Antidysrhythmics Flashcards

1
Q

Procainamide hydrochloride trade name

A

procainamide

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2
Q

procainamide hydrochloride class

A

antidysrhythmic

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3
Q

procainamide hydrochloride expected effect

A

depress excitability of cardiac muscle to electrical stimulation and slows conduction in atrium, bundle of His, increases refractory period.

Sodium channel blocker, slowing conduction sodium ions thru sodium channels. Blocking these channels slows conductivity & prolongs action potential & refractory period. Result is decrease excitability and impulse conduction of atria & ventricles

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4
Q

why use procainamide hydrochloride

A

ventricular dysrhythmia

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5
Q

procainamide hydrochloride dose

A

20-50mg/min (17mg/kg)

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6
Q

procainamide hydrochloride route admin

A

IV, IM

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7
Q

procainamide hydrochloride adverse effects

A

skin sores, hives, fever, chills

- heart block, circa collapse, angioedema, tornadoes de points, agranulocytosis

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8
Q

procainamide hydrochloride nursing implications

A
  • use ECG to check PR-QRS segments
  • blood levels & CBC
  • vitals
  • respiratory status (rate, rhythm, crackles)
  • toxicity (confusion, nausea, vomit, drowsy)
  • CNS effects (dizzy, confused, seizure)
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9
Q

propanolol trade names

A

inderal, inderal LA, Innopran

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10
Q

propranolol expected effect

A

non selective beta blockers with negative inotropic, chronotropic, dromotropic properties

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11
Q

why use propanolol

A

angina, hypertension, dysrhythmias, migraine, cyanotic spells from aortic stenosis, MI

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12
Q

dosage of propanolol

A

PO: 10-30mg tid qid, IV 1-3mg give 1mg/min may report after 2 mins & q4h intervals

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13
Q

propanolol routes admin

A

PO, IV

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14
Q

propanolol adverse effects

A

bradycardia, CHF, pulmonary edema, dysrhythmias, thrombocytopenia, Stevens Johnson syndrome, toxic epidermal necrolysis

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15
Q

propanolol nursing implications

A
  • no abrupt discontinuation
  • monitor with ECG
  • note angina pain (duration, time started)
  • fluid overload (edema)
  • tolerance
  • headache, light head, low BP= lower dose
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16
Q

adenosine trade name

A

adenocard

17
Q

adenosine drug classes

A

antidysrhythmic, endogenous nucleoside

18
Q

adenosine expected effect

A

slow conduction thru AV node, interrupt re-entry pathways into AV node & restore normal sinus rhythm in patients with tachycardia, hypoxia

19
Q

why use adenosine

A

PSVT, MI, CAD, Wolff Parkinson white syndrome

20
Q

adenosine route admin

A

IV

21
Q

adenosine doses

A

IV bol 6mg, if sinus rhythm not return to normal give 12mg by IV BOL> may repeat 12mg dose

22
Q

adenosine adverse effects

A

atrial tachydysrhythmias, AV block, cardiac arrest, atrial, bronchospasms

23
Q

adenosine nursing implications

A

cardiopulmonary status: BP, pulse, respiration, rhythm, ECG intervals, dysrhythmias
respiratory status: rate, rhythm, lung fields, crackles

24
Q

amiodarone trade names

A

cordarine, pacerone, nexterone

25
Q

amiodarone drug classes

A

antidysrhythmic, iodinated benzofuran derivative

26
Q

amiodarone expected effect

A

prolong action potential & refractory period, beta & alpha blocker, increase PR QT intervals, decrease sinus rate, peripheral vascular resistance

27
Q

why use amiodarone

A

ventricular tachycardia, ventricular fibrillation, supraventircular dysrhythmias

28
Q

amiodarone routes of admin

A

PO, IV

29
Q

amiodarone adverse effects

A

sinus arrest, CHF, SA node dysfunction, AV block, hepatotoxcitiy, pulmonary toxcitiy

30
Q

amiodarone nursing implications

A

assess: electroylytes, CNS, cardiac, resp
teach: no grape juice,do not discontinue abruptly

31
Q

amiodarone black box

A

pulmonary toxicity, monitor with ECG

32
Q

amiodarine doses

A

ventricular dysrhythmias
PO 800-1600mg/day for 1-3wk, then 600-800mg/dayfor 1 mo, IV is 150mg for 10mins then slow 360mg 6h
supraventricular dysrhythmias
PO 1.2-1.8g/ day until 10g, then 200-400mg/day,
IV 5-7mg/kg for 30-60min, then 1.2-1.8g in IV