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Pharmacology > Antarhythmics > Flashcards

Flashcards in Antarhythmics Deck (25):
1

Antiarrhythmic Medications Info

1. Suppress dysrhythmias
a. Work c depressing automaticity by decreasing conduction
b. Increasing refractoriness to premature stimulation
c. Some meds work c atrial vs venticular
2. Classified by their effect on the cardiac electrical conduction system
3. Classifications are divided into 4 main categories

2

Electrical Conduction

1. Properties of cardiac tissue
a. Automaticity
b. Contractility
c. Conductivity
d. Excitability
2. Any antiarrhythmic can become a proarrhythmic

3

Mechanism of Action

1. Each class works in a different to suppress the arrhythmia
2. Class 1 Rx are membrane stabilizing agents which act on the Na+ channels
3. 3 subgroups in class 1 bc the agents have cellular repolarization & action potential duration

4

Class 1

A. Na+ channel blockers
B. Ventricular dysrhythmias
C. Tx life threatening arrhythmias
D. Fallen out of use due to S.E.

5

Class 2

1. Class 2 are Beta blockers which reduce or block SNS stimulation to the heart & transmission of impulses in the cardiac conduction system
2. Affect mostly slow tissue
3. Tx Atrial & Ventricular

6

Name 2 Class 1 medications

1. Procainamide
2. Lidocaine

7

Name 1 class 2 medication

1. Propranolol

8

Class 2 Contraindication

1. Bradycardia
2. Cardiogenic shock
3. Asthma

9

Class 2 Adverse Effects

1. Hypotension
2. Bradycardia
3. Bronchospasm

10

Class 3

1. K+ channel blocker
2. Class 3 agents increase the action potential duration
3. Tx Atrial & ventricular dysrhythmias

11

Name 1 class 3

1. Amiodarone*

12

Class 3 Contraindication

1. Bradycardia
2. Heart block
3. Cardiogenic shock
4. Pregnancy

13

Class 3 Rx Interaction

1. Digoxin
2. Warfarin

14

Class 3 Adverse Effects

1. Hypotension
2. Bradycardia
3.GI upset
4. QT prolongation
5. Pulmonary fibrosis

15

Class 4

1. Class 4 CCB & block the slow channels, Reduces rigitity of atriols & veinules
2. Used for atrial dysrhythmias

16

Name 2 class 4 CCB

1. Diltiazem
2. Verapamil

17

Class 4 Contraindication

1. Heart block
2. Bradycardia
3. CHF
4. Hypotension
5. Pregnancy

18

Class 4 Adverse Effects

1. Hypotension
2. CHF
3. Edema
4. Dizziness/fatigue/Headache
5. Avoid IV Beta Blockers c IV CCB

19

Class 4 RN Implication/Teaching

1. Potent Drugs
2. Thorough drug Hx & Rx interactions
3. Monitor BP & HR
4. Monitor EKG
5. Monitor K+ levels
6. No skipping doses
7. Withhold if HR less than 60

20

Amiodarone

1.K+CB
2. Used only for life threatening Atrial or Ventricular dysrhythmias

21

Amiodarone Adverse Effects

1. Bradycardia
2. Arrhythmias
3. HF
4. Heart Block
5. Hepatic failure
6.pulmonary tox/Resp distress

22

Amiodarone Rx interaction

1. BB
2. CCB
3. Digoxin
4. Grapefruit juice

23

Amiodarone Monitored Labs

1. ALT
2. AST
3. T3 & T4

24

Amiodarone Contraindications

1. Heart block
2. Cardiogenic shock

25

Amiodarone RN Implication/Teaching

1. Obtain baseline BP, HR, liver function.
2. Advise pt to wear sunscreen
3. Take c food
4. Do not stop abruptly