Antiarrhythymics Flashcards
The antiarrhthymic that slows conduction from the SA node to accessory/purkinje fibers?
Amiodarone
What might you see if you gave your patient less than 0.5 MG of atropine IV?
Paradoxical bradycardia
Two antiarrhythmic medications that a provider might order to treat pulseless ventricular fibrillation or VTACH?
Amiodarone and lidocaine
What is the average half-life of amiodarone (Cordarone)?
40-61 days
What slows the rate of the SA node impulse formation, therefore, this medication might be ordered when a patient is in Torsades De Pointe?
Magnesium Sulfate
What medication is used to terminate SVT/ AV reentrant tachycardia?
Adenosine
A baseline ECG must be completed and the QT and QTc must be calculated, approved by provider prior to initiating this medication?
Dofetilide (tikosyn)
Where can you find the calculation to determine QTc?
Lexidrug
After giving a dose of Tikosyn, when should you repeat the EKG?
2-3 hours after
What steps must be taken if your patient missed more than 1 dose of tikosyn?
Notify provider, time restarts.
Which specialty must initiate/reinitiate Tikosyn?
Cardiologist
A patient on a maintenance dose of Tikosyn is admitted to the hospital for cellulitis. Must they be admitted to tele?
Yes, for HR and rhythm monitoring
Major side effect of Deofetilide (Tikosyn)?
Torsades de pointes
Why is it important to measure the QTc prior to giving Tikosyn?
Make sure the QT isn’t too long.
What are the actions of Tikosyn?
Converts AFIB and AFlutter to sinus, prolongs repolarization, and maintenance of NSR.
This patient is given their third dose of Dofetilide (Tikosyn), and the QT interval measurement is 0.55 seconds, what should you do next?
Hold med, call cardiologist.
My patient just converted to NSR after receiving Tikosyn, how long do they need to be observed before they can be discharged and why?
12 hours after to monitor the QT intervals.
You just decreased your patients dose from 250 mcg to 125 mcg, how long will they need to continuous cardiac monitoring?
Additional 6 doses/3DAYS OR 12 hours after NSR
Antiarrhythmic requires peak and trough levels to monitor for toxicity and could be ordered to control ventricular heart rate for a patient diagnosed with HF?
Digoxin
The antidote medication requires continuous cardiac monitoring during infusion and, for not less than, 24 hours following infusion?
Digoxin immune (digifab)
What could happen if patient receives two antiarrhythmyic medications?
Pro-Arrhythmias
What medication increases the SA and AV nodal automaticity and AV conduction to treat bradycardia?
Atropine sulfate
Side effects of atropine?
Tachycarida, Ventricular arrhythmia, afib, HA, dry mouth, dilated pupils.
What will your patient feel like after adenosine?
BAD
What symptoms would a patient experience when receiving lidocaine (xylocaine)?
- CNS - agitation and anxiety
- GI
- Hypotension
- Dizzy and confused (because it passes the BBB)
What is the dose guideline for dobutamine?
Cannot exceed more than 5 mcg/kg/minute in PCU
What is the dose guideline for dofetilide (tikosyn)?
It can only be given orally
What is the dose guideline for Amiodarone?
1st dose 300mg, 2nd dose 150mg, IVP for pulseless VT/VF
What is the dose guideline for Adensonine?
1st dose 6mg, 2nd dose 12 mg with rapid saline flush.
What is the dose guideline for lidocaine?
1st dose 1-1.5mg/kg, 2nd dose 0.5-0.75mg/kg IVP
What is the dose guideline for Magnesium Sulfate?
1-2 grams diluted with D5W over 5-60 minutes
What is the dose guideline for nitroglycerin paste?
Topical ointment 0.5-2 inches
What is the dose guideline for atropine?
1.0 mg IVP quickly for symptomatic bradycardia.
