Rhythm Control Flashcards
Amiodarone dosage
AKA Cordarone
600-1200 mg QD for 1-2 wks, then taper to lowest possible dosage
200 mg QD for maintenance dosage
Disopyramide dosage
AKA Norpace
400-800 mg per day in divided doses
Dofetilide dosage
AKA Tikosyn
500 mcg PO q12 hrs at initiation of therapy, titrate downward based on QT response
Flecainide dosage
AKA Tambocor
100-150 mg taken at onset of a fib
May also be taken BID for prevention of a fib
Ibutilide
AKA Corvert
A one-time 1 mg dosage, may repeat once after 10 minutes if no response
Procainamide
Up to 50 mg per kg per day in divided doses
Propafenone
AKA Rythmol
225-425 mg PO q12 hours
Quinidine
324-648 mg
1-2 tablets every 8-12 hrs
Sotalol
AKA Betaspace
80-160 mg BID
AE Cordarone
AKA Amiodarone
abnormal cardiac conduction, anaphylaxis, HF, pulmonary toxicity, ocular toxicity, thyroid abnormalities, hypersensitivity rxn, liver failure, lupus, thyromocytopenia, Stevens-Johnson Syndrome
AE Norpace
AKA Disopyramide
torsades de pointes (uncommon and distinctive form of polymorphic ventricular tachycardia characterized by a gradual change in the amplitude and twisting of the QRS complexes around the isoelectric line), drug induced lupus, hepatotoxicity, hypoglycemia, HF
AE Tikosyn
AKA Dofetilide
Prolonged QT interval and various proarrhythmias
Use is restricted to trained prescribers and facilities
In-hospital ECG monitoring required for at least 3 days
AE Tambocor
AKA Flecainide
Various proarrhythmias, torsades de points
NOT recommended for pts with chronic a fib
AE Corvert
AKA Ibutilide
Polymorphic ventricular tachycardia, hypotension, HA
Caution is needed in pots with QT elongation, hypokalemia, hypomagnesemia, bradycardia
Continuous ECG monitoring required for 4 hrs after last dosage
AE Procainamide
Procainamide
agranulocytosis, aplastic anemia, coag disorder, arrhythmia, hepatotoxicity, drug-induced lupus
AE Rythmol
AKA Propatenone
agranulocytosis, angina, chest pain, HF, atrioventricular shock, bradyarrhythmias, hypotension, palpitations, sinus arrest, drug-indced lupus, bronchospasm
AE Quinidine
Quinidine
various proarrhythmias, tornadoes de pointes, hepatotoxicity, kidney dz, myelosuppression (bone marrow suppression), drug-induced lupus
AE Betaspace
AKA Sotalol
torsades de pointes, various proarrhythmias, HF, bradycardia, heart block, asthma
Continuous ECG monitoring required for 3 days after initiation of therapy
Avoid in renal insufficient pts
What anti-arrhythmic medications are preferred in pts with minimal or no heart disease and preserved LV systolic fxn?
Flecainide and propafenone
What anti-arrhythmic medications are preferred in pts with HF?
Amiodarone and foretilide
What pts use “pill-in-the-pocket” method and what meds are used for this?
Paroxysmal a fib
Flecainide or propafenone
Guidelines for anticoag in cardioversion
3 weeks before and 4 weeks after cardioversion because thrombi may form as soon as 48 hrs after the onset of a fib
