Dysrhythmias Medication

Question 1

Class 1A, 1B, 1C

Answer 1

Na+ channel blockers
(Procainamide,Lidocaine, Proprafenone)

Question 2

Class II

Answer 2

Beta Blockers
(Propranolol)

Question 3

Class III

Answer 3

K+ channel blockers
(Amiodarone)

Question 4

Class IV

Answer 4

Ca2+ channel blockers
(Verapamil)

Question 5

Digoxin

Answer 5

Use: HF and atrial fibrillation
Mechanism of action: Stimulates the vagus nerve causing it to release more acetylcholine. Also inhibits enzymes found in cardiac cells (potassium-ATPase, sodium)

Question 6

Digoxin HYC

Answer 6

Narrow therapeutic index
Causes GI disturbances (1st sign of toxicity- anorexia, n/v)
May cause visual disturbances as toxicity worsens (Blurred or yellow vision; halos around objects)
May cause Bradydysrhmias- causes dizziness fainting(syncope), and even death

Question 7

Amiodarone

Answer 7

Use: many dysrhythmias
Mechanism of action: Blocks potassium channels in the heart. Also sodium channels, beta receptors, and calcium channels.

Question 8

Amiodraone Toxicities (High Yield Concepts)

Answer 8

Lung (pulmonary fibrosis), Liver (Hepatotoxicity), Thyriod(hypo/hyperthyroidism), and Eye problems (optic neuropathy and corneal deposits)
** Can sometimes worsen heart rhythm problems or create new ones»> applies to all dysrhythmia meds

Question 9

Adenosine

Answer 9

Uses: Resets the heart, administered for SVT
Mechanism of Action: Slows down electrical activity in the SA and AV nodes.

Question 10

Adenosine High Yield Concept

Answer 10

Impending sense of doom and SOB

Question 11

In your own words, what is atrial fibrillation?

Answer 11

Irregular & rapid heart rhythm.

Question 12

What does adenosine do to a person’s cardiac rhythm?

Answer 12

Slows electrical activity in the SA & AV Nodes

Question 13

How do you administer adenosine?

Answer 13

It must be infused very quickly via an IV line. Push it very rapidly (1-2 seconds) and immediately flush the line with 20 mL of saline

Question 14

What condition does adenosine treat?

Answer 14

Supraventricular Tachycardia (SVT)

Question 15

Amiodarone is toxic to which organs?

Answer 15

Lung, liver, thyroid, and eyes

Question 16

Why are blood thinners often prescribed to someone with atrial fibrillation?

Answer 16

Chaotic heart rhythm can cause blood to get trapped in the atria, which can form blood clots. Blood thinners reduce the likelihood of blood clots forming

Question 17

What wave on the EKG is abnormal or missing with atrial fibrillation?

Answer 17

P wave

Question 18

Digoxin Therapeutic Index

Answer 18

HF: 0.5-1.0 ng/ml
Atrial fibrillation: 1.0-2.0 ng/ml
Level should never go above 2.0

Question 19

Digoxin Toxicity antidote

Answer 19

Digoxin Immune Fab