Dysrythmia Drugs

Question 1

There is a greater use of non-pharmacological management for cardiac dysrythmia’s some of them include :

Answer 1

• destroying dysrythmogenic areas within the heart using ablation (cardiac ablation is a procedure to scar or destroy tissue in your heart that’s allowing incorrect signals to cause an abnormal heart rhythm.
• implanting devices for sensing, cardioverting, defibrillating or pacing patient

Question 2

Antidysrythmic drug therapy indication for use:

Answer 2

• conversion of atrial fibrillation or flutter to Normal sinus rhythm
• maintaining normal sinus rhythm post conversion
• suppression of fast or irregular ventricular rate that alters cardiac output
• presence of dangerous dysrythmias that are potentially fatal

Question 3

Antidysrythmic drug therapy mechanisms of action:

Answer 3

• reduce automaticity
• slow conduction period of impulses throughout heart
• prolong refractory period

Question 4

Antidysrythmic drug are classified by ?

Answer 4

Mechanism of action and conduction system effect

Question 5

non-pharmacological therapy for dysrythmias is the

Answer 5

preferred initial treatment of several dysrythmias this includes:

• pacemakers
• defibrillators
• radiofrequency catheter ablation
• surgery to deactivate ectopic foci
• other strategies

Question 6

procainamide hydrochloride

Answer 6

uses: atrial and ventricular tachydysrythmias

significant adverse effects: include ventricular dysrythmia’s and blood disorders

Question 7

lidocaine is used for _______ dysrythmias only

Answer 7

ventricular dysrythmias

Question 8

lidocaine has significant adverse events on the ________ and these are

Answer 8

significant adverse events on the central nervous system: twitching, convulsions, confusion, resp depression or arrest, hypotension, bradycardia, and dysrythmias

Question 9

flecainide

Answer 9

• first line drug in the treatment of atrial fibrillation
• has a negative inotropic effect and depress left ventricular function
• adverse effects: dizziness, visual disturbances, and dyspnea

Question 10

class 2: B-blockers

Answer 10

• reduce or block sympathetic nervous system stimulation, thus reducing transmission of impulses in the hearts conduction system
• depress phase 4 depolarization
• general myocardial depressants for both supraventricular and ventricular dysrythmia’s
• also used as an antianginal and antihypertensive drugs

Question 11

class 3: amiodarone, dronedarone, sotalol, ibutilide

Answer 11

• increase APD
• prolong repolarization in phase 3
• used for dysrythmias that are difficult to treat: life-threatening ventricular tachycardia or fibrillation or flutter that is resistant to other drugs

Question 12

amiodarone hydrochloride

Answer 12

• blocks both a and b adrenergic receptors of the sympathetic nervous system
• uses: one of the most effective antidysrythmic drugs for controlling supraventricular and ventricular dysrythmias
• most serious effect; pulmonary toxicity
• other adverse effects; corneal micro-deposits, which may cause visual halos, photophobia and dry eyes, photosensitvity and pulmonary toxicity
• nursing: important to monitor bp frequently after admin (ie. q5 min)

Question 13

Class IV: calcium channel blockers

Answer 13

• inhibits slow channel (calcium-dependent) pathways
• depress phase 4 depolarization
• reduce atrioventricular function
• used for paraxysomal supraventricular tachycardia, (PSVT); rate control for atrial fibrillation and flutter

Question 14

anti-dysrhythmic adverse affects:

Answer 14

• hypersensitivity rx
• nausea, vomiting and diarrhea
• dizziness
• headache and blurred vision
• prolongation of QT interval

Question 15

all anti-dysrhythmic drugs can cause

Answer 15

dysrythmias

Question 16

Anti-dysrhythmic drug interactions:

Answer 16

• warfarin: monitor INR

- grapefruit juice: amiodarone, disopyramide and quinidine

Question 17

nursing implications for anti-dysrythmic drugs

Answer 17

-measure serum potassium levels before initiating therapy

Question 18

nursing implications during drug therapy of drugs;

Answer 18

-monitor cardiac rhythm, HR, BP, general well-being, skin color, temp and heart and lung sounds