As per US FDA guidelines as per USPDA 1997

It is the intention to bring out the salient features. Hence relevent details as prescribed by US FDA guidelines as per USPDA 1997  are brought out clearly in the following chapters. 

Descriptons are detailed only to the Group Head and the indiviual items can be seen by visiting the Web Site 

ANTIARRHTTHMIC-

Include-                                                                                                                             Acebutol, Amiadarone,Atenolol, Atropine, Digitoxin, Digoxin, Diltiazem,Disopyramide, Encainide, Flecainide, Glycopyrolate, Hyoscyamine, Lidocaine, Metoprolol, Mexiletine, Morricizine, Nadaolol, Oxyprenolol, Phenytoin, Procainamide, Propranol, Quinidine, Scopolamine, Sotalol, Timolol, Tocainide, Verapramil 

ARRHYTHMIAS-                                                                                                                 Occur at all ages but, the incidence and prevalance increase with advancing ages . Approximately10% of people over the age of 75 years are in paermanent atrial fibrillation.

Arrhtthmias may present with  range of symptoms , including palpitations, chest pain, dyspnoea, Stokes-Admam attacks, pressyncope , dizziness, thromboembolic complications and sudden death. Differential diagnosis often require specilist  investigationeg 24  hour ambilatory monitoring

Treatment-                                                                                                                 Causes of arrhythmias , suc as in throtoxicosis, alcholism,and excess caffeine consumption must be excluded. Treat is baed on upon known electrophysiological . The Vaughan -Williams classification is a guide to antiarrhythmic drugs based upon drug mechanism of action.

Class 1 a,b, and c membrane stablising drugs- Quinidine, Procainamide,vblock SVT, VT, Lignocaine , Mexilitine  , Flecainide

Class II Betablockers include. Non-selective Beta blockers- Alprenol, oxyprenol, pinodiol, propranol, solatol, timolol,. Cardio-selective B1 blockers- Atenol, metaprolol, practolol,

Class III - Amiodarone, Solatol, Breytylium

Class IV Calcium hannel blockers- including Verapramil, but excluding nifedipine

ACE INHIBITORS-                                                                                                       

Include- Captopril, enalapril, fosinopril, lisonopril, perindopiril, quinapril, ramipril, transdopril

-Beta-adrenergic blockers include-

Atenolol, Acebutol, Betaxolol, Bisoprolol,Cartelol,Esmolol, Labetatol,Metoprolol, Nadolol, Oxypeprenol, Penbutolol, Pinodol, Propranolol, Solatol, Timolol,

Refer - Atenolol 

1. Do not discontinue medication abruptly, except on advise of physician. Sudden cessation of   therapy may precipitate or exacerabate angina.

2. Consult pharmacist or physician before using other products which may contain alpha  adrenergic stimulants (eg. nasal decongestants, otc cold preparations)

3. Notify physician if symptoms of CHF occur (eg. difficult breathing, especially on exertion or when lying down., night cough, swelling of the extremities).

4. Notify physician if any of these occur; slow pulse rate, dizziness, lightheadedness, confusion or   depression, skin rsh, fever, sore throat or unusual bleeding or bruising.

5. May produce drowsiness, lightheaedness, blurred vision, patient should observe caution while  driving or performing tasks requiring alertness, coordination or physical dexterity.

6. Allergies- Tell your doctor if you had any unusual or allergic reactions to bet-blockers.
    Tell your doctor if you are allergic to any other substances such as foods, or drink

7. Pregnancy- use of beta-blockers during  pregnancy has been associated with low blood sugar,   breathing problems, a slower heart rate, low blood pressure in the new born infant.

8. Breast-feeding- it is not known whether bisoprolol, carteolol or pentbutol pass into breast milk.  Mothers who are taking beta blockers and who wish to breast feed should discuss with the doctor.

9. Children- some of these medicines have been used in children and in effective doses, have not shown to cause side effects.

10. Elderly- Side effects are more likely to occur in elderly. Beta blockers may reduce tolerance to   cold temperature in elderly patients

11. Other medicines- Tell your doctor if you are taking any other  medicines-
    
      Allergy shots or  Allergy skin tests - betablockers may increase the risk of serious       allergic reactions

 12. Other medical problems- Tell your doctor if you have other medical problems-
     
    Allergy or  Bronchitis or Emphysema - betablockers may increase trouble in                 breathing  of this medicine may be increased because of slow removal from the body
 
   13. Missed dose-
      If you miss of this medicine take it as soon as possible.
      However, it it is within 4 hours of your next dose ( 8 hrs if you are using atenolol,              labetolol, madolol, penbutol, solatolol or extended release metoprolol,oxeprenol, or          propranol,)  skip the next dose and go back to your dosing schedule     

      Do not double doses.