antidysrrythmias Flashcards
dyssrythmias can develop when ?
association with many conditions
After MI, cardiac surgery, or as a result of CAD
Disturbances of cardiac rhythm are the result of abnormally functioning cardiac cell
shifting of electrolytes will change ?
The excitability in the cell
The electrical impulse leads to
contraction of the myocardial muscle
what are Supraventricular dysrhythmias
Originate above the ventricles in SA or AV node or atrial myocardium, QRS complex will be narrow
what are Ventricular dysrhythmias
Originate below the AV node in the His-Purkinje system or ventricular myocardium- we would defibrillate in this case , easy to get people back from this
what is ectopic foci ?
pre mature contractions- when there is firing of a cell too early
PACS, PJCS, PVCs
why are we concerned about R on T ?
disruption of all of the conduction
what is a conduction block ?
Dysrhythmias that involve the disruption of impulse conduction between the atria and ventricles
- seen with old hearts
what is A fib ?
contraindications of antidysrrthimc drugs
Known drug allergy
Second- or third-degree AV block, bundle branch block, cardiogenic shock, sick sinus syndrome, and any other ECG changes depending on the clinical judgment of a cardiologist.
Other antidysrhythmic drugs
- block a a postive ion from getting into cell we will be changing the action potential
MONA
morphine, oxygen, nitro, asprin- what should be given for a heart attack
adverse effects of antidysthymics
Hypersensitivity reactions
Nausea, vomiting, and diarrhea
Dizziness
Headache and blurred vision
Prolongation of the QT interval - repolarization would be slower
what is procainamide ?
Pronestyl : atrial and ventricular tachydysrhythmias
Significant adverse effects: include ventricular dysrhythmias, blood disorders, systemic lupus erythematosus (SLE)–like syndrome, nausea, vomiting, diarrhea, fever, leukopenia, maculopapular rash, flushing, and torsades de pointes resulting from prolongation of the QT interval
contraindications of pronestyl ?
known hypersensitivity, heart block, and SLE
what is the action of lidocaine ?
raises the ventricular fibrillation threshold, used for cardiac irritability , very possible to overdose on lidocaine
adverse effects of lidocaine ?
Significant adverse effects: twitching, convulsions, confusion, respiratory depression or arrest, hypotension, bradycardia, and dysrhythmias
contraindications of lidocaine
hypersensitive, severe SA or atrioventricular (AV) intraventricular block, or Stokes-Adams or Wolff-Parkinson-White syndrome
beta blockers - severe bradycardia ( less than 60) dont give betablocker
what is atenolol
Cardioselective beta blocker; preferentially blocks the beta1-adrenergic receptors that are located primarily in the heart
Noncardioselective beta blockers block not only the beta1-adrenergic receptors in the heart but also the beta2-adrenergic receptors in the lungs and therefore can exacerbate pre-existing asthma or chronic obstructive pulmonary disease
Amiodarone
wide complex tachycardia or ventriciuar dysrythmias , potentiates digoxin ( makes digoxin much stronger so
what is diltizem ?
what is adenosine ?
- will see asystole for a short amount of time after the drug is pushed
Slows conduction through the AV node
Used to convert PSVT to sinus rhythm
Very short half-life—less than 10 seconds
Only administered as fast intravenous (IV) push
May cause asystole for a few seconds
Other adverse effects are minimal
nursing implciations of dysthrymias ?
Obtain a thorough drug and medical history.
Measure baseline blood pressure (BP), pulse, input and output, and cardiac rhythm.
Measure serum potassium levels before initiating therapy.
During therapy, monitor cardiac rhythm, heart rate, BP, general well-being, skin color, temperature, and heart and lung sounds.
Assess plasma drug levels as indicated.
Monitor for toxic effects.
administration of lidocaine should only be given as an IV
False , they should not be given as an IV and only as a local aesthetic
