Page 1 of 1: ventricular extrasystole who had AMI

drnikhil1 · Credits: 3863 My Scrapbook

what is the rx of a pt with ventricular extrasystole who had AMI 8 days back ?

b blockers

mexiletine

procainamide

verapamil

akanksha · Credits: 41247 My Scrapbook My Reading List 14 Books

beta blockers are considered as the safest & most useful drug in symptomatic post MI extrasystoles!

findjag · Credits: 2236 My Scrapbook

Lidocaine is the drug of choice for VES in Acute MI. Alternatives are Procainamide, Disopyramide and Mexiletine. Since Mexiletine has more adverse effects when compared to Procainamide answer should be Procainamide. Ref Tripathi 4th ed p 518.

akanksha · Credits: 41247 My Scrapbook My Reading List 14 Books

usefulness of beta blockers in Post MI arrythmias have been prooved beyond doubt.

anti arrythmics (viz lignocaine/procainamide) are usually reserved for VT/VF (not extrasystoles).

In fact,the use of anti arrythmics may adversly affect the mortality statistics & may lead to asystoles!

Even in the setting of VT/VF,antiarrythmics are used only as a 2nd option,where cardioversion isnt possible or cant be tried.

Kindly go thru pg 1396/1397 Harrisons.

Guest · Credits: 78425 My Scrapbook My Reading List 262569 Books

thanx for ur rply

Guest · Credits: 78425 My Scrapbook My Reading List 262569 Books

Currently, no evidence supports treatment of ASYMPTOMATIC VPCs after MI with medication other than beta-blockers. Treatment considerations include symptoms caused by VPC, other prognostic variables (ie, presence or absence and type of structural heart disease, CAD, and LV dysfunction), and adverse effects (specifically proarrhythmic effects of medications).
Beta blocker is the straight forward answer but I'm sure that there are more details in the question, that might change the answer.

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