Atrial Fib Treatments

Question 1

First line treatment of Afib?

Answer 1

Beta blockers OR nondihydropyridine CCB’s

Question 2

What beta blockers are recommended for afib?
- Doses?

Answer 2

Metoprolol: 25-100mg PO 2/d
Atenolol: 25-100mg PO 1/d
Propranolol: 10-40mg PO 3-4/d

Question 3

What NdH CCB’s are recommended for a fib?
-Doses?

Answer 3

Diltiazem: 120-360mg PO 1/d
Verapamil: 180-480mg PO 1/d

Question 4

Avoid _______ in pt with COPD and acute decomp HF

Answer 4

Beta blockers

Question 5

Avoid _______ in pt with ADHF

Answer 5

CCB’s

Question 6

Second line treatment for afib?
- Doses?

Answer 6

Digoxin: .125-.25mg PO 1/d

Question 7

Third line treatment for afib?
Doses?

Answer 7

Amiodarone: 100-200mg PO 1/d

Question 8

Afib RVR first line treatment?

Answer 8

B blockers or NdHP CCB’s

Question 9

What beta blockers are recommended for AFIB RVR?
-Doses? Frequency? Max?

Answer 9

Metoprolol: 2.5-5mg IV (once over 2 min, repeat every 5 min as needed up to 3 times)

Esmolol: 500mcg/kg IV (once over 1 min. then 50mcg/kg/min IV infusion, max. 300mcg/kg/min)

Propranolol: 1mg IV (once over 1 min, repeat every 2 min as needed up to 3 times

Question 10

What NdHP CCB’s are recommended for afib RVR?
-Doses? Frequency? Max?

Answer 10

Diltiazem: .25mg/kg IV (once over 2 min then 5-10mg/hr IV infusion)

Verapamil: .075-.15mg/kg IV (once over 2 min; give additional 10mg IV after 30 min, then .005mg/kg/min IV infusion)

Question 11

Amiodarone treatment of afib RVR?
-Dose, frequency, max (if applicable)?

Answer 11

300 mg IV infusion over 1 hour, then 10-50mg/hr IV infusion over 24hrs