term1 Definition1term2 Definition2term3 Definition3
Please sign in to your Google account to access your documents:
Class I (A,B,C)
- Quinidine
- Disopyramide phosphate (Norpace)
- Procainamide (Pronestyl)
- Moricizine (Ethmozine)
- Lidocaine (Xylocaine)
- Mexiletine (Mexitil)
- Tocainide HCI (Tonocard)
- Phenytoin sodium (Dilantin)
- Propafenone (Rhythmol)
- Flecainide acetate (Tambocor)
Indication:
- premature beats, atrial flutter, a-fib
- contraindicated in heart block
- ventricular dysrhythmias
- unlabeled use: digitalis for induced dysrhythmias
Adverse reaction: diarrhea, hypotension, ECG change, cinchonism, interact with many common drugs, hypotension, CNS effects, seizures, GI distress, bradycardia, dizziness, slurred speech, ventricular dysrhythmias
Nursing implication:
- instruct client to monitor pulse rate and rhythm
- monitor ECG
- monitor for tinnitus and visual disturbances
- lidocaine administered IV bolus and by infusion
- monitor for confusion, drowsiness, slurred speech, seizures with lidocaine
- administered oral drugs with food
- may cause digoxin toxcitity
Class II
- Propranolol HCI (Inderal)
- Metoprolol (Lopressor)
- Atenolol (Tenormin)
Indications
- supraventricular and ventricular tachydysrhythmias
Adverse reaction:
- hypotension
- bradycardia
- bronchospasm
Nursing implication: monitor vital sign & contraindicated in asthma
Class III (Inotropics)
- Amiodarone HCI (Cordarone)
- Sotalol ( Betapace)
- Dofetilide (Tikosyn)
- Dronedarone (Multaq)
- Ibutilide (Convert) IV
Indication: ventricular dysrhythmias
Adverse reaction: dysrhythmias. HTN or hypotension, muscle weakness, tremors, photophobia
nursing implication:
- amiodarone is now one of the first choice drug
- monitor vital signs ECG
- instruct client taking amiodarone to wear sunglasses and sunscreens when outside
Class IV
- Verapamil HCI (Isoptin, Calan)
- Diltiazem (Cardizem)
Indication: supraventricular dysrhythmias
Adverse reaction: hypotension, bradycardia, constipation
- monitor BP and pulse
- instruct client to change positions slowly
Atropine sulfate (Atropisol)
Indication: bradycardia
Adverse reaction: chest pain, urinary retention, dry mouth
nursing implication: monitor HR & pulse, assess for chest pain, urinary retention, and avoid use with glaucoma
Digoxin (Lanoxin)
Indication: supraventricular dysrhythmias, a-fib
Adverse reaction: bradycardia, dysrhythmias, anorexia, nausea, vomiting, diarrhea, visual disturbances
- monitor pulse rate and rhythm
- check apical pulse for one full minute before administering hold if bp is less 60 bpm & notify physician
- instruct client to report signs of toxicity
- hypokalemia increases the risk for toxicity
- causes hypercalcemia
Epinephrine (adrenaline)
indication: cardiac arrest
adverse reaction: tachycardia, HTN
- impaired renal function can cause toxicity; monitor BUN and creatinine
- monitor pulse return in asystole
- monitor vital sign
Vasopressors
- Norepinephrine bitartrate (Levophed)
Indication: Dilated coronary arteries and causes peripheral vasoconstriction for emergency hypotensive states not caused by blood loss, vascular thrombosis, or anesthesia using cyclopropane or halothane
adverse reaction: can cause severe tissue necrosis, sloughing, and gangrene if infiltrates (blanching along vein pathway is preliminary sign of extravasation)
- rapidly inactivated by various body enzymesl need to ensure IV patency
- use cautiously in previously hypertensive clients
- check BP every 2-5 min
- use large veins to avoid complication of prolonged vasoconstriction
- pressor effects potentiated by many drugs; check drug-drug interactions
- have phentolamine (Regitine) diluted per protocol for local injection if infiltrates
Cardiotonic/Vasoldilator (Human B-type Natriuretic Peptide: HBNP
- Nesiritide (Natrecor)
- treatment of acutely decompensated HF in clients who have dyspnea at rest or with minimal activity
- reduce PCWP and reduces dyspnea
- hypotension is primary side effect and can be dose limiting
- dysrhythmias
- headaches, dizziness, insomnia, tremors, parasthesias
- abdominal pain, nausea and vomiting
- many drug-drug interactions
- monitor bp and telemetry
- as diuresis occurs, monitor electrolytes, especially k+
- watch for overresponse to treatment in older adults
Need help typing ? See our FAQ (opens in new window)
Please sign in to create this set. We'll bring you back here when you are done.
Discard Changes Sign in
Please sign in to add to folders.
Sign in
Don't have an account? Sign Up »
You have created 2 folders. Please upgrade to Cram Premium to create hundreds of folders!