Anti-Arrhythmics Flashcards
Adenosine
Name
Adenocard
Adenosine
Class
anti-dysrhythmic
Adenosine
Description
adenosine can “chemically cardiovert” PSVT to a normal sinus rhythm. It has a half life of 10 seconds and does not cause hypotension
Adenosine
Indications
Narrow, complex paroxysmal supraventricular tachycardia refractory to vagal maneuvers
Adenosine
Contraindications
Atrial fibrilation, 2nd and 3rd degree heart block, sinus node disease, or asthma
Adenosine
Precautions
it may cause transient dysrhythmias especially asystole, COPD
Adenosine
Dosage/Route
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
Amiodarone
Name
Cordarone, Pacerone
Amiodarone
Class
Antidysrhythmic (KCL blocker)
Amiodarone
Description
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
Amiodarone
Indications
Life-threatening ventricular and supraventricular dysrhythmias, frequently atrial fibrilation
Amiodarone
Contraindications
cardiogenic shock, severe sinus bradycardia, or advance heart block
Amiodarone
Dosage/Route
150mg over 10 minutes for PT with pulses or 300mg pulseless IVP
Pedi: 5mg/kg IV/IO then 15 mg/kg/day
Bretylium
Name
Bretylol
Bretylium
Class
Antidysrhythmic (KCL blocker)
Bretylium
Description
Bretylium causes a release of norepinepherine, depresses ventricular fibrilation, and reduces ectopy. Bretylium surpresses ventricular tachydysrhythmias including vfib with reentry mechanisms
Bretylium
Indications
ventricular fibrilation and ventricular tachycardia refractory to lidocaine
Bretylium
Contraindications
none
Bretylium
Dosage/Route
5mg/kg IV, then 10mg/kg/15-30 mins, to a max of 30mg/kg
Lidocaine
Name
Xylocaine
Lidocaine
Class
antidysrhythmic (NA+ blocker)
Lidocaine
Description
Lidocaine is an antidysrhythmic that supresses automaticity and raises stimulation threshold of the ventricles. it also causes sedation, anticonvulsant and analgesic effects
Lidocaine
Indications
Pulseless ventricular tachycardia, ventricular fibrillation, ventricular tachycardia with pulses
Lidocaine
Contraindications
Hypersensitivity to amide-type local anesthetics, supraventricular dysrhythmias, stokes-adam snydrome, 2nd or 3rd degree heart blocks, and bradycardias
Lidocaine
Precautions
hepatic or renal impairment, CHF, hypoxia, respiratory depression, hypovolemia, myasthenia gravis, shock, elderly
Lidocaine
Dosage/Route
cardiac arrest
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
Lidocaine
Dosage/Route
head injury premedicate
1mg/kg IVP
Procainamide
Name
Pronestyl
Procainamide
Class
anti arrhythmic (NA+ blocker)
Procainamide
Description
Procainamide prolongs ventricular repolarization, slows conduction, and decreases myocardial excitability
Procainamide
Indications
Ventricular fibrillation, and pulseless ventricular tachycardia refractory to lidocaine
Procainamide
Contraindications
Hypersensitivity to procainamide or procaine, myasthenia gravis, and 2nd or 3rd degree heart block
Procainamide
Precautions
hypotension, cardiac enlargement, CHF, AMI, ventricular dysrhythmias from digitalis, hepatic or renal impairment, or bronchial asthma
Procainamide
Dosage/Route
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
