NR 291 Chapter 25: Antidysrhythmic Drugs

NR 291 STUDY GUIDE EXAM 3 Study Guide – Exam 3 60 Questions – Multiple Choice, Select All That Apply, Multiple Sequence Chapter 25: Antidysrhythmic Drugs • Which 3 electrolytes are involved in cardiac electrical impulses o Sodium, potassium, and calcium • Common dysrhythmias (ventricular, supraventricular, conduction blocks) o Ventricular  Ventricular tachycardia  Ventricular fibrillation o Supraventricular dysrhythmias  Supraventricular tachycardia (SVT)  Atrial flutter  Atrial fibrillation o Conduction blocks  First-degree  Second-degree (Mobitz I – Wenchebach, & Mobitz II)  Third-degree (complete heart block) – no drug therapy • Name of classification system for antidysrhythmics o “Vaughan Williams Classification” o Know which drug classifications slow down the heart  CCBs, Digoxin, Beta-Blockers o Know which drugs slow the heart’s electrical impulses by blocking potassium channels  Amiodarone, Sotalol, Dofetilide • Class I: fast sodium channel blockers, negative inotropic effect (decrease contractility) o 1a: quinidine, procainamide: 1, 5  For a fib, premature atrial contraction, premature ventricular contractions, and v tach  Adv Eff • Quinidine – cinchonism (tinnitus, loss of hearing, slight blurring of vision, and GI upset) • Procainamide – systemic lupus erythematosus (30%), torsades de pointes (multiple V Tach) o 1b: lidocaine, phenytoin: 1, 5, 12 • Lidocaine is used for ventricular dysrhythmias only o Adv Eff – CNS – twitching, convulsions, confusion, tinnitus • Phentoid is used for atrial and ventricular Tach caused by digitalis tox, and long QT syndrome  These drugs act on ischemic myocardial tissue  Give Diulantin if seizures occur o 1c: flecainide, propafenone: 1, 5  More pronounced sodium channel blocking effect  Used for severe Vent dysrhythmias, A fib/flutter, Wolff-Parkinson-White syndrome, and SVT  Adv Eff – dizinness, visual disturbances, dyspnea, metallic taste with propafenone  Flecainide is first line for A Fib • Class II: Beta-Blockers (-olol): 1, 5