antidysrhythmics

Question 1

What are cardiac dysrhythmias?

Answer 1

They are any deviation from a normal HR or pattern that slow down conduction in the heart.

Question 2

What are cardiac dysrhythmias caused by?

Answer 2

MI, hypoxia, hypercapnia, thyroid disease, CAD, electrolyte imbalance, hyper/hypo kalemia and magnesemia.

Question 3

What are the types of antidysrhythmics?

Answer 3

Sodium channel blockers, Beta blockers, Potassium channel blockers (amiodarone), Calcium channel blockers (verapamil and diltiazem).

Question 4

How do sodium channel blockers work?

Answer 4

They decrease sodium influx into cardiac cells, which decreases conduction and ectopy (extra beats).

Question 5

Which sodium channel blocker meds are used for PAT and SVT?

Answer 5

Quinidine, Procainamide, Disopyramide.

Question 6

Which sodium channel blockers are used for VT and VFIB?

Answer 6

Lidocaine, Flecainide, Mexitiletine HCL.

Question 7

How do beta blockers work?

Answer 7

They decrease conduction velocity, improve automaticity and recovery time, and decrease afib, tachycardia, and dysrhythmias.

Question 8

What beta blockers are used as antidysrhythmics?

Answer 8

Acebutolol (Sectral) and Sotalol.

Question 9

What is sotalol used for?

Answer 9

Mostly used for patients with AFIB.

Question 10

What is acebutolol (Sectral) used for?

Answer 10

It is a B1 blocker, used more for patients with ventricular dysrhythmias, angina, and HTN.

Question 11

What pregnancy category is acebutolol (Sectral)?

Answer 11

Pregnancy category B.

Question 12

What are the contraindications of acebutolol (Sectral)?

Answer 12

2nd/3rd degree heart block, severe bradycardia, severe HF, and cardiogenic shock.

Question 13

In what patients should we take caution with when giving acebutolol (Sectral)?

Answer 13

Patients undergoing major surgery, patients with renal/hepatic impairment, patients with Labile Mellitus.

Question 14

What drug interactions occur with acebutolol (Sectral)?

Answer 14

Increased effects with diuretics, prolonged hypoglycemia, antagonist effect with albuterol, terbutaline, and metaproterenol. May also increase ACT, AST, ALP, BUN and K+.

Question 15

What are the side effects of acebutolol (Sectral)?

Answer 15

Dizziness, nausea, headache, fatigue, hypotension, diaphoresis.

Question 16

What are the adverse effects of acebutolol (Sectral)?

Answer 16

Palpitations with abrupt discontinuation, and bradycardia.

Question 17

What are life threatening effects of acebutolol (Sectral)?

Answer 17

Agranulocytosis and bronchospasm with high doses.

Question 18

How do potassium channel blockers work?

Answer 18

They increase refractory period and prolong action potential.

Question 19

Which potassium channel blocker is used as an antidysrhythmic?

Answer 19

Amiodarone (Codarone).

Question 20

What is Amiodarone (Codarone) used for?

Answer 20

Mostly used for AFIB, but can also be used in a code situation when a patient has VTACH or VFIB.

Question 21

What tests should be taken, when, and why?

Answer 21

Thyroid and pulmonary function tests at beginning of treatment, 6 months in, and then yearly, because it can cause hypothyroidism and pulmonary fibrosis.

Question 22

How do calcium channel blockers work?

Answer 22

They block calcium influx, decreasing cardiac response and conduction.

Question 23

What are the ONLY calcium channel blockers used as antidysrhythmics?

Answer 23

Verapamil and diltiazem.

Question 24

What are the contraindications of calcium channel blockers?

Answer 24

Heart block, severe bradycardia, heart failure.