Antiarrhythmic Agents Flashcards
What are antiarrhythmic agents?
Drugs that affect the action potential of cardiac cells and are used to treat arrhythmias and restore normal rate and rhythm
What is bradycardia?
HR < 60 bpm
What is a heart block?
a block that inhibits the conduction of the electrical signal through the cardiac conduction system
Where can heart blocks happen in the heart?
@ the atrioventricular (AV) node, blocking the conduction from the atria into the ventricles
@ the bundle branches within the ventricles, preventing normal conduction of an impulse to the muscle there
What is hemodynamics?
the study of the forces moving blood throughout the cardiovascular system
What causes a premature atrial contraction (PAC)?
an ectopic focus in the atria that stimulates an atrial response
What causes premature ventricular contraction (PAC)?
an ectopic focus in the ventricles that stimulates the cells and causes an early contraction
What does it mean for a drug to be proarrhythmic?
the drug tends to cause arrhythmias
What is tachycardia?
HR > 100bpm
Go through the 5 phases of the cardiac muscle cell
PHASE 0: Na2+ moves into the cell and causes rapid positive charge
PHASE 1: K+ move out of the cells causing the cell charge to become more negative
PHASE 2: Ca2+ moves into the cells and maintain the charge of the cell
PHASE 3: K+ moves out of the cell rapidly causing the cell to repolarize back to a negative charge
PHASE 4: The cell is back at rest, ready to go again
What are 5 things that can cause arrhythmias?
Electrolyte disturbances that alter the action potential
Decreases in O2 delivered to the cells
Structural damage (i.e. MI, cardiomyopathy) changing the conduction pathway through the heart
Acidosis or accumulation of waste products altering the action potential
Drugs that alter the action potential or cardiac conduction
What is an atrial flutter and what can it cause if untreated?
rapid atrial contraction while the ventricles remain normal
Can cause a serious stroke
What is the MOA of Class I Antiarrhythmics?
Block the Na2+ channels in the cell membrane during an action potential (phase 0)
What is the MOA of Class II Antiarrhythmics?
Block beta-receptors, causing a depression of phase 4 of the action potential
What is the MOA of Class III Antiarrhythmics?
Block K channels, prolong phase 3 of the action potential
What is the MOA of Class IV Antiarrhythmics?
Block calcium channels in the cell membrane (phase 2)
Before administering an antiarrhythmic to a child, we should consider what surgery?
Ablation procedures
Which antiarrhythmic is approved for use with children?
Digoxin
What are the nursing considerations for children taking an antiarrhythmic?
Monitor closely - more likely to experience ADEs
Dosages should be calculated by age and weight
In what situations do we use or not use an antiarrhythmic in adults?
The patient is likely experiencing a severe cardiac situation
Monitor frequently
AVOID USE in PG and lactation
Which age group are antiarrhythmics frequently prescribed for?
Older Adults
When administering antiarrhythmics to an older adult, what should the nurse remember?
Older adults are more likely to experience ADEs
Start at a lower dose
Double Quarter Pounder…
w/ Lettuce, Mayo, and Tomato…
and More Fries Please!
Picture of the McDonald’s M with salt shakers helps us remember WHAT about these drugs?
CLASS 1A
Disophyramide
Quinidine
Procainamide
CLASS 1B
Lidocaine
Mexiletine
Tocainide
CLASS 1C
Moricizine
Flecainide
Propefanone
CLASS I Na2+ CHANNEL BLOCKERS
SAD banana
Sotalol
Amiodarone
Dofelitide
CLASS III K CHANNEL BLOCKERS
Very Dairy
Verapamil
Diltiazem
CLASS IV Ca2+ CHANNEL BLOCKERS
What is the MOA of Adenosine?
Completely stops the heart
Why do we use adenosine?
To convert a supraventricular tachycardia to sinus rhythm when vagal maneuvers have been ineffective
What nursing considerations do we need to know for administering adenosine?
Have the crash cart ready just in case the heart doesn’t start again
If the pt is awake and alert, warm him/her that it will be incredibly painful
What is the MOA of Digoxin?
Slows Ca2+ from leaving the cell, prolonging the action potential and slowing conduction and HR
Why do we use Dronedarone?
To reduce the risk of hospitalization in patients with paroxysmal or persistent AF or flutter who have risk factors for CVD and are in sinus rhythm or scheduled to be converted to sinus rhythm
