Antidysrhythmics Ib Lidocaine

Question 1

define repolarization

Answer 1

movement towards refractory/resting phase; K is completely out now; phase starts at 1 and plateaus at phase 2 and continues to phase 3 of action potential

Question 2

the phase between repolarization and refractory phase?

Answer 2

phase 3; magnesium activates the Na-K pump to fascilitate the movement of K back into the cell; Na and Ca move out; when complete, refractory phase 4 has been reached.

Question 3

define refractory phase

Answer 3

resting state; diastole to fill in with blood; phase 4 of action potential; cell CANNOT respond to new stimulus; K is inside and Na is outside once again

Question 4

Sodium channel blockers does this

Answer 4

decrease fast influx of Na into cell; depress past 0 of action potential; effect is decrease automaticity/formation and conduction of electrical stimulus

Question 5

indication of sodiume channel blockers

Answer 5

tx L/T dysrhythmias

Question 6

contraindications of sodium channel blockers

Answer 6

cardiogenic SHOCK; 2nd or 3rd AV BLOCK; GLAUCOMA; caution cardiomyopathy, renal, hepatic d/o

Question 7

nsg responsibilities with sodium channel blockers

Answer 7

PC HF, hypokalemia, hypernatremia (?)

Question 8

sodium channel blocker toxicity s/s

Answer 8

seizure; confusion; drowsiness; hearing impairement

Question 9

sodium channel blockers are divided into 3 subgroups

Answer 9

Ia, Ib, Ic

Question 10

sodium channel blocker subclass Ib does this

Answer 10

slow conduction; shorten repolarization (get to refractory/rest sooner)

Question 11

example of subclass Ib drug

Answer 11

lidocaine

Question 12

subclass Ib lidocaine indication

Answer 12

Ventriculare dysrhythmia r/t MI, cardiac surgery/catherization, electrical cardioversion; alternative to potassium channel blocker Class III amiodarone for life threatening ventricular dysrhythmia

Question 13

subclass Ib lidocaine safe dosage/route/onset/duration

Answer 13

50-100 mcg bolus in 2-3 min IV (Onset 1-2 min Duration 20 min)

Question 14

subclass Ib lidocaine toxicity s/e

Answer 14

seizure; confusion; drowsiness; hearing impairment

Question 15

subclass Ib lidocaine contraindication

Answer 15

allergy to amide anesthetic (lidocaine family); stroke adams syndrome with slow HR r/t heart blocks; AV heart BLOCK

Question 16

subclass Ib lidocaine nsg responsibility

Answer 16

need close cardiac monitoring! Caution with 70+ yo and hepatic impairment