Antidysrhythmics Flashcards
Procainamide hydrochloride trade name
procainamide
procainamide hydrochloride class
antidysrhythmic
procainamide hydrochloride expected effect
depress excitability of cardiac muscle to electrical stimulation and slows conduction in atrium, bundle of His, increases refractory period.
Sodium channel blocker, slowing conduction sodium ions thru sodium channels. Blocking these channels slows conductivity & prolongs action potential & refractory period. Result is decrease excitability and impulse conduction of atria & ventricles
why use procainamide hydrochloride
ventricular dysrhythmia
procainamide hydrochloride dose
20-50mg/min (17mg/kg)
procainamide hydrochloride route admin
IV, IM
procainamide hydrochloride adverse effects
skin sores, hives, fever, chills
- heart block, circa collapse, angioedema, tornadoes de points, agranulocytosis
procainamide hydrochloride nursing implications
- use ECG to check PR-QRS segments
- blood levels & CBC
- vitals
- respiratory status (rate, rhythm, crackles)
- toxicity (confusion, nausea, vomit, drowsy)
- CNS effects (dizzy, confused, seizure)
propanolol trade names
inderal, inderal LA, Innopran
propranolol expected effect
non selective beta blockers with negative inotropic, chronotropic, dromotropic properties
why use propanolol
angina, hypertension, dysrhythmias, migraine, cyanotic spells from aortic stenosis, MI
dosage of propanolol
PO: 10-30mg tid qid, IV 1-3mg give 1mg/min may report after 2 mins & q4h intervals
propanolol routes admin
PO, IV
propanolol adverse effects
bradycardia, CHF, pulmonary edema, dysrhythmias, thrombocytopenia, Stevens Johnson syndrome, toxic epidermal necrolysis
propanolol nursing implications
- no abrupt discontinuation
- monitor with ECG
- note angina pain (duration, time started)
- fluid overload (edema)
- tolerance
- headache, light head, low BP= lower dose
adenosine trade name
adenocard
adenosine drug classes
antidysrhythmic, endogenous nucleoside
adenosine expected effect
slow conduction thru AV node, interrupt re-entry pathways into AV node & restore normal sinus rhythm in patients with tachycardia, hypoxia
why use adenosine
PSVT, MI, CAD, Wolff Parkinson white syndrome
adenosine route admin
IV
adenosine doses
IV bol 6mg, if sinus rhythm not return to normal give 12mg by IV BOL> may repeat 12mg dose
adenosine adverse effects
atrial tachydysrhythmias, AV block, cardiac arrest, atrial, bronchospasms
adenosine nursing implications
cardiopulmonary status: BP, pulse, respiration, rhythm, ECG intervals, dysrhythmias
respiratory status: rate, rhythm, lung fields, crackles
amiodarone trade names
cordarine, pacerone, nexterone
amiodarone drug classes
antidysrhythmic, iodinated benzofuran derivative
amiodarone expected effect
prolong action potential & refractory period, beta & alpha blocker, increase PR QT intervals, decrease sinus rate, peripheral vascular resistance
why use amiodarone
ventricular tachycardia, ventricular fibrillation, supraventircular dysrhythmias
amiodarone routes of admin
PO, IV
amiodarone adverse effects
sinus arrest, CHF, SA node dysfunction, AV block, hepatotoxcitiy, pulmonary toxcitiy
amiodarone nursing implications
assess: electroylytes, CNS, cardiac, resp
teach: no grape juice,do not discontinue abruptly
amiodarone black box
pulmonary toxicity, monitor with ECG
amiodarine doses
ventricular dysrhythmias
PO 800-1600mg/day for 1-3wk, then 600-800mg/dayfor 1 mo, IV is 150mg for 10mins then slow 360mg 6h
supraventricular dysrhythmias
PO 1.2-1.8g/ day until 10g, then 200-400mg/day,
IV 5-7mg/kg for 30-60min, then 1.2-1.8g in IV
