Sodium Channel Blocker

Aka: Sodium Channel Blocker

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II. Causes: Cardiovascular

  1. Antiarrhythmics
    1. See Sodium Channel Blockade Antiarrhythmics
    2. Class Ia: Lengthens Action Potential duration
      1. Quinidine
      2. Procainamide (Pronestyl)
      3. Disopyramide (Norpace)
      4. Amiodarone (also Class II, III, IV)
      5. Ajmaline (used to diagnostically provoke Arrhythmia in suspected Brugada Syndrome)
    3. Class Ib: Shortens Action Potential duration
      1. Lidocaine (Xylocaine)
      2. Tocainide (Tonocard)
      3. Mexiletine (Mexitil)
      4. Aprindine
    4. Class Ic: Slows conduction
      1. Flecainide (Tambocor)
      2. Encainide (Enkaid)
      3. Propafenone (Rythmol)
      4. Moracizine (Ethmozine, off U.S. market in 2007)
  2. Diuretic
    1. Triamterene
    2. Amiloride
  3. Beta-Blockers (esp. non-selective)
    1. Acebutolol
    2. Oxprenolol
    3. Propranolol

III. Causes: Neurologic

  1. Seizure
    1. Lamotrigine
    2. Oxcarbazepine
    3. Phenytoin (Dilantin, Shortens Action Potential duration)
    4. Fosphenytoin
    5. Eslicarbazepine
    6. Carbamazepine
    7. Lacosamide
    8. Topiramate
    9. Rufinamide
  2. Anesthetic
    1. Lidocaine
  3. Muscle Relaxants
    1. Cyclobenzaprine

IV. Causes: Psychiatric

  1. Tricyclic Antidepressant
    1. Amitriptyline
    2. Desipramine
    3. Imipramine
    4. Nortriptyline
  2. Other Antidepressants (SSRI, SNRI)
    1. Bupropion
    2. Citalopram
    3. Fluoxetine
    4. Paroxetine
    5. Venlafaxine
  3. Antipsychotics
    1. Thioridazine
    2. Loxapine

V. Causes: Miscellaneous

  1. Amantadine
  2. Cocaine
  3. Tetrodotoxin
  4. Tramadol
  5. Antihistamines
    1. Chlorpheniramine
    2. Diphenhydramine
    3. Dimenhydrinate
    4. Doxepin
  6. Antimalarial Agents
    1. Chloroquine
    2. Hydroxychloroquine
    3. Quinine

VI. Resources

  1. Sodium Channel Blocker Toxicity (Internet Book of Critical Care)
    1. https://emcrit.org/ibcc/nacb/

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