Antidysrhythmic Drugs Flashcards
Amiodarone (__other name____)
Cordarone
Amiodaron Class and Action
Class:
- Class III antidysrhythmic
- K+ blockade (primarily potassium channels)
Action:
-Prolongs duration of action potential and effective refractory period (Phase 2) Prolong QT.
-They dont compete (noncompetitive) with Beta-andrenoreceptor and calcium channel
Amiodaron Indications (dose)
V-Tach with pulse
(ADULT: If pt is stable: 150 mg SIV infusion in 50 ml over 10-15 min repeat x1)
Pulseless V-Tach or V- Fib
(ADULT: 300mg IVP
2nd dose 150 mg IVP
Max = 450 mg)
Amiodaron
Contraindications,
Side Effects,
and Special Considerations
Contraindication:
- Cardiogenic shock
- Hypotension
- Bradycardia
Side Effects:
- Hypotension
- Headache
- Bradycardia
Special Considerations:
- Amiodarone has actions of all classes
- Maintenance drip of 1 mg/min
- Do not exceed 2 grams
Cardizem (__other name____)
Diltiazem
Cardizem Class and Action
Class:
Non-DHP calcium channel blocker
Action:
- Slows conduction, at AV node,
- Causes coronary and peripheral vasodilation
- ONSET = 2-5 minutes
Cardizem Indications (dose)
Rapid A-Fib (>170)
Rapid A-Flutter (>170) Multifocal atrial tachycardia SVT refractory to Adenosine
(dose: 0.25 mg/kg SIVP (over 2 minutes))
Cardizem
Contraindications,
Side Effects,
and Special Considerations
CONTRAINDICATIONS
- BP<90
- Wolf-Parkinson-White syndrome or short P-R interval syndrome
- Heart block
- Sinus Tach
- Cardiogenic shock
SIDE EFFECTS:
- Hypotension, bradycardia, syncope
- Dizziness, nausea, vomiting, dry mouth
- Dyspnea
SPECIAL INFORMATION:
- Known A-Fib or A-Flutter, Cardizem is drug of choice
- Hypotension may result (carefully monitor vital signs)
Lidocaine 2% (____other name_____)
Xylocaine
Lidocaine 2% Class and Action
Class:
Class Ib Antiarrhythmic - Weak Na+ blockade AND local Anesthetic
ACTION: - Sodium channel blocker - Alters phase “0” diastolic depolarization ONSET = 30-90 sec DURATION = 10-20 min
Lidocane 2% Indications (dose)
V-Tach, with pulse
ADULT: 1-1.5 mg/kg, q 8 min, half initial dose (0.5-0.75mg/kg)
Max dose: 3mg/kg
Pulseless V-Tach or V-Fib
ADULT:
1.5 mg/kg, q 5 min Max dose: 3 mg/kg
Local anesthetic for relief of pain during intraosseous fluid administration
0.5 mg/kg IO bolus, slowly, maximum dose is 50mg
Lidocane 2%
Contraindications,
Side Effects,
and Special Considerations
CONTRAINDICATIONS:
- Heart blocks
SIDE EFFECTS:
- Slurred speech
- Seizures
- Heart blocks
- Increase in conduction with A-Fib & A-Flutter
- Neurologic anesthesia (aphasia, numbness/tingling in face,
seizures that are hard to stop, visual disturbances
SPECIAL INFORMATION:
- Geriatric >70 or known liver or kidney failure, sequential dose is 1⁄4
of initial dose. - Lidocaine metabolized in the liver, bad liver = more drug/side effects
- Maintenance drip: 1 g / 250 ml at 1 mg/min above conversion dose 2-4 mg/min.
- Pt must be monitored closely with maintenance drip
Procainamide (____other name_____)
Pronestyl
Procainamide Class and Action
CLASS:
- Class IA Ventricular Antiarrythmic Na+ channel blocker
ACTION:
- Increases duration of the refractory period
- Depresses the excitability of the myocardium to electrical stimulation, and reduces conduction velocity in the atria, ventricles, His-Purkinje system
- ONSET = 10-30 min
- DURATION = 3-6 hrs
Procainamide Indications (dose)
V-Tach with a pulse
A-Fib with WPW:
- 20mg/min, Max loading 17mg/kg
