Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Antidysrythmics > Flashcards

Antidysrythmics Flashcards

1
Q

Lidocaine (Xylocaine)

-Mechanism of action

A
  • Suppresses automaticity and deplo is His/purkinjie system.
  • Suppresses ventricular ectopy and increases vent threshold for dysrhythmias, but increases threshold for defib.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lidocaine

-Indication

A
  • VT w/pulse
  • Alt second-line therapy to Amiodarone in CA (VF/Pulse VT) and hemodynamially stable, wide complex monomorphic VT
  • malignant PVC >6 Unifocal PVC/min Multifocal PVC’s Couplets R on T Phenomena
  • Pain control w/ I/O
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Lidocaine (Xylocaine)

  • Contraindications
A
  • Hypersensitivity
  • Supraventricular Dysrhythmias
  • Untreated Sinus Brady
  • 2nd Degree Mobitz II HB
  • 3rd Degree HB
  • Stokes-Adams Syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Lidocaine (Xylocaine)

  • Precautions
A
  • CNS depression may occur in doses greater than 300 mg/hr
  • Liver/Renal disease
  • CHF
  • Hypovolemia
  • Shock
  • Myasthenia Gravis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Lidocaine (Xylocaine)

  • Side Effects
A
  • AMS (including Confusion)
  • Bradycardia
  • Hypotension
  • Seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lidocaine (Xylocaine)

  • Interactions
A
  • Caution when administered with B-Blockers or procainamide as drug toxicity may result.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lidocaine

-Dosage/Route: CA

A
  • No pulse:

>Adult: 1-1.5 mg/kg IVP, repeat at half of initial dose q 5 minutes; max of 3mg/kg. (Single dose of 1.5 if moving to amiodarone) ETT: 2-4 mg/kg q 3-5 minutes

>Pedi: 1 mg/kg IVP/IO/ETT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lidocaine

-Dosage/Route: CA w/ a pulse, and Infusion

A

CA-

>1-1.5 mg/kg IVP, repeat at 1/2 initial dose q 5-10 minutes; max of 3 mg/kg.

>Infusion- 1-4 mg/min using “+1 rule”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lidocaine

-I/O Pain Control

A
  • Adult: 0.5 mg/kg max of 40 mg IVP 1% or 2%
  • Pedi: 0.5 mg/kg IVP 1% or 2%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lidocaine (Xylocaine)

  • Pharmacokinetics: Absorption/Duration/Half-Life
A
  • Absorption: 3 minutes
  • Duration: 10-20 minutes
  • Half-Life: 1.5-2 hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Amiodarone (Cordarone)

-Functional Class

A
  • Class III Antidysrhythmic (K+ channel blocker)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Amiodarone (Cordarone)

  • Mechanism of Action
A
  • Acts directly on all cardiac tissue.
  • Prolongs action potential and refractory period durations by blocking Ka+ without significantly effecting resting membrane potential. Also blocks Na+
  • IV relaxes vascular smooth muscle, decreasing PVR and increases coronary blood flow.
  • Blocks effects of sympathetic stimulation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Amiodarone (Cordarone)

-Indications

A
  • Life-threatening ventricular and supraventricular dysrhythmias.
  • VF, VT, A-fib, A-flutter, SVT, and WPW.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Amiodarone (Codarone)

-Contraindications

A
  • Hypersensitivity to Iodine
  • Cardiogenic Shock
  • Severe Sinus Brady
  • Av Block
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Amiodarone (Cordarone)

  • Precautions
A
  • Severe liver disease
  • Pregnancy
  • Nursing mothers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Amiodarone (Cordarone)

  • Interactions
A
  • Increases Digoxin levels and enhances pharmacological effets of procainamide, lidocaine, quinidine, and oral coagulants.
  • Concurrent use of CCB, B-Blockers, fentanyl, or Cimetidine may potentiate sinus brady.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Amiodarone (Cordarone)

  • Side Effects
A
  • CHF
  • Angioedema
  • Hypotension
  • AV Blocks
  • Hepatotoxicity
  • Cardiogenic Shock
  • Bradycardia
  • Sinus Arrest
  • Prolonged Q-T interval
  • Fatigue
  • N/V
  • Permanent Blindness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Amiodarone (Cordarone)

-Dosage/Route: Pulse, Pulseless, and Maintenance infusion

A

Adult:

  • Pulse: 150 mg (in 50-100 mL of NS) IV infusion over 10 min. May repeat once after 10 minutes.
  • Pulseless: 300 mg IVP, repeat in 3-5 min at 150 mg IVP
  • Maintenance Infusion: 1 mg/min over 6 hrs. Pedi: 5 mg/kg IV/IO
  • Post Arrest: 150 mL NS slow IV/IO over 8-10 min
19
Q

Adenosine (Adenocard)

-Functional Class

A
  • Antidysrhythmic
20
Q

Adenosine (Adenocard)

-Mechanism of Action

A
  • Naturally occurring nucleoside
  • Decreases conduction through AV node
  • Interrupts AV and SA re-entry pathways restoring normal sinus rhythm in pts with SVT.
21
Q

Adenosine (Adenocard)

-Indications

A
  • SVT refractory to Vagal Maneuvers
  • Wolf-Parkinson-White syndrome
  • Symptomatic monomorphic wide-complex tachycardia w/ regular rhythm
22
Q

Adenosine (Adenocard)

-Contraindications

A
  • 2 and 3 deg heart block
  • Symptomatic Bradycardia
  • Sick Sinus Syndrome
  • Hypertension
23
Q

Adenosine (Adenocard)

  • Precautions
A
  • Place Pt in semi-fowlers as they will typically develop arrhythmias at the time of conversion.
  • Caution with Asthma pts.
24
Q

Adenosine (Adenocard)

  • Interactions
A
  • Pts taking caffeine or xanthines (aminophylline/ theophylline) may require larger doses as they antagonize adenosine.
  • Pt in dipyridamole (Persantine) and carbamazepine (Tergretol) may require smaller doses as these drugs potentiate adenosine’s effects.
25
Q

Adenosine (Adenocard)

  • Side Effects
A
  • Side effects usually self-limiting due to short half-life
  • Syncope
  • Palps
  • C/P
  • Hypotension
  • Dysrhythmias
  • Dyspnea
  • Dizz
  • N/V
26
Q

Adenosine (Adenocard)

-Dosage/Route

A
  • Adult- 6 mg rapid IVP, following w/ 10-20 mL NS. No conversion in 1-2 min. 12 mg rapid IVP, follow w/ 10-20 mL NS. No conversion in 1-2 minutes follow with additional 12 mg rapid IVP and 10-20 mL flush.
  • Pedi- Med Control Option

>0.1 mg/kg IVP/IO (max single of 6 repeat once in 1-2 min at 0.2 mg/kg max dose of 12.

27
Q

Diltiazem (Cardizem)

-Functional Class

A
  • Class IV antidysrhythmic (Ca Channel Blocker)
28
Q

Diltiazem (Cardizem):

-Mechanism of Action

A
  • Inhibits Ca+ influx in slow channel cells of myocardial and arterial smooth muscle.
  • Ca+ is kept at sub threshold making cells unavailable for excitation and contraction.
  • Reduces PVR by inhibiting smooth vascular muscle contraction. Causes Coronary artery diolation.
  • Inhibits coronary spasm and also slows SA and AV conduction.
29
Q

Diltiazem (Cardizem)

-Indication

A
  • SVT refractory to adenosine
  • Rapid A-fib and A-flutter
30
Q

Diltiazem (Cardizem)

-Contraindication

A
  • Hypersensitivity
  • Sick Sinus Syndrome
  • 2 and 3 deg heart block
  • Hypotension
  • WPW
  • w/ wide complex tachycardia
31
Q

Diltiazem (Cardizem)

  • Precautions
A
  • Avoid in pts taking oral B-Blockers
  • Monitor for hypotension resulting from peripheral vasodilation.
  • Caution with CHF
32
Q

Diltiazem (Cardizem)

  • Interactions
A
  • B-Blockers may increase digoxin levels.
33
Q

Diltiazem (Cardizem)

  • Side Effects
A
  • C/P
  • Bradycardia
  • Hypotension
  • Syncope
  • CHF
  • Dysrhythmias
  • 2nd/3rd degree AV block
  • Dyspnea
  • Palps
  • N/V, H/A, Sweating and dizz
34
Q

Diltiazem (Cardizem)

-Dosage/Route

A
  • Bolus: 0.25 mg/kg slow IVP, repeat in 15 min at 0.35 mg/kg slow IVP.
  • IV Infusion: 5-15 mg/hr, titrate to HR
35
Q

Metoprolol (Lopressor)

-Functional Class

A
  • Class II Antidysrhythmic (Beta Blocker)
36
Q

Metoprolol (Lopressor)

-Mechanism of Action

A
  • Blocks Beta-1 receptors located on cardiac muscle with little to no effect on B-2 in doses less than 100 mg.
  • Reduces HR and CO at rest and during exercise and lowers BP.
37
Q

Metoprolol (Lopressor)

-Indications

A
  • C/P associated with AMI and ACS
  • Angina Pectrois
  • SVT
38
Q

Metoprolol (Lopressor)

-Contraindications

A
  • Hypersensitivity
  • Sinus Brady
  • Heart Block gtr than 1 (except when w/ PC)
  • Cardiogenic Shock
  • Uncompensated Cardiac Failure
  • Pregnancy 2nd/3rd trimester
  • Asthma/COPD
39
Q

Metoprolol (Lopressor, Toprol-XL)

  • Side Effects
A
  • Bronchospasm
  • Bradycardia
  • Palps
  • Edema
  • CHF
  • Reduced Peripheral Circulation
  • Drowsiness
  • Insomnia
40
Q

Metoprolol (Lopressor, Toprol-XL)

  • Interactions
A
  • Drugs which slow AV conduction (Digoxin) as the effects may be accumulative with B-Blockers
  • Glucagon: Metoprolol may blunt the hyperglycemic action of glucagon.
  • Verapamil or Diltiazem may have synergistic pharmacological effects when taken concurrently with B-Blockers.
41
Q

Metoprolol (Lopressor, Toprol-XL)

  • Precautions
A
  • Impaired Hepatic/Renal Function
  • CHF controlled by Digitalis or Diuretics
  • Do not mix with IV CCB
42
Q

Metoprolol (Lopressor)

-Dosage/Route

A
  • 5 mg slow IVP (over 2-5 min) q 5 min x3; max of 15 mg
  • Acute MI: Maintain systolic >100 and HR >60
  • SVT: Maintain HR 90-100.
43
Q
A

Pharmacology (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions