Chapter 36: Cardiac Meds Flashcards
Lidocaine/xylocaine
PVC, VT, VF
Watch for confusion, paresthesias, slurring of speech, drowsiness, or seizure activity. CNS adverse effects predominate, may require a decrease in dosage for discontinuation.
Patient response includes depresses the automaticity at the Purkinje fibers. Decreases irritability of the myocardium. Shortens repolarization
Type 1b drugs
Shorten repolarization.
Treat or prevent ventricular premature beats, ventricular tachycardia, ventricular fibrillation. Includes lidocaine and Mexitil
Mexiletine hydrochloride/mexitil
Type 1B that shortens repolarization
PVC, VT, VF
Monitor blood pressure and heart rate. Assess for tremors, blurred vision, dizziness, ataxia, or confusion. Hypotension and bradycardia may occur. CNS adverse reactions predominate.
Depresses automaticity of Purkinje fibers. Decreases irritability of the myocardium
Class III
Lengthen the absolute refractory and prolong repolarization and the action potential duration of ischemic cells. Include amiodarone, ibutilide, and are used to treat or prevent ventricular premature beats, VT, VF
Amiodarone hydrochloride/cordarone
AF, PAF, PSVT, Life-threatening ventricular dysrhythmias
Monitor for return of rhythm and poults which is the expected response. Use extreme caution with patients receiving other antidysrhythmic’s because of reduced hepatic and renal clearance.
Drug is irritating to peripheral vasculature. Use an infusion pump and PVC tubing with an in-line filter and infuse via a central line.
Rapid loading dose must not be administered faster than 10 minutes. Stay with the patient and monitor heart rate and blood pressure. Hypotension may occur and infusion may need to be slowed. Do not discontinue it unless necessary.
Continually monitor ECG rhythm strip for prolonged QT interval. Bradycardia and AV block may occur and are treated by slowing the rate or pacemaker. It may cause worsening of ventricular dysrhythmias
Report any muscle weakness, tremors, difficulty with ambulation. Report shortness of breath, cough, pleuritic pain, fever which can indicate pulmonary toxicity. Report visual disturbances and wear sunglasses. Uses sunscreen for photosensitivity. Report signs of thyroid problems are hepatotoxicity which may need a decreased dose.
Other side effects include cough, dizzy, numbness in fingers and toes, painful breathing, shortness of breath, trouble with walking.
Class IV
Slow the flow of calcium into the cell during depolarization, thereby depressing the automaticity of the SA and the AV nodes, decreasing the heart rate, prolonging the AV nodal refractory period and conduction. Calcium channel blockers such as verapamil, diltiazem. They are used to treat SVT, atrial flutter, atrial fibrillation to slow the ventricular response.
Diltiazem hydrochloride/cardizem
AFib, atrial flutter, PSVT
Patient response include slows ventricular conduction, lowers blood pressure, reduces chest pain.
Bradycardia and hypotension may occur, monitor heart rate and blood pressure. Teach patients to remain recumbent for at least one hour after IV admin.
Heart failure may occur, requiring a decrease or discontinuation of the dosage. Report dyspnea, orthopnea, distended neck veins, or swelling of the extremities.
Atropine sulfate
Parasympathetic or vagolytic agent. Treats Vagally induced bradycardia
Used to treat bradycardia. Increased heart rate is expected, monitor the rate and rhythm. It may cause ischemia in patients with CAD. Monitor for chest pain. Assess for urinary retention and dry mouth because it is anti-cholinergic. Avoid using in patients with acute angle closure glaucoma because it increases intraocular pressure.
Adenosine/adenocard
PSVT, WPW
Restarts the heart. Slows AV nodal conduction to interrupt reentry pathways
a short period of asystole is common after administration. Bradycardia and hypotension may occur. Common side effects include facial flushing, shortness of breath, dyspnea, and chest pain. Recurrence of PSVT is common. PVCs may occur
Epinephrine
Asystole,VF, VT, PEA, hypotension, anaphylaxis.
First line in all cardiac arrest. It hasn’t alpha adrenergic effect to increase vasomotor tone for myocardial in cerebral perfusion. It’s beta-adrenergic effects stimulate the heart and increased myocardial contractility to improve cardiac output.
Expected response is the return of rhythm and pulse. Assess for tachycardia, dysrhythmias, or hypertension. Assess for the development of coarse VF when given during VF.
Heparin
AFib, Aflutter,
Prevention of clots. There is an increased risk for bleeding
Class I
Membrane stabilizing agents to decrease automaticity. There are three subclassification. Type 1A moderately slows conduction and prolongs repolarization, prolonging the QT interval. Type 1B shortens repolarization. Type 1C slows conduction and widens the QRS complex.
