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34 Cards in this Set

  • Front
  • Back
What do antiarrhythmics do?
suppression of cardiac arrhythmias
Antiarrhythmics correct cardiac arrhythmias by a variety of ________
mechanisms
What is the therapeutic goal of antiarrhythmics? (2)
decreased symptomatology
increased hemodynamic
performance
What does the choice of agent depend on? (2)
etiology of arrhythmia
individual patient
characteristics
What should be corrected before therapy is initiated
(e.g., electrolyte disturbances, other drugs)
treatable causes of arrhythmias
How are antiarrhythmics generally classified?
by their effects on cardiac conduction tissue
What 3 drugs are also used as antiarrhythmics?
adenosine
atropine
digoxin
What is one major Class I drug that shares the properties of 1A, 1B, and 1C?

1A
depresses Na conductance
increases APD and ERP
decrease membrane
responsiveness

1B
increase K conductance
decrease APD and ERP

1C
profound slowing of
conduction
markedly depress phase 0
moricizine
What are 3 Class IA drugs that:
depress Na conductance
increase APD and ERP
decrease membrane
responsiveness
disopyramide
procainamide
quinidine
What are 4 Class IB drugs that increase K conductance, decrease APD and ERP?
lidocaine
mexiletine
phenytoin
tocainide
What are 2 Class 1C drugs that work by profound slowing of conduction, markedly and markedly depress phase 0?
flecainide
propafenone
What are 3 Class II drugs that:
interfere with Na conductance
depress cell membrane
decrease automaticity
increase ERP of the AV node
block excess sympathetic
activity
acebutolol
esmolol
propranolol
What are 3 Class III drugs that interfere with: norepinephrine
increase APD and ERP
amiodarone
dofetilide
ibutilide
sotalol
What are 2 Class IV drugs that increase AV nodal ERP
and block calcium channels?
diltiazem
verapamil
The contraindications differ ______ among various agents.
greatly
Precautions differ _____ among agents used.
greatly
Appropriate dosage adjustments should be made in elders and those with what kind of impairment? (2)
renal
hepatic
What should be monitored throughout IV administration and periodically throughout oral administration? (3)
ECG
pulse
blood pressure
Potential Nursing Diagnoses?
Cardiac output, decreased
Knowledge deficit, related
to medication regimen
What pulse should be taken before administration of oral doses?
apical
While taking oral doses, if heart rate is less than 50 bpm, what should happen?
withhold dose
notify physician or hcp of
less than 50 bpm heart rate
Where are apical pulses taken?
at the apex which is usually located between the fourth and sixth intercostal spaces, near or medial to the left midclavicular line;

this is usually the point where the heartbeat is FELT or SEEN most strongly

(FYI: however, to AUSCULTATE
for heart sounds and murmurs, use precordial sites which are:
aortic
pulmonic
tricuspid
mitral
Erb's point

(each area is named after the heart valve primarily responsible for the sounds that are heard best in that location)
Where are apical pulses taken?
between the fourth and sixth intercostal spaces
Oral doses of antiarrhythmics should be administered with?
a full glass of water
Most sustained-release preparations should be?
swallowed whole

(don't crush, break, or chew tablets or open capsules, unless specifically instructed)
Patient/Family teaching tips?
Take oral doses around the
clock even if feeling
better
Teach family member how to
take pulse
Patient should report changes
in pulse rate or rhythm to
hcp
Don't take OTC meds without
consulting hcp
Carry ID about med
Make follow-up exams
Effectiveness of therapy can be demonstrated by?
resolution of cardiac arrhythmias without detrimental side effects
Name Class IA drugs? (4)
disopyramide Norpace, Norpace CR, {Rythmodan}, {Rythmodan-LA)

moricizine Ethmozine

procainamide Procanbid, Promine, Pronestyl, Pronestyl-SR

quinidine gluconate
Quinaglute Dura-Tabs, Quinalan, {Quinate}

quinidine sulfate
{Apo-Quinidine}, Cin-Quin, {Novoquinidin}, Quinidex Extentabs, Quinora
Name Class IB drugs? (4)
lidocaine
PARENTERAL:
LidoPen, Xylocaine, {Xylocard}
LOCAL ANESTHETIC:
Dilocaine, Lidoject, Nervocaine, Octocaine, Xylocaine
MUCOSAL: Anestacon, Xylocaine Viscous
PATCH: Lidoderm
TOPICAL: DermaFlex, ELA-Max, Solarcaine Aloe Extra Burn Relief, Xylocaine, Zilactin-L

mexiletine Mexitil

phenytoin Dilantin, diphenylhydantoin, DPH, Phenytek

tocainide Tonocard
Name Class IC drugs? (2)
flecainide Tambocor

propafenone Rythmol
Name Class II drugs? (4)
acebutolol {Monitan}, Sectral

esmolol Brevibloc

propranolol {Apo-Propranolol}, {Betachron E-R}, Inderal, Inderal LA, InnoPran XL, {Novopranol}, {pms Propranolol}

sotalol Betapace, Betapace AF, {Sotacor}
Name Class III drugs? (3)
amiodarone Cordaron, Pacerone

dofetilide Tikosyn

ibutilide Corvert
Name Class IV drugs? (2)
diltiazem (Apo-Diltiaz}, Cardizem, Cardizem LA, CartiaXT, Dilacor XR, Diltia XT, {Novo-Diltazem}, Nu-Diltiaz, {Syn-Diltiazem}, Tiamate, Tiazac

verapamil Apo-Verap, Calan, Calan SR, Covera-HS, Isoptin, Isoptin SR, {Novo-Veramil}, {Nu-Verap}, Verelan, Verelan PM
Name 3 miscellaneous antiarrhythmics?
adenosine Adenocard, Adenoscan

atropine Atro-Pen

digoxin Digitek, Lanoxicaps, Lanoxin