so much for taking your precious time to simplify stuff for us Dr. DirtyUSMLE.
    Can you make a video on how best to recall all these fun facts from all your videos. I don't mean to sound ungrateful for everything you're doing for us🤭
    Oh, I'm quadrupling the amount I'd pledged on your patreon. What I'd have paid a tutor is what I'll donate
    I hope others can do the same, to show appreciation for your hard work you put in to making it easy for us.
    Thank you Dr. DirtyUSMLE sir.

  • @rosannamaeperez7066
    @rosannamaeperez7066 2 года назад

    You are amazing!! You made it so easy and simple.

  • @ihabhassan2476
    @ihabhassan2476 Год назад

    Thanks a lot for your awesome work!!

  • @papoullah2087
    @papoullah2087 4 года назад +5

    Thank you very much for this video,,, very detailed explation Loved the Salty Cab 🚕 idea 😉 but I wish you explained use dependance and reverse use dependance 😊

  • @shikshadahiya2967
    @shikshadahiya2967 Год назад

    You’re videos are great but this one the way you simplified it its amazing 👏🏻👏🏻

  • @sruthigk9111
    @sruthigk9111 4 года назад +3

    Thank you so much.Really helpful class.Thank u for explaining with tips ,mnemonics,images and voice all sounds pretty gud for a lecturer.

  • @camipiche6709
    @camipiche6709 Год назад +1

    Very Informative..3/17/23 Educational purposes for work

  • @AK06ApeX
    @AK06ApeX Год назад +2

    🤣 WoW 😂 Great job man
    Another way to remember the names. If youve heard heard the song "Hotel California" in that main chorus rhythm sing the following
    Smoke (Sodium)
    Better. (Beta)
    Pot. (Potassium)
    (In)
    California. (Calcium)
    Adenosine
    Mg
    Hope this helps

  • @Ajiizleee
    @Ajiizleee 2 года назад +2

    Gingival Hyperplasia and Ca Channel Blockers seems to be high yield for my Q banks.

  • @rushiagarkar3119
    @rushiagarkar3119 4 года назад +2

    Nice work.

  • @bobbudweiser1886
    @bobbudweiser1886 3 года назад

    Great presentation, hard core over-acronymaged!

  • @Arsenal4Life_GoGunners
    @Arsenal4Life_GoGunners 2 года назад

    Very useful intro to cardiology medications!

  • @seersha2937
    @seersha2937 Год назад

    Tyvm. I’m going to watch it over and over. 👍

  • @hodabahmanoff7835
    @hodabahmanoff7835 3 года назад

    YOUR BEST VIDEO. THANK YOU

  • @drsentichubalongchar5772
    @drsentichubalongchar5772 4 года назад

    U made it too easy for all of us..great upload👍

  • @staypurpleponyboy
    @staypurpleponyboy 2 года назад +4

    These pneumonics also help solidify the info:
    For the K-Channel (Class III) he mentioned the AIDS pneumonic
    "Kant Kure AIDS with Potassium"
    Also class II - Bets Blockers
    Two B's / double B's = class two
    Calcium channel blockers
    Verapamil and diltiazem are the only Non-dihydropyridines in the CCB class
    They are "Very Different" (since they are the only two that have a significant impact on cardiac conduction / heart rate)

  • @Redwood_13
    @Redwood_13 6 месяцев назад +1

    Thank you so much,your videos are so helpful 😊.

  • @Sasukeloverxxx
    @Sasukeloverxxx 4 года назад +4

    If you had a vid to help keep a1, a2, B1, B2, mAChR stuff straight, that would be bae. FA has it diagrammed out, but it's not as sexy. Relevant to pretty much every system and it kicks my butt in all of them (currently in cardio and had it in msk and GI)

  • @junaidmushtaq9421
    @junaidmushtaq9421 4 года назад

    Thanks you so much , i learn antiarrythmics Drugs quickly in a easy way,

  • @vanshajchandra307
    @vanshajchandra307 3 года назад +1

    Omg thank you so much Dr Dirty..you are amazing.....this topic has been such a nightmare for me since the med school

  • @mrmc55
    @mrmc55 5 месяцев назад

    Extremly helpful; thank you

  • @EIonsMusk
    @EIonsMusk Год назад

    amazing content, as always!

  • @narancauk
    @narancauk 4 года назад

    majestic thank you

  • @yeeshao9233
    @yeeshao9233 4 года назад

    Thank you, thank you, thank you

  • @user-mj9dr5cn1p
    @user-mj9dr5cn1p Год назад +1

    Wonderful

  • @Bestcomment_
    @Bestcomment_ Год назад +1

    Β blockers also elongate the floor (sounds like four). The floor being phase four.

  • @kokocipher
    @kokocipher Год назад +1

    Procainamide => SLE
    "it's HIP to have lupus"
    HIP: Hydralazine
    Isoniazid
    Procainamide

  • @ahmedsaleem5357
    @ahmedsaleem5357 2 месяца назад +1

    lots of love you made it a peice of cake

  • @fariyaashrafkazi6185
    @fariyaashrafkazi6185 Год назад +1

    Thanks a tonne!!😊

  • @yup9832
    @yup9832 2 года назад

    thank you i love the mnemonics

  • @smilesandmilestones
    @smilesandmilestones 4 года назад +1

    🙇‍♀️regards to u!!

  • @jamesStone22
    @jamesStone22 4 года назад +1

    which antiarrythmic causes tall t wave? amiodarone, digoxin or ibutilide? best ans?

  • @sanchitakharoliwal5140
    @sanchitakharoliwal5140 2 года назад

    Thank youuu so much for this video it was so helpful ❤️

  • @Awa-2021
    @Awa-2021 Месяц назад

    Thanks for this video 😊

  • @zummaransari3497
    @zummaransari3497 Месяц назад

    Thanks!

  • @ahmadfares5243
    @ahmadfares5243 2 года назад

    Great 👍 👌 👍

  • @Frugal_Not_Cheap
    @Frugal_Not_Cheap 9 месяцев назад

    Thanks Dirty you rock!!!...For Beta Blockers, you can also say SE: affects Breathing, Balls, Blood glucose masking

  • @ughsirius
    @ughsirius Год назад +1

    THANK YOU SOOO MUCH

  • @LD-ky8bo
    @LD-ky8bo 11 месяцев назад

    Thank you!

  • @starstuff137
    @starstuff137 3 года назад

    Thank you so much 🥺

  • @Gemosiku
    @Gemosiku 3 года назад

    Thanks fam, that was really helpful

  • @djwolf005
    @djwolf005 4 года назад +3

    Hi, could you please make a video comparing different types of benzodiazepines? Thank you!

  • @MedicAbbas
    @MedicAbbas 2 месяца назад

    @11:10, I would suggest the fact that they're class II can be related to the rule of 4s in that 2squared is 4; class II, 2squared adds to the rule of 4s ;)

  • @Sreeja196
    @Sreeja196 8 месяцев назад

    You are a saviour!

  • @Ruqaya_pearl
    @Ruqaya_pearl 4 года назад +1

    You my friend a legend

  • @joaocadula5903
    @joaocadula5903 Год назад

    You are smart!...

  • @marishabelova3706
    @marishabelova3706 28 дней назад

    You’re the best ❤

  • @kevouyreid4518
    @kevouyreid4518 3 года назад

    Excellent 21:33. Well spent.

  • @faree38green
    @faree38green 4 года назад

    Awesome!

  • @DrA902
    @DrA902 Год назад

    He save me literally 😢❤

  • @drkrunalpatelortho
    @drkrunalpatelortho 3 года назад +2

    Class 1a and class 3 has increase Tdp so they prolong Qtc so they are high yield
    Class 1c is like c for chooter (shooter)so like in video games First Person shooter(Flecainamide, and P)
    Procainamide has more A then propafenone
    So more A goes higher so A grade
    So class 1A and later is class 1C

  • @arielmandelblum
    @arielmandelblum 2 года назад +1

    I'm not going to lie, when you said your mnemonic for CCB's I felt like Jimmy Neutron experiencing a brain blast. 20/10 video

    • @noorrefai4639
      @noorrefai4639 2 месяца назад

      My IQ definitely jumped a few points after hearing it 😂

  • @marlinmathew6734
    @marlinmathew6734 6 месяцев назад

    are all these affecting the myocardial action potenital? beta blocker and phase 4 slow depolarization sounds more like the pacemakeer potential

  • @sarah8844
    @sarah8844 7 месяцев назад

    amazing

  • @tassneemgamal3125
    @tassneemgamal3125 10 месяцев назад

    Thank you so much😭😭😭😭😭❤❤❤❤❤❤

  • @1412Z
    @1412Z 11 месяцев назад

    thanks

  • @Camboo10
    @Camboo10 4 года назад +3

    Not sure if this helps anyone, but a way to remember what blocker goes with what class is that for the chemicals it goes in the order on the periodic table and for beta blocker, beta = 2nd = II. Just my II cents.

  • @Geoblek1
    @Geoblek1 Год назад +1

    took me 5 years to remember the D in class I antiarrhythmics is Dysopyramide and the D in class III is dofetilide

  • @Dr.Ismaili
    @Dr.Ismaili 4 года назад

    You could say, that beta is the second letter in the greek alphabet, there by completting the class II mnemonic

  • @user-ul2sd8yc3g
    @user-ul2sd8yc3g 2 года назад +1

    10:13
    Isn’t the red graph a nodal action potential graph?

  • @abdullahislam6760
    @abdullahislam6760 3 года назад

    perfect

  • @musafiz6164
    @musafiz6164 4 года назад +4

    Me trying to keep things simple and stupid at the same time 🔥🔥✊🏾😂..
    This was very helpful though

  • @user-dr7fw8pr6m
    @user-dr7fw8pr6m Год назад

    thank you perfect video can someone answer this :
    slowing down the influx of sodium ions into cardiac muscle cells causing a decrease in the excitability of the cells it has a beta adrenergic blocker which can cause bradycardia and bronchospasm :
    sotalol
    propafenone
    verapamil
    mexitilene

  • @Sponge247
    @Sponge247 4 года назад +1

    knowing how these change EKG is also important

  • @owensaenz1065
    @owensaenz1065 Год назад +9

    Thank you!! You can also remember that Beta-Blockers are class II because Beta is the 2nd letter in Greek alphabet.
    Beta = 2nd letter = Class II

  • @sitotatarekegn7977
    @sitotatarekegn7977 4 месяца назад +1

    Dirty you are a life saviour. Do us this favour and pin the mnemonics of the comment section, please.

  • @whiteguyplays6229
    @whiteguyplays6229 2 года назад

    how is phase 3 affected in CCB's when phase 3 is for potassium efflux

  • @iqbalbutt9464
    @iqbalbutt9464 11 месяцев назад

    Beta blockers - 2Bs , class II

  • @user-hv2gq4wv8b
    @user-hv2gq4wv8b Год назад +2

    "How do you remember xyz? Well unfortunately you have to memorize" ... yeaahh. that's basically entire medicine *eye roll*

  • @fatimak7825
    @fatimak7825 3 года назад +1

    why did you draw nodal and ventricular APs interchangeably?

    • @meganmcdermott5746
      @meganmcdermott5746 3 года назад +1

      noticed that too... great video but those should definitely be different APs

  • @faizanahmed5368
    @faizanahmed5368 2 года назад +3

    One pro tip; class 1 and 3 act on contractile cell & class 2 and 4 are for Nodal Cells.
    So while looking at those graph on first aid don’t get confused it just different cells.

  • @michaelmakarchuk8662
    @michaelmakarchuk8662 4 года назад

    Beta blocker s/e = B - b0ner block (impotence), B - bronchospasm (COPD exac.)

  • @VIVI1337
    @VIVI1337 3 года назад

    Amiodarone has the least chance to cause TdP (but still can), high yield.

  • @son6428
    @son6428 4 года назад +1

    I love you!!!!

  • @justsomeguy6730
    @justsomeguy6730 2 года назад +1

    Good shit.
    Great shit, even.

  • @masterimbecile
    @masterimbecile 3 года назад

    Beta is the second Greek letter, it is also class 2 antiarrhythmics