Week 10- Arrhythmias - Pharmacuetical care Issues Flashcards
What is the arrythmia causing heart block
bradycardia
what is the arrhythmia causing AF
tachycardia
How is COmplete heart block diagnosed
ECG - Regular P wave but QRS not always present
What treatment is provided for CHB
PPM
Drug therapy review
What drugs are usually stopped after a CHB
- Warfarin is stopped so a PPM can be put in
- Diltiazem ( Rate limiting CCB)
- B - blocker
What is the criteria for first, second & third degree heart block
1:1 P waves to QRS BUT long PR interval
delayed AV node conduction
2nd degree - Not all P waves present in QRS complex
A contraction not always follewed by VEntricular contraction
2:1 ratio
3 degree - No conductive through AV node
SA continues contraction of atria
Much slower ventricular contraction
What are the pharmacuetical care issuues with bradycardia ( Heart block)
- Stop rate controlling drugs
- Stop anticoagulants until PPM done
What drug therapy is given for rhythm & rate control in heart block
- Amiodarone
- 200mg tds 1 week then BD for 2 week
Rate control - Digoxin
500mcg 2x stat dose 6 hrs apart
What are the side effects of Amiodarone ?
- Bradycardia
- Phototoxicity
- grey skimn
- liver dysfunction
- pulmonary toxicit
- thyroid dysfunction
What are Digoxin Side effects
- Nausea
- vomiting
- anorexia
- Bradycardia
What are the interactions between amiodarone and digoxin ?
Amiodarone increases digoxin SO if combined half the digoxin dose
