Antarhythmics

Question 1

Antiarrhythmic Medications Info

Answer 1

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

Question 2

Electrical Conduction

Answer 2

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

Question 3

Mechanism of Action

Answer 3

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

Question 4

Class 1

Answer 4

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

Question 5

Class 2

Answer 5

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

Question 6

Name 2 Class 1 medications

Answer 6

1. Procainamide

2. Lidocaine

Question 7

Name 1 class 2 medication

Answer 7

1. Propranolol

Question 8

Class 2 Contraindication

Answer 8

1. Bradycardia
2. Cardiogenic shock
3. Asthma

Question 9

Class 2 Adverse Effects

Answer 9

1. Hypotension
2. Bradycardia
3. Bronchospasm

Question 10

Class 3

Answer 10

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

Question 11

Name 1 class 3

Answer 11

1. Amiodarone*

Question 12

Class 3 Contraindication

Answer 12

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

Question 13

Class 3 Rx Interaction

Answer 13

1. Digoxin

2. Warfarin

Question 14

Class 3 Adverse Effects

Answer 14

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

Question 15

Class 4

Answer 15

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

Question 16

Name 2 class 4 CCB

Answer 16

1. Diltiazem

2. Verapamil

Question 17

Class 4 Contraindication

Answer 17

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

Question 18

Class 4 Adverse Effects

Answer 18

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

Question 19

Class 4 RN Implication/Teaching

Answer 19

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

Question 20

Amiodarone

Answer 20

1. K+CB

2. Used only for life threatening Atrial or Ventricular dysrhythmias

Question 21

Amiodarone Adverse Effects

Answer 21

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

Question 22

Amiodarone Rx interaction

Answer 22

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

Question 23

Amiodarone Monitored Labs

Answer 23

1. ALT
2. AST
3. T3 & T4

Question 24

Amiodarone Contraindications

Answer 24

1. Heart block

2. Cardiogenic shock

Question 25

Amiodarone RN Implication/Teaching

Answer 25

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