Antidysrhythmics Flashcards
Amiodarone (Cordarone, Pacerone)
Class
Antidysrhythmic (KCL Blocker)
Amiodarone
Another Name
Cordarone
Pacerone
Amiodarone (Cordarone, Pacerone)
Description
Antidysrhythmic that prolongs duration of the action potential and refactory period and relaxes smooth muscle, reducing peripheral vascular resistance and increasing coronary blood flow
Amiodarone (Cordarone, Pacerone)
Indication
Life threatening ventricular and super-ventricular dysrhythmias, frequently atrial fibrillation
Amioderone (Cordarone, Pacerone)
Contraindication
Cardiogenic shock, severe sinus bradycardia, advanced heart block
Amiodarone (Cardarone, Paceron)
Dose/Route
150mg over 10 min pt w/ pulses
300mg pulseless IVP
Pedi: 5mg/kg IV/IO then 15 mg/kg/day
Bretylium
Another Name
Bretylol
Bretylol
Another Name
Bretylium
Bretylium (Bretylol)
Class
Antidysrhythmic (KCL Blocker)
Bretylium (Bretylol)
Description
Causes release of norepinephrine, depresses ventricular fibrillation and reduces ectopy. Suppresses ventricular tachydysrhythmias including vfib with reentry mechanisms
Bretylium (Bretylol)
Indications
Ventricular fibrillation and ventricular tachycardia refactory to lidocaine
Bretylium (Bretylol)
Contraindications
None
Bretylium (Bretylol)
Dose/Route
5mg/ kg IV then 10mg/kg /15-30 min to max 30mg/kg
Adenosine
Another Name
Adenocard
Adenocard
Another Name
Adenosine
Adenosine (Adenocard)
Class
Antidysrhythmic
Adenosine (Adenocard)
Description
Can “chemically cardiovert” PSVT to normal sinus. Half life 10 seconds and does not cause hypotension
Adenosine (Adenocard)
Indication
Narrow, complex paroxysmal SVT refactory to vegal maneuvers
Adenosine (Adenocard)
Contraindication
Afib, 2nd-3rd degree heart block, sinus node disease, or asthma.
Adenosine (Adenocard)
Precautions
May cause dysrhythmias especially asystole, COPD
Adenosine (Adenocard)
Dose/Route
6 mg rapidly (over 1-2 sec) IV, then flush line rapidly w/ saline. If ineffective 12 mg in 1-2 min may be repeated
Lidocaine
Another Name
Xylocaine
Xylocaine
Another Name
Lidocaine
Lidocaine (Xylocaine)
Class
Antidysrhythmic (NA+ Blocker)
Lidocaine (Xylocaine)
Description
Antidysrhythmic that suppresses automaticity and raises stimulation threshold of the ventricles. Also causes sedation, anticonvulsant, analgesic effects
Lidocaine (Xylocaine)
Indication
Pulseless ventricular tachycardia, ventricular fibrillation, ventricular tachycardia (w/ pulse)
Lidocaine (Xylocaine)
Contraindication
Hypersensitivity to amide-type local anesthetics, super ventricular dysrhythmias, Stroke-Adams syndrome, 2nd-3rd degree heart block, bradycardia
Lidocaine (Xylocaine)
Precautions
Hepatic or renal impairment, CHF, hypoxia, respiratory depression, hypovolemia, myasthenia gravis, shock, elderly.
Lidocaine (Xylocaine)
Dose/Route
Cardia Arrests: 1-1.5 mk/kg IV repeated every 3-5 min up to 3 mg/kg, consider 1/2 dose for elderly. Follow conversion with drip of 2-4 mg/min. 1 gram/250cc
Head injuries: 1 mg/kg IVP
Pedi: 1 mg/kg IV repeat 3-5 min up to 3 mg, follow conversion with drip of 20-30 mcg/kg/min
Procainamide
Another Name
Pronestyl
Pronestyl
Another Name
Procainamide
Procainamide (Pronestyl)
Class
Anti-arrhythmic
Procainamide (Pronestyl)
Description
Prolongs ventricular repolarization, slows conduction and decreases myocardial excitability.
Procainamide (Pronestyl)
Indication
V-fib and pulseless ventricular tachycardia refactory to lidocaine
Procainamide (Pronestyl)
Contraindications
Hypersensitivity to procaine, myasthenia gravis and 2nd-3rd degree heart block
Procainamide (Pronestyl)
Precaution
Hypostension, cardiac enlargement, CHF, AMI, ventricular dysrhythmias from digitalis, hepatic or renal impairment, or bronchial asthma
