Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
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 |