Real Life Pharmacology - Pharmacology Education For Health Care Professionals

In this episode, we are going to review antiarrhythmic drugs that clinicians may encounter in practice: Digoxin, Propafenone, Dofetilide, and a few others. While these drugs are commonly used in the management of atrial fibrillation and other rhythm disturbances, they each come with important pharmacology and safety considerations that pharmacists and healthcare providers need to recognize. Digoxin is a cardiac glycoside that increases contractility while also slowing AV node conduction through enhanced vagal tone, making it useful for rate control in atrial fibrillation, particularly in patients with heart failure. However, it has a narrow therapeutic index, and toxicity can occur if renal function declines or electrolyte abnormalities develop. Propafenone is a Class IC sodium channel blocker used primarily for rhythm control in atrial fibrillation. A key clinical pearl with this medication is that it should generally be avoided in patients with structural heart disease due to the risk of proarrhythmia. D