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Transition to Nursing > Antiarrhythmic medications > Flashcards

Antiarrhythmic medications Flashcards

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1
Q

Class IA Action

A

Moderate depression of depolarization
Prolongs repolarization
Treats and prevents atrial and ventricular dysrhythmias

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2
Q

Class IA drug names

A

quindine (Quinaglute, Quindix, Cardioquin)
procainamide (Pronestyl, Procan SR)
disopyramide (Norpace)

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3
Q

Class IA Side Effects

A 
Dec. cardiac contractility
Prolonged QRS, QT
Proarrhythmic
Hypotension with IV admin
Diarrhea with quindine, constipation with dysopyramide
Cinochonism with quindine
Lupuslike syndrome with procainamide
Anticholinergic effects: dry mouth, urinary hesitancy with disopyramide
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4
Q

Class IA Nursing Intervenion

A

Observe for HF
Monitor BP with IV admin
Monitor QRS duration for inc. >50% from baseline
Monitor fr prolonged QT
Monitor N-acetyl procainamide (NAPA) lab values during procainamide therapy
If admin for AFIB, ensure pt has been pretreated with medications to control AV conduction

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5
Q

Class IB Action

A

Minimal depression of depolarization
Shortened repolarization
Treat ventricular dysrhythmias

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6
Q

Class IB Drugs

A

lidocaine (Xylocaine)
mexiletine (Mexitril)
tacanide (Tonocard)

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7
Q

Class IB Side Effects

A

CNS changes ( confusion, lethargy)
Bradycardia
Gi distress
Tremors

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8
Q

Class IB Nursing interventions

A

Monitor for CNS changes and tremors

Discuss with primary provider dec. lidocaine dose in older adult pt and pt with cardiac/liver dysfuction

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9
Q

Class IC Action

A

Marked depression of depolarization
Little effect on repolarization
Treat atrial and vetricular dysrhythmias

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10
Q

Class IC Drugs

A

Flecainide (tambocor)

propafenone (Rhythmol)

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11
Q

Class IC Side Effects

A

Proarrhythmic
HF
Dizzness, visual disturbances, dyspenea

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12
Q

Class IC Nursing intervenions

A

Dec. dose with renal dysfuntion and strict vgeterian diets

Avoid use in pt with structural heart disease (CAD, HF)

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13
Q

Class II Action

A

Dec. automaticity and conduction

Treat atrial and ventriclar dysrhythmias

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14
Q

Class II Drugs

A 
acebutolol (Sectral)
atenlol (Tenormin)
bisoprolol/HCTZ(Hydroclorothiazide) (Ziac, Zebeta)
esmolol (Brevibloc)
labetalol (Trandate)
Metropolol (lopressor, Toprol-XL)
nadolol (Corgard)
nevibolol (Bystolic)
propranolol (Inderal)
sotalol (Betapace; Sorine; also Class III actions)

-lol beta-blockers

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15
Q

Class II Side Effects

A 
Bradycardia, AV Block
Dec contractility
Brinchospasm
Nausea
Asymptomatic and symptomatic hypotension
Masks hypoglycemia and thyrotoxicosis
CNS disturbances (confusion, dizziness, fatigue, depression)
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16
Q

Class II Nursing interventions

A

Monitor HR, PR interval, S/S of HF, especially in those taking CCBs)
Monitor blood glucose level in pt with type 2 diabetes
Caution the pt about abrupt withdrawal to avoid tachycardia, hypertension, and myocardial ischemia

17
Q

Class III Actions

A

Prolongs repolarization
Amiodarone treats and prevents ventricular and atrial dysrhythmias, especially in pt with ventriuclar dysfunction
Dofetilide and abutilide treat and prevents atrial dysrhythmias.

18
Q

Class III Drugs

A

amidarone (Cordarone)
dofetilide (Tikosyn)
ibutilide (Convert)

19
Q

Class III Side Effects

A 
Pulmonary toxicity (amiodarone) 
Corneal microdeposits (amiodarone)
Photosensitivity ( Amiodarone)
Bradycardia
Hypotension, especially with IV admin
Polymorphic ventricular dysrhythmia (rare with amidarone)
N/V
Potentiates digoxin (amiodarone) 
Sotalol?
20
Q

Class III Nursing interventions

A

Make sure pt is sent for baseline pulmonary funtion tests (amiodarone)
Closely monitor pt
Assess for contraindications prior to admin
Monitor QT duration
Continuous ECG monitoring with initiation of dofetilide and ibutilide
Monitor renal function

21
Q

Class IV Actions

A

Blocks calcium channel

Treats and prevents paroxysmal atrial dysrhythmias

22
Q

Class IV Drugs

A

verapamil (Calan, Isoptin)

dilitiazem (Cardizem, Dilacor, Tiazac, Diltia, Cartia)

23
Q

Class IV Side Effects

A

Bradycardia, AV blocks
Hypotension with IV admin
HF, peripheral edema
Constipation, dizziness, headache, nausea

24
Q

Class IV Nursing interventions

A

Monitor for signs and symptoms of HF
Monitor for HR, PR interval
Monitor for BP, closely with IV admin.
Do not crush sustained-release meds

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