dysrhythmia drugs (broadhead)

Question 1

prototype names for class 1/Sodium channel blockers

Answer 1

class 1A Quinidine and Procainamide (Pronestyl; class 1B Lidocaine (Xylocaine); class 1C Flecainide (Tabocor)

Question 2

action of quinidine and procainamide

Answer 2

slows impulse conduction, decreases automaticity of ventricles, lengthens refractory period

Question 3

indications for quinidine and procainamide

Answer 3

treats atrial fibrillation and flutter, supraventricular and ventricular tachycardias; procainamide - short terms, quinidine - long term

Question 4

side effects for quinidine and procainamide

Answer 4

nausea, vomiting, diarrhea, ventricular dysrhythmias, arterial embolism, sppeed shock; procainamide - SLE, agranulocytosis

Question 5

adverse reactions for quinidine and procainamide

Answer 5

long QT leading to torsades de points

Question 6

contraindications for quinidine and procainamide

Answer 6

known allergy, widened QT, heart block, hypotension

Question 7

special considerations for quinidine and procainamide

Answer 7

monitor HR and BP, monitor ECG periodically, monitor plasma levels

Question 8

action of lidocaine

Answer 8

slows impulse conduction, decreases automaticity of ventricles, shortens refractory period

Question 9

indications for lidocaine

Answer 9

IV controls ventricular dysrhythmias caused by MI, cardiac surgery or procedures, digoxin toxicity; local - provides anesthesia

Question 10

side effects of lidocaine

Answer 10

hypotension, bradycardia, heart block, decreases QR interval

Question 11

adverse effects of lidocaine

Answer 11

toxicity (confusion, drowsiness, restlessness, paresthesias, twitching or tremors, seizures, respiratory arrest)

Question 12

contraindications of lidocaine

Answer 12

known allergy, supraventricular dysrhythmias, heart block

Question 13

special considerations for lidocaine

Answer 13

monitor CNS effects, monitor vital signs and cardiac rhythm

Question 14

flecainide actions

Answer 14

slows impulse conduction, decreases automaticity of ventricles

Question 15

indications of flecainide

Answer 15

treats serious supraventricular and ventricular tackydysrhythmias and controlled by other drugs

Question 16

side effects of flecainide

Answer 16

blurry vision, difficulty focusing, worsening heart failure, edema, widens QRS, prolongs PR/QT intervals

Question 17

adverse effects of flecainide

Answer 17

cardiovascular collapse, arrest, fatal ventricular dysrhythmias

Question 18

contraindications of flecainide

Answer 18

second or third degree block, recent MI, electrolyte imbalance

Question 19

special considerations of flecainide

Answer 19

monitor for visual effects for cracks in the lungs, edema, and weight gain, monitor periodic ECG

Question 20

class 2/beta adrenergic blockers prototype name

Answer 20

propanolol (Inderal)

Question 21

actions of propanolol

Answer 21

decreases sympathetic nervous system effects, decreases SA/AV node automaticity, decreases contracility

Question 22

indications for propanolol

Answer 22

treats tachydysrhythmias, hypertension, pain from angina, decreases mortality following MI, prophylaxis for migranes

Question 23

side effects of propanolol

Answer 23

bradycardia, heart failure with sudden withdrawl, causes angina or MI, Raynaud’s confusion, fatigue, drowsiness

Question 24

adverse effects of propanolol

Answer 24

pulmonary edema, heart failure, laryngospasm

Question 25

contraindications of propanolol

Answer 25

bradycardia, pulmonary edema, cardiogenic shock, COPD

Question 26

special considerations for propanolol

Answer 26

monitor HR if

Question 27

class3/potassium channel blockers prototype name

Answer 27

amiodarone (Cordarone)

Question 28

action of amiodarone

Answer 28

decrease automaticity, slows conduction through the AV node, decreases contractility, dilates coronary and peripheral vessels, widens QRS, prolongs QT and PR intervals

Question 29

indications for amiodarone

Answer 29

manages life threatening ventricular tachycardia or fibrillation that is resistant to other drugs, treats atrial fibrillaiton

Question 30

side effects of amiodarone

Answer 30

nausea, vomiting, constipation, bradycardia, and hypotension, worsening heart failure, bue-gray discoloration of skin, dizziness, hallucinations, tremors

Question 31

adverse effects of amiodarone

Answer 31

pulmonary toxicity with pneumonitis

Question 32

contraindications of amiodarone

Answer 32

bradycardia, severe hepatic disease

Question 33

special considerations of amiodarone

Answer 33

monitor bowl function and pulmonary function, monitor vision, HR, BP, ECG, skin and CNS

Question 34

class 4/calcium channel blockers prototype name

Answer 34

verapamil (Calan) and diltiazem (Cardizem)

Question 35

actions of verapamil and diltiazem

Answer 35

slows sutomaticity of the SA node, slows conduction through the AV node, decreases contractility, prolongs PR interval

Question 36

indications for verapamil and diltiazem

Answer 36

converts supraventricular tachycardia to NSR, slows rate of atrial fibrillation and flutter, treats angina and hypertension

Question 37

side effects of verapamil and diltiazem

Answer 37

hypotension expecially with IV dose, bradycardia, heart failure, peripheral edema of feet and legs, lightheadedness, dizziness

Question 38

adverse effects of verapamil and diltiazem

Answer 38

dysrhythmias, Stevens Johnsons syndrome

Question 39

contraindications of verapamil and diltiazem

Answer 39

cardiogenic shock, hypotension

Question 40

special considerations for verapamil and diltiazem

Answer 40

monitor vital signs, ECG, hold for systolic BP >90 or