• Introduction 

• Illustrated mechanism of action 

• Examples of Medication Brand Names (with Images)

• Indication

• Side Effects 

• Precautions & Contraindications 

• Monographs

• Reference 

Class Ic antiarrhythmic drugs were developed in the late 20th century as part of the Vaughan-Williams classification system. These drugs, including flecainide and propafenone, were designed to offer strong sodium channel blockade with minimal effect on repolarization.

They gained attention due to their potent effect in suppressing ventricular and supraventricular arrhythmias. However, after the CAST (Cardiac Arrhythmia Suppression Trial) in the late 1980s, concerns were raised about their proarrhythmic risks in patients with structural heart disease.

Since then, their use has become more selective, primarily reserved for patients with normal cardiac function and without significant underlving heart disease.

propafenone and flecainide, bind avidly to the fast sodium channel, which results in a drastic slowing of the action potential's phase 0 and hence, a more dramatic effect on QRS duration. They do not affect action-potential duration and are contraindicated in patients with any history of structural or ischemic heart disease especially post MI because of their proarrhythmic effects.

Furthermore, they are used to treat both supraventricular and ventricular arrhythmias.

Paroxysmal supraventricular tachycardia (abnormal fast beating of the heart above the lower chambers)

Atrial fibrillation and flutter (rapid and irregular heartbeats in the upper chamber of the heart)

Last resort in refractory ventricular tachycardia (also called electrical storm, two or more episodes of ventricular tachycardia that occur with a time interval)

Serious side effects of class IC antidysrhythmics include:

Proarrhythmogenic (these drugs are contraindicated immediately after heart attack)

Life-threatening ventricular tachycardia (abnormal heartbeats that occur in the lower chambers)

QT prolongation (heart muscle takes longer than usual to recover after each beat

Congestive heart failure (heart doesn't pump blood as well as it should)

Bronchospasm (airways go into spasm and contract)

Other common side effects include:

Nausea and vomiting

Blurred vision

Headache

Constipation

Bitter taste

They may interact with cimetidine, digoxin, ketoconazole, orlistat, quinidine, rifampin, blood thinners, antidepressant, HIV or AIDS medication, other heart rhythm medications, medicines to treat psychiatric disorders, or beta-blockers. Tell your doctor all medications and supplements you use. During pregnancy, They should be used only when prescribed. They passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breastfeeding

https://www.sehatok.com/%D8%A7%D9%84%D8%A3%D8%AF%D9%88%D9%8A%D8%A9/%D9%81%D9%84%D9%8A%D9%83%D9%8A%D9%86%D8%A7%D9%8A%D8%AF-flecainide 

https://www.rxlist.com/living_with_atrial_fibrillation_slideshow_pictures/article.htm

https://go.drugbank.com/categories/DBCAT002518

https://www.sketchy.com/medical-lessons/class-i-a-c-antiarrythmics 

https://images.app.goo.gl/jvfBjNFn1QJ8GWZg9

https://www.sehatok.com/%D8%A7%D9%84%D8%A3%D8%AF%D9%88%D9%8A%D8%A9/%D8%A8%D8%B1%D9%88%D8%A8%D8%A7%D9%81%D9%8A%D9%86%D9%88%D9%86-propafenone