Anti-Arrhythmics

Question 1

Adenosine

Name

Answer 1

Adenocard

Question 2

Adenosine

Class

Answer 2

anti-dysrhythmic

Question 3

Adenosine

Description

Answer 3

adenosine can “chemically cardiovert” PSVT to a normal sinus rhythm. It has a half life of 10 seconds and does not cause hypotension

Question 4

Adenosine

Indications

Answer 4

Narrow, complex paroxysmal supraventricular tachycardia refractory to vagal maneuvers

Question 5

Adenosine

Contraindications

Answer 5

Atrial fibrilation, 2nd and 3rd degree heart block, sinus node disease, or asthma

Question 6

Adenosine

Precautions

Answer 6

it may cause transient dysrhythmias especially asystole, COPD

Question 7

Adenosine

Dosage/Route

Answer 7

6mg rapidly (over 1-2 seconds) IV, then flush line rapidly with saline. If ineffective, 12mg in 1-2 minutes, may be repeated

Pedi: 0.1mg/kg (over 1-2 seconds) IV followed by rapid saline flush, then 0.2 mg/kg in 1-2 minutes to max 12mg

Question 8

Amiodarone

Name

Answer 8

Cordarone, Pacerone

Question 9

Amiodarone

Class

Answer 9

Antidysrhythmic (KCL blocker)

Question 10

Amiodarone

Description

Answer 10

Amiodarone is an antidysrhythmic that prolongs the duration of the action potential and refractory period and relaxes smooth muscles, reducing peripheral vascular resistance and increasing coronary artery flow

Question 11

Amiodarone

Indications

Answer 11

Life-threatening ventricular and supraventricular dysrhythmias, frequently atrial fibrilation

Question 12

Amiodarone

Contraindications

Answer 12

cardiogenic shock, severe sinus bradycardia, or advance heart block

Question 13

Amiodarone

Dosage/Route

Answer 13

150mg over 10 minutes for PT with pulses or 300mg pulseless IVP

Pedi: 5mg/kg IV/IO then 15 mg/kg/day

Question 14

Bretylium

Name

Answer 14

Bretylol

Question 15

Bretylium

Class

Answer 15

Antidysrhythmic (KCL blocker)

Question 16

Bretylium

Description

Answer 16

Bretylium causes a release of norepinepherine, depresses ventricular fibrilation, and reduces ectopy. Bretylium surpresses ventricular tachydysrhythmias including vfib with reentry mechanisms

Question 17

Bretylium

Indications

Answer 17

ventricular fibrilation and ventricular tachycardia refractory to lidocaine

Question 18

Bretylium

Contraindications

Answer 18

none

Question 19

Bretylium

Dosage/Route

Answer 19

5mg/kg IV, then 10mg/kg/15-30 mins, to a max of 30mg/kg

Question 20

Lidocaine

Name

Answer 20

Xylocaine

Question 21

Lidocaine

Class

Answer 21

antidysrhythmic (NA+ blocker)

Question 22

Lidocaine

Description

Answer 22

Lidocaine is an antidysrhythmic that supresses automaticity and raises stimulation threshold of the ventricles. it also causes sedation, anticonvulsant and analgesic effects

Question 23

Lidocaine

Indications

Answer 23

Pulseless ventricular tachycardia, ventricular fibrillation, ventricular tachycardia with pulses

Question 24

Lidocaine

Contraindications

Answer 24

Hypersensitivity to amide-type local anesthetics, supraventricular dysrhythmias, stokes-adam snydrome, 2nd or 3rd degree heart blocks, and bradycardias

Question 25

Lidocaine Precautions

Answer 25

hepatic or renal impairment, CHF, hypoxia, respiratory depression, hypovolemia, myasthenia gravis, shock, elderly

Question 26

Lidocaine Dosage/Route cardiac arrest

Answer 26

1-1.5mg/kg IV repeated every 3-5 mins up to 3mg/kg, consider half dose for elderly. follow conversion with a drip of 2-4mg/min 1gram/250cc pedi: 1mg/kg IV, repeat every 3-5 mins, follow conversion with a drip of 20-50 mcg/kg/min

Question 27

Lidocaine Dosage/Route head injury premedicate

Answer 27

1mg/kg IVP

Question 28

Procainamide Name

Answer 28

Pronestyl

Question 29

Procainamide Class

Answer 29

anti arrhythmic (NA+ blocker)

Question 30

Procainamide Description

Answer 30

Procainamide prolongs ventricular repolarization, slows conduction, and decreases myocardial excitability

Question 31

Procainamide Indications

Answer 31

Ventricular fibrillation, and pulseless ventricular tachycardia refractory to lidocaine

Question 32

Procainamide Contraindications

Answer 32

Hypersensitivity to procainamide or procaine, myasthenia gravis, and 2nd or 3rd degree heart block

Question 33

Procainamide Precautions

Answer 33

hypotension, cardiac enlargement, CHF, AMI, ventricular dysrhythmias from digitalis, hepatic or renal impairment, or bronchial asthma

Question 34

Procainamide Dosage/Route

Answer 34

20-30 mg/min IV drip Stop Points: 1) up to 17mg/kg to effect, then 1-4 mg/min 2) ectopy resolves 3) QRS widens more than 50% from original 4) hypotension ensues Pedi: 15mg/kg IV/IO over 30-60 mins