Pharm Ch 22 24 25 General

Front 1

Antidysrhythnmic Drugs:
Class I

Back 1

moricizine

Front 2

Antidysrhythnmic Drugs:
Class Ia

Back 2

disopyramide
procainamide
quinidine

Front 3

Antidysrhythnmic Drugs:
Class Ib

Back 3

lidocaine
mexiletine
phenytoin

Front 4

Antidysrhythnmic Drugs:
Class Ic

Back 4

flecainide
propafenone

Front 5

Antidysrhythnmic Drugs:
Class II

Back 5

All B-blockers like
atenolol
esmolol
metoprolol

Front 6

Antidysrhythnmic Drugs:
Class III

Back 6

amiodarone
sotalol*
ibutilide
dofetilide

* also has Class II properties

Front 7

Antidysrhythnmic Drugs:
Class IV

Back 7

diltiazem
verapamil

Front 8

Effects of Antidysrhythmic Drugs:
Class I

Back 8

* prolong AV nodal conduction velocity
* prolong bundle of His and Purkinje cell conduction velocity
* Prolong the PR and QRS complex intervals of the ECG
* Eliminate or reduces ectopic foci stimulation
* Have minimal effect on the SA node and automaticity

Front 9

Effects of Antidysrhythmic Drugs:
Class Ia

Back 9

* Depress myocardial excitability
* Prolong the ERP
* Eliminate or reduce ectopic foci stimulation
* Decrease inotropic effect
* Have anticholinergic (vagolytic) activity

Front 10

Effects of Antidysrhythmic Drugs:
Class Ib

Back 10

* Decrease myocardial excitability in the ventricles
* Eliminate or reduce ectopic foci stimulation in the ventricles
* Have minimal effect on the SA node and automaticity
* Have minimal effect on the AV node and conduction
* Have minimal anticholinergic (vagolytic) activity

Front 11

Effects of Antidysrhythmic Drugs:
Class Ic

Back 11

* Produce dose-related depression of cardiac conduction, especially in the bundle of His-Purkinje system
* Have minimal effect on atrial conduction
* Eliminate or reduce ectopic foci stimulation in the ventricles
* Have minimal anticholinergic (vagolytic) activity
* Flecainide use now reserved for the most serious dysrhythmias

Front 12

Effects of Antidysrhythmic Drugs:
Class II

Back 12

* Block B-adrenergic cardiac stimulation
* Reduce SA nodal activity
* Eliminate or reduce atrial ectopic foci stimulation
* Reduce ventricular contraction rate
* Reduce cardiac output and blood pressure

Front 13

Effects of Antidysrhythmic Drugs:
Class III

Back 13

* Prolong the ERP
* Prolong the myocardial action potential
* Block both alpha and beta adrenergic cardiac stimulation

Front 14

Effects of Antidysrhythmic Drugs:
Class IV

Back 14

* Prolong AV nodal ERP
* Reduce AV nodal conduction
* Reduce rapid ventricular conduction caused by atrial flutter

Front 15

Antidysrhythmic Drugs: Mechanisms of Action
Class I
Action & Tissue

Back 15

Action: Blocks sodium channels, affects phase O

Tissue: Fast

Front 16

Antidysrhythmic Drugs: Mechanisms of Action
Class II
Action & Tissue

Back 16

Action: Decreases spontaneous depolarization, affects phase 4

Tissue: Slow

Front 17

Antidysrhythmic Drugs: Mechanisms of Action
Class III
Action & Tissue

Back 17

Action: Prolongs APD (Action Potential Duration)

Tissue: Fast

Front 18

Antidysrhythmic Drugs: Mechanisms of Action
Class IV
Action & Tissue

Back 18

Action: Blocks slow calcium channels

Tissue: Slow

Front 19

Antidysrhythnmic Drugs:
Class OTHER

Back 19

digoxin, adenosine

Front 20

Define the Vaughan Williams Functional Class:
Class I

Back 20

Membrane-stabilizing drugs; fast sodium channel blockers

Front 21

Define the Vaughan Williams Functional Class:
Class Ia

Back 21

↑ blockade of sodium channel, delay repolarization, ↑ APD

Front 22

Define the Vaughan Williams Functional Class:
Class Ib

Back 22

↑ blockade of sodium channel, accelerate repolarization, ± APD

Front 23

Define the Vaughan Williams Functional Class:
Class Ic

Back 23

↑↑↑ blockade of sodium channel, ± repolarization; also suppress reentry

Front 24

Define the Vaughan Williams Functional Class:
Class II

Back 24

B-blocking drugs

Front 25

Define the Vaughan Williams Functional Class:
Class III

Back 25

Drugs whose principal effect on cardiac tissue is to ↑ APD

Front 26

Define the Vaughan Williams Functional Class:
Class IV

Back 26

Calcium channel blockers

Front 27

Define the Vaughan Williams Functional Class:
Other

Back 27

Antidysrhythmic drugs that have the properties of several classes and therefore cannot be placed in one particular class

Front 28

Antidysrhythmic Drugs: Indication
Class Ic

Back 28

Severe ventricular tachycardia and supraventricular tachycardia dysrhythmias, atrial fibrillation and flutter, Wolff-Parkinson-White syndrome

Front 29

Antidysrhythmic Drugs: Indication
Class I

Back 29

Symptomatic ventricular and life-thretening dysrhythmias

Front 30

Antidysrhythmic Drugs: Indication
Class II

Back 30

Both supraventricular and ventricular dysrhythmias (act as general myocardial depressants)

Front 31

Antidysrhythmic Drugs: Indication
Class IV

Back 31

Paroxysmal supraventricular tachycardia; rate control for atrial fibrillation and flutter

Front 32

Antidysrhythmic Drugs: Indication
Class III
AMIODARONE

Back 32

Life-threatening ventricular tachycardia or fibrillation that is resistant to other drug therapy. This drug has also been very effective in the treatment of sustained ventricular tachycardias. It has recently been used more frequently to treat atrial dysrhyhmias as well.

Front 33

Antidysrhythmic Drugs: Indication
Class III
SOTALOL

Back 33

This drug has Class II properties as well.
Usually reserved for the treatment of documented life-threatening ventricular dysrhythmias such as sustained ventricular tachycardia.

Front 34

Antidysrhythmic Drugs: Indication
Class III
IBUTILIDE

Back 34

Conversion of atrial fibrillation or flutter to a normal sinus rhythm.

Front 35

Antidysrhythmic Drugs: Indication
Class III
DOFETILIDE

Back 35

Conversion of atrial fibrillation or flutter to a normal sinus rhythm.

Front 36

Antidysrhythmic Drugs: Indication
Class Ia

Back 36

Atrial fibrillation, premature atrial contractions, premature ventricular contractions, ventricular tachycardia, Wolff-Parkinson-White syndrome

Front 37

Antidysrhythmic Drugs: Indication
Class Ib

Back 37

Ventricular dysrhythmias only (premature ventricular contractions, ventricular tachycardia, ventricular fibrillation)

Front 38

amiodarone: what Vaughn Williams class?

Back 38

Class III

Front 39

amiodarone works by ...

Back 39

Amiodarone (Cordarone, Pacerone) markedly prolongs the APD and the ERP in all cardiac tissues. also block both a & b adrenergic receptors of the SNS.

Front 40

procainamide: adverse effects

Back 40

Significant adverse effects include ventricular dysrhythmnias and blood disorders.
Drug-induced lupuslike (erythmatosus-like) syndrome (idiosyncratic): arthralgia, fever, pleuropericarditis, hepatomegaly, positive result on antinuclear antibody test. Gastrointestinal effects such as nausea, vomiting, and diarrhea. Fever, leukopenia, maculopapular rash, urticaria, pruritus, flushing, and torsades de pointes resulting from prolongation of the QT interval.

Front 41

Nursing Process:
assessment findings -
ANTIDYSRHYTHMICS

Back 41

Baseline ECG, heart rate, rhythm, character, heart sounds, blood pressure, including postural blood pressures, apical-radial pulse deficits, jugular vein distenstion, edema, prolonged capillary refill (longer than 5 seconds), decreased urinary output, activity intolerance, chest pain or pressure, dyspnea, syncope or dizziness, fatigue, nausea, changes in alertness, anxiety, and abnormal serum electrolyte levels. Renal and hepatic function studies. Blood counts for clotting problems (thrombocytopenia). Documentation of baseline neurological functioning and ID any deficits, such as muscle weakness. Skin for bruise/bleading, bleeding gums, black tarry stools, hematuria, or hematemesis. Drug containdications. GRAPEFRUIT JUICE - inhibits metabolism by Cytochrome P-450 3A4 enzyme

Front 42

Nursing Process:
assessment findings -
ANTIHYPERTENSIVES

Back 42

1

Front 43

Nursing Process:
assessment findings -
DIURETICS

Back 43

1

Front 44

Nursing Process:
diagnosis -
ANTIDYSRHYTHMICS

Back 44

1

Front 45

Nursing Process:
diagnosis -
ANTIHYPERTENSIVES

Back 45

1

Front 46

Nursing Process:
diagnosis -
DIURETICS

Back 46

1

Front 47

Nursing Process:
interventions -
ANTIDYSRHYTHMICS

Back 47

1

Front 48

Nursing Process:
interventions -
ANTIHYPERTENSIVES

Back 48

1

Front 49

Nursing Process:
interventions -
DIURETICS

Back 49

1

Front 50

Nursing Process:
teaching points -
ANTIDYSRHYTHMICS

Back 50

1

Front 51

Nursing Process:
teaching points -
ANTIHYPERTENSIVES

Back 51

1

Front 52

Nursing Process:
teaching points -
DIURETICS

Back 52

1