Class I Flashcards
Class 1A/ sodium channel blocker
Quinidine (long term use), procainamide (Pronestyl)- for short term use.
procanimide and quinidine
Blocks the entry of sodium into cells of the myocardium,bundle of His, bundle branches and purkinje fibers (moderate blockade)
- slows impulse conduction
- decreases automaticity of the ventricles
- increase the refractory period
These are use to treat A-Fib, SVT and VT.
Monitor- BP for hypotension, ECG during IV push, pulmonary embolism. Assess for SLE and agranulocytosis in pts taking procanimide and for cinchonism in pts that take quinidine.
Give quinidine oral most often to prevent hypotension and around meal if no GI upset present.
Use IV pump with procainamide to prevent rapid infusion, DO NOT MIX with other meds.
DO NOT give if have allergy to yellow dye #5 for procanimide (deceased WBC or agranulocytosis, MG, SLE,
DO NOT give quiniade if allergic to quinine
DO NOT GIVE in severe heart block or with widen QT or torsades de pointes.
DO NOT DRINK Grapefruit juice, chonlinergic or antichonlinergic drugs, HTN meds, digoxin, other antdysrhymics`
Class 1B/ sodium channel blockers
Lidocaine (Xylocaine), mexiletine (mexitil)
Lidocaine (Xylocaine)
Blocks the entry of sodium into cells of the myocardium,bundle of His, bundle branches and purkinje fibers (moderate blockade)
- slows impulse conduction
- decreases automaticity of the ventricles
- shorten refractory period.
These are use to treat A-Fib, SVT and VT
Causes CNS effects- confusion, muscle trwiching/ tremors, paresthesias, seizures, respiratory failure.
Hypoetension, bradycardia, heart block w/ high doses, small decrease in QR interval
Assess for CNS effects, v/s and ECG
Given IM, IV GIVE IV slow at 4mg/min. DO NOT MIX with other drugs
PT needs to report numbness or paresthesia
DO NOT GIVE if- SVT, brady or heart block. Caution in malignant hyperthermia.
DO NOT MIX- beta blockers, procanimide, quinidine and phenytoin
