Drug Class - Antiarrhythmics
Terms
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- What do antiarrhythmics do?
- suppression of cardiac arrhythmias
- Antiarrhythmics correct cardiac arrhythmias by a variety of ________
- mechanisms
- What is the therapeutic goal of antiarrhythmics? (2)
-
decreased symptomatology
increased hemodynamic
performance - What does the choice of agent depend on? (2)
-
etiology of arrhythmia
individual patient
characteristics -
What should be corrected before therapy is initiated
(e.g., electrolyte disturbances, other drugs) - treatable causes of arrhythmias
- How are antiarrhythmics generally classified?
- by their effects on cardiac conduction tissue
- What 3 drugs are also used as antiarrhythmics?
-
adenosine
atropine
digoxin -
What is one major Class I drug that shares the properties of 1A, 1B, and 1C?
1A
depresses Na conductance
increases APD and ERP
decrease membrane
responsiveness
1B
increase K conductance
decrease APD a - moricizine
-
What are 3 Class IA drugs that:
depress Na conductance
increase APD and ERP
decrease membrane
responsiveness -
disopyramide
procainamide
quinidine - What are 4 Class IB drugs that increase K conductance, decrease APD and ERP?
-
lidocaine
mexiletine
phenytoin
tocainide - What are 2 Class 1C drugs that work by profound slowing of conduction, markedly and markedly depress phase 0?
-
flecainide
propafenone -
What are 3 Class II drugs that:
interfere with Na conductance
depress cell membrane
decrease automaticity
increase ERP of the AV node
block excess sympathetic
activity -
acebutolol
esmolol
propranolol -
What are 3 Class III drugs that interfere with: norepinephrine
increase APD and ERP -
amiodarone
dofetilide
ibutilide
sotalol -
What are 2 Class IV drugs that increase AV nodal ERP
and block calcium channels? -
diltiazem
verapamil - The contraindications differ ______ among various agents.
- greatly
- Precautions differ _____ among agents used.
- greatly
- Appropriate dosage adjustments should be made in elders and those with what kind of impairment? (2)
-
renal
hepatic - What should be monitored throughout IV administration and periodically throughout oral administration? (3)
-
ECG
pulse
blood pressure - Potential Nursing Diagnoses?
-
Cardiac output, decreased
Knowledge deficit, related
to medication regimen - What pulse should be taken before administration of oral doses?
- apical
- While taking oral doses, if heart rate is less than 50 bpm, what should happen?
-
withhold dose
notify physician or hcp of
less than 50 bpm heart rate - Where are apical pulses taken?
- between the fourth and sixth intercostal spaces
- Oral doses of antiarrhythmics should be administered with?
- a full glass of water
- Most sustained-release preparations should be?
-
swallowed whole
(don't crush, break, or chew tablets or open capsules, unless specifically instructed) - Patient/Family teaching tips?
-
Take oral doses around the
clock even if feeling
better
Teach family member how to
take pulse
Patient should report changes
in pulse rate or rhythm to
hcp
Don't take OTC meds without
consulting hcp
Carry ID about med
Make follow-up exams - Effectiveness of therapy can be demonstrated by?
- resolution of cardiac arrhythmias without detrimental side effects
- Name Class IA drugs? (4)
-
disopyramide Norpace, Norpace CR, {Rythmodan}, {Rythmodan-LA)
moricizine Ethmozine
procainamide Procanbid, Promine, Pronestyl, Pronestyl-SR
quinidine gluconate
Quinaglute Dura-Tabs, Quinalan, {Quinate}
quinidine sulfate
{Apo-Quinidine}, Cin-Quin, {Novoquinidin}, Quinidex Extentabs, Quinora - Name Class IB drugs? (4)
-
lidocaine
PARENTERAL:
LidoPen, Xylocaine, {Xylocard}
LOCAL ANESTHETIC:
Dilocaine, Lidoject, Nervocaine, Octocaine, Xylocaine
MUCOSAL: Anestacon, Xylocaine Viscous
PATCH: Lidoderm
TOPICAL: DermaFlex, ELA-Max, Solarcaine Aloe Extra Burn Relief, Xylocaine, Zilactin-L
mexiletine Mexitil
phenytoin Dilantin, diphenylhydantoin, DPH, Phenytek
tocainide Tonocard - Name Class IC drugs? (2)
-
flecainide Tambocor
propafenone Rythmol - Name Class II drugs? (4)
-
acebutolol {Monitan}, Sectral
esmolol Brevibloc
propranolol {Apo-Propranolol}, {Betachron E-R}, Inderal, Inderal LA, InnoPran XL, {Novopranol}, {pms Propranolol}
sotalol Betapace, Betapace AF, {Sotacor} - Name Class III drugs? (3)
-
amiodarone Cordaron, Pacerone
dofetilide Tikosyn
ibutilide Corvert - Name Class IV drugs? (2)
-
diltiazem (Apo-Diltiaz}, Cardizem, Cardizem LA, CartiaXT, Dilacor XR, Diltia XT, {Novo-Diltazem}, Nu-Diltiaz, {Syn-Diltiazem}, Tiamate, Tiazac
verapamil Apo-Verap, Calan, Calan SR, Covera-HS, Isoptin, Isoptin SR, {Novo-Veramil}, {Nu-Verap}, Verelan, Verelan PM - Name 3 miscellaneous antiarrhythmics?
-
adenosine Adenocard, Adenoscan
atropine Atro-Pen
digoxin Digitek, Lanoxicaps, Lanoxin