Reading...
Play button
Play button
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;
35 Cards in this Set
- Front
- Back
|
what are examples of antidysrhytmic drugs in class 1a
|
Disopyramide (Norpace, Norpace CR)
Procainamide (Pronestyl, Procanbid, Pronestyl-SR, Procan SR Quinidine(Quinidex, Cardioquin, Guinaglute, Dura-Tab) |
|
|
what is the class 1a antidysrhytmic drug-norpace,norpace CR
|
Used for ventricular dysrhythmias
Side effects are hypotension, widening of the QRS interval on EKG Norpace - PO 150 mg q 6 hr Norpace CR -= 300 mg q 12 hr with range of 400-800 mg divided doses |
|
|
what is the class 1a antidysrhytmic drug-procainmide (pronestyl,pronestyle-SR, procan SR)
|
Atrial and ventricular tachydysrhythmias
Prevents recurrence of PVCs Can produce lumpus erythmatosis syndromes GI problems – diarrhea, N/V Emergency IV dosage – 20 mg/min up to 17 mg/kg until desired rhythm, then hang drip 2gm/500 cc NS or D5W and run 2 mg/min PO doses on p. 368 |
|
|
what is the class 1a antidysrhytmic drug quinidine (quinidex,cardioquin,quinaglute,dura tab)
|
Direct activity on heart and anticholinergic effect
Accelerates conduction Causes cinchonism – tinnitus, loss of hearing, slight blurring of vision, and GI upset. Adverse effects are cardiac asystole, PVCs Dosage on page 368 Precipates torsades de pointes (Treatment for this is magnesium IV) 4 to 1 drip |
|
|
what are examples of class 1b antidysrhytmic drugs
|
Lidocaine
Mexiletine (Mexitil) Tocainide(Tonocard) |
|
|
what is the class 1b antirhythmic drug- lidociane
|
Most effective drug for ventricular dysrhythmias associated with acute MI
IV because of first-pass effect Dosage 1 mg/kg up to 3mg/kg Lidocaine drip 2 gms/500 NS or D5W – 2mg/min Raises ventricular fibrillation threshold Adverse effects – convulsions, confusion, respiratory arrest |
|
|
what is the class 1b antirhythmic drug-mexitil
|
Similar to Lidocaine
Suppresses PVCs Usually taken with Beta blockers Adverse effects – nausea, vomiting, dizziness, tremor Take with food or antacid Don’t give with block |
|
|
what is the class 1b antirhythmic drug - tocainide (tonocard)
|
Active chemical derivative of lidocaine
Ventricular dysrhythmias Side effects – dizziness, paresthesias, and tremor |
|
|
what is a 4 to 1 drip
|
15 – 1 mg/min
30 – 2mg/min 45 – 3 mg/min 60 – 4 mg/min |
|
|
what are examples of class 1c antidysrhythmic drugs
|
Flecainide (Tambocor)
Propafenone(Rhythmol) |
|
|
what is the class 1c antidysrhythmic drug- flecainide (tambocor)
|
Limited to Sustained ventricular tachycardia
Must be in the hospital to begin treatment Many sudden cardiac deaths with Tambocor |
|
|
what is the class 1c antidysrhythmic drug-rythmol (propafenonoe)
|
Reduces fast inward sodium current in Purkinje fibers and to myocardial fibers
Mild beta-blocking effects For life threatening ventricular dysrhythmias Low doses works on atrial fibrillation Well tolerated and used a lot Side effects – metallic taste in mouth, constipation, headache, N/V Take with food Do not take if have a history bradycardia, hypotension, heart failure |
|
|
what are examples of class II antidysrhythmic drugs
|
Beta Blockers
Reduced heart rate, delayed AV node conduction, reduced myocardial contractility Put on beta blockers after an MI Atenolol – Tenormin Esmolol – Brevibloc Metoprolol- Lopressor, Toprol-XL Propranolol – Inderal Sotalol - Betapace beta blockers cause tremors if pt has MI put on beta blocker |
|
|
what is the class II antidysrhythmic drug-tenormin (atenolol)
|
Cardioselective betablocker
Blocks beta1 Hypertension, angina Contraindicated in bradycardia, second or thrid degree block, heart failure, and shock ask if they have asthma |
|
|
what is the class II antidysrhythmic drug-esmolol (brevibloc
|
Supraventicular rhythms
Available only IV form Takes some calculation to give |
|
|
what is the class II antidysrhythmic drug-metorolol (lopressor, Toprol-XL
|
Cardioselective beta blocker
Hypertension, angina 5mg q5 min x 3 dose total 15mg |
|
|
what is the class II antidysrhythmic drug-propranololIinderal
|
One of the first beta blockers
Used for dysrhythmias Blocks beta1 and beta2 Reduces heart rate, delays AV conduction, and reduces myocardial contractility and automaticity |
|
|
what is the class II antidysrhythmic drug-sotalol (beta pace)
|
Beta1 and Beta2
Reserved for lift threatening dysrhythmias Can cause tachycardia or fibrillation Torsades de pointes |
|
|
what are examples of class III antidysrhythmic drugs
|
Aminiodarone (Cardarone, Pacerone)
Bretylium Ibutilide(Corvert) |
|
|
what is the class III antidysrhythmic drug-aminiodarone (cardarone, pacerone)
|
Blocks alpha & beta-adrenergic receptors of the SNS
One of the most effective antidysrhythmic agents for controlling supraventricular and ventricular dysrhythmias Indicated for sustained ventricular dysrhythmias Effective in 40-60% of all patients with ventricular tachycardia |
|
|
aminodarone con't
|
Many unwanted adverse effects: hypothyroidism, hyperthyroidsims, corneal microdeposits which causes visual halos, photophobia, and dry eyes. Eye problems occur in all adults who take for more than 6 months
Most serious adverse affect is pulmonary toxicity which is fatal Has a very long half-life- may take 2-3 months for side effects to subside Contraindicated with sinus bradycardia or second-third degree heart block |
|
|
what is the class III antidysrhythmic drug-ibutilide (corvert)
|
For atrial dysrhythmias
Atrial fibrillation and atrial flutter Used for rapid conversion to normal sinus rhythm Only available in IV form, single-dose 10 ml vial in 0.1mg/ml concentration Dosed based on patient’s weight Prodysrhythmic effect, most significantly ventricular tachycardia and torsades de pointes |
|
|
what are examples of the class IV antidysrhythmic drugs
|
Calcium channel blockers
Diltiazem (Cardizem) Verapamil(Calan, Isoptin, Verelan) |
|
|
what are 3 classes of calcium channel blockers
|
Verapamil
Diltiazem – Cardizem, Dilacor XL Dipine” |
|
|
what is the Verapamil (Isoptin, SR, Verelan, Verelan Pm, Calan, Calan SR, Apo-Verap, Novo-Veramil, NuVerap)
|
block calcium channels primarily on the coronary vessels and AV node – increase blood flow to the heart and decreases impulses through the AV node – used to decrease workload of the heart and slow the heart rate; HTN, angina, atrial fib
|
|
|
what is the Diltiazem – Cardizem, Dilacor XL
|
dilates calcium channels on the coronary and peripheral vessel calcium channels, used for atrial fib, HTN, Angina, Vasospasm
|
|
|
what is the "Dipine”
|
peripheral vessel calcium channel blockers
|
|
|
what are examples of "dipine"
|
Amiodipine (Norvasc)
Felodipine (Plendil)strongest, so potenent causes pedal edema Nifedipine (Porcardia) Nicardipine (Cardene) Isradipine (Dynacirc) Nisoldipine (Sular) Amiodipien + Atorvastatin =Caduet |
|
|
what are teh clinical uses of the dipine
|
Hypertension
Vasospasm (Prinzmetal’s angina, Raynaud’s phenomenon, cocaine-induced vasospasms FYI – Ureteral spasm with small kidney stones Male contraceptive – must have calcium to penetrate the egg |
|
|
what are the side effects of calcium channel blockers
|
Verapamil – significant constipation
Dipines – peripheral vasodilation with headaches, hypotension, peripheral edema Diltiazem – less constipation Say yes to drugs no to grapefruit – does not allow metabolism |
|
|
what is the CCB drug-diltiazem (cardizem)
|
Temporary control of rapid ventricular response in a patient with atrial fibrillation or flutter and PSVT
Contraindicated in Acute MI, pulmonary congestion, Wolff-Parkinson-White syndrome, severe hypotenison, cardiogenci shock, sick sinus syndrome, or second or third degree AV block. Must monitor heart rhythm and blood pressure |
|
|
what is the CCB drug-verapamil (calanm isoptin, verelan)
|
Inhibits calcium ion influx across the slow calcium channels in cardiac conduction
Used to prevent recurrent PSVT and to control ventricular response in atrial flutter or fibrillation Verapamil is also used to treat angina, hypertension, and hypertrophic cardiomyopathy |
|
|
what is the CCB drug-adenosine
|
Adenosine (Adenocard) is an unclassified antidysrhythmic agent.
Indicated for conversion of PSVT to sinue rhythm Contraindicated in patients with second or third-degree block, sick sinus syndrome, atrial flutter or fibrillation, or ventricular tachycardia Give 6 mg IV, then 12 mg Asystole may occur for a few seconds after administration |
|
|
what are nursing impplications for antidysrhythmic drugs
|
Class Ia – use cautiously in patients with electrolyte imbalances, especially hypokalemia
Class Ib – monitor closely in geriatric patients and with hepatic or renal disease, heart failure, bradycardia, or those that weight less than 111 lbs. Class Ic – watch with severe renal or liver disease, heart failure, prolonged QT intervals and blood dyscrasias Urinary pH causes serum levels of quinidine to be elevated Lidocaine toxicity may result from concurrent administration of propranolol (Inderal) or cimetidine. Causes block Class Ic agents increase serum digoxin levels and digoxin toxicity with flecainide |
|
|
what are the interactions of antidysrhythmic drugs
|
Produce hypotensive effects when taken with alcohol, beta-blockers, CCBs, phenothiazines, and Viagra
|
