SODIUM CHANNEL BLOCKER TOXICITY

Course overview

MEDICATIONS THAT ACT BY SODIUM CHANNEL BLOCKADE HAVE A WIDE VARIETY OF CLINICAL APPLICATIONS. BROADLY THEY INCLUDE VAUGHN WILLIAMS CLASS 1 ANTIARRHYTHMICS, LOCAL ANESTHETICS, MANY MEDICATIONS USED TO TREAT NEUROPATHIC PAIN (INCLUDING TRICYCLIC ANTIDEPRESSANTS (TCAS)), ANTICONVULSANTS, AND COCAINE. SPECIFIC EXAMPLES INCLUDE QUINIDINE AND PROCAINAMIDE, (CLASS 1A ANTIARRHYTHMICS), LIDOCAINE, MEXILETINE, AND PHENYTOIN (CLASS 1B), FLECAINIDE AND PROPAFENONE (CLASS 1C), CARBAMAZEPINE AND LAMOTRIGINE. THERE ARE MANY TCAS, BUT ONLY IMIPRAMINE AND AMITRIPTYLINE CONTINUE TO BE USED IN THE US TODAY. INSECTICIDES ALSO CAUSE SODIUM CHANNEL BLOCKADE. TOXICITY OF ALL THESE SUBSTANCES, WHETHER INTENTIONAL OR ACCIDENTAL, CAN LEAD TO CATASTROPHIC EFFECTS INCLUDING DEATH. THIS ACTIVITY REVIEWS THE ETIOLOGY, PRESENTATION, EVALUATION, AND MANAGEMENT/PREVENTION OF SODIUM CHANNEL BLOCKADE TOXICITY, AND REVIEWS THE ROLE OF THE INTERPROFESSIONAL TEAM IN EVALUATING, DIAGNOSING, AND MANAGING THE CONDITION.