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3312 #3
Cardiovascular Drugs- Antidysrhythmics
| Question | Answer |
|---|---|
| agents that alter the heart's electrical conduction system are known as | antidysrhythmics |
| drugs that are used to treat or prevent abnormal cardiac rates and/or rhythms | antidysrhythmics |
| 3 goals of antidysrhythmics are: | 1. suppress or treat dysrhythmias 2. prevent or relieve symptoms 3. prolong survival |
| T or F Antidysrhythmics are used to potentially prolong life | True |
| heart's ability to generate an electrical impulse is known as | automaticity |
| movement of sodium and calcium ions into the cell, and movement of potassium out of the cell is known as | initiation of electrical impulse |
| period of decreased excitability is known as | refractory period |
| Dysrhythmia from SA node is called | sinus dysrhythmia |
| dysrhythmia from AV node is called | nodal dysrhythmia |
| dysrhythmia from atrium is called | atrial dysrhythmia |
| dysrhythmia from ventricles is called | ventricular dysrhthmia |
| A main concern with dysrhythmias is | decreased cardiac output |
| T or F An action of antidysrhythmics is to increase aut0maticity | False- an action of antidyysrhythmics is to decrease automaticity |
| T or F An action of antidysrhythmics is to slow conduction of electrical impulses | True |
| T or F An action of antidysrhythmics is to prolong refractory period | True |
| 3 Actions of Antidysrhythmics are: | 1. reduce automaticity 2. slow conduction of electrical impulses 3. prolong refractory period |
| T or F worsening of existing dysrhythmias is a potential general side effect or adverse effect | True |
| T or F New dysrhythmias will not occur as a result of antidysrhythmic use | False- new dysrhythmia formation is an adverse/general side effect of antidysrhythmic use |
| T or F Heart failure can be a general/adverse side effect of antidysrhythmic use | True |
| T or F Hypertension is a general/adverse side effect of antidysrhythmic use | False- hypotension is a general/adverse side effect of antidysrhythmic use |
| T or F fatigue is a general/adverse side effect of antidysrhythmic use | True |
| 5 General/Adverse Side effects are: | 1. worsening or existing dysrhythmias 2. New dysrhythmias 3. heart failure 4. hypotension 5. fatigue |
| 4 Classifications of Antidysrhythmics: | 1. Class 1: Sodium-channel blockers; 1A, 1B, 1C 2. Class 2: beta-adrenergic blockers 3. potassium channel blockers 4. calcium channel blockers |
| Classification of antidysrhythmic that prevents NA+ influx into myocardium | Class 1A Sodium Channel Blocker |
| 3 Mechanisms of Class 1A Sodium Channel Blockers (qunindine) are: | 1. reduces automaticity 2. slows conduction 3. prolongs refractory period |
| Example of Class 1A Sodium Channel Blocker is | quinidine |
| Unique features of Class 1A Sodium Channel Blocker | cinchonism- diarrhea |
| 2 Mechanisms of Class 1B Sodium Channel Blockers (lidocaine) | 1. decreases ventricular automaticity 2. selective depression of ectopic pacemakers |
| lidocaine falls under which Sodium Channel Blocker | Class 1B |
| quinidine falls under which sodium Channel Blocker | Class 1A |
| tamborcor falls under which Sodium Channel Blocker | Class 1C |
| propranolol falls under which class of antidysrhythmics | Class 2: Beta Adrenergic Blockers |
| unique features of Class 1B Sodium Channel Blockers include: | 1. CNS stimulation or depression (dose-dependent) |
| Mechanism of Class 1C Sodium Channel Blockers (flecainide) | greatly decreases ventricular conduction |
| flecainide is an example of which class of antidysrhythmic | Class 1C Sodium Channel Blocker |
| unique features of Class 1C Sodium Channel Blockers | 1. reserved for LIFE-THREATENING ventricular dysrhythmias that do not respond to safer drugs |
| unique features of Class 1C Sodium Channel Blockers | 1. reserved for LIFE-THREATENING ventricular dysrhythmias that do not respond to safer drugs |
| mechanisms of Class 2 Beta Adrenergic Blocker (propranolol) | 1. prevent adrenergic stimulation 2. myocardial depresion |
| propranolol is an example of which type of antidysrhythmic | Class 2 Beta Adrenergic Blockers |
| Unique features of Class 2 Beta Adrenergic Blockers (propranolol) | 1. activity intolerance 2. hypoglyemia (masks symptoms) 3. risk of bronchoconstriction |
| What is unique about flecainide | it is a last resort drug |
| All beta blockers end in? | olol |
| How do Class 2 Beta Adrenergic Blockers mas symptoms of hypoglycemia | symptoms of hypoglycemia occur due to stimulation of SNS, these meds block this ability to stimulate SNS, thus masking symptoms |
| Mechanisms of Class 3 Potassium Channel Blockers (amiodarone) | 1. inhibits adrenergic stimulation (prolongs refractory period) 2. slows SA, AF conduction |
| amiodarone is an example of what type of antidysrhythmic | Class 3 Potassium Channel Blocker |
| unique features of Class 3 Potassium Channel Blockers (amiodarone) are | 1. used in ER situations, given IV 2. limited use PO; serious adverse effects 3. long half life |
| A serious adverse effect of Class 3 Potassium Channel Blockers (amiodarone) is | pulmonary fibrosis |
| what is unique about Class 3 Potassium Channel Blockers in relation to pharmacist | pharmacist must counsel pt before giving |
| mechanisms of Class 4 Calcium Channel Blockers (verapamil) | 1. improves coronary blood flow by relaxing smooth muscle 2. slows SA and AV conduction |
| verapamil is an example of which class of antidysrhythmic | Class 4 Calcium Channel Blockers |
| unique features of Class 4 Calcium Channel Blockers | effect on heart rate and blood pressure |
| contraindication for antidysrhythmics | heart block |
| Interactions with antidysrhythmics would include any other drugs that affect ___ | 1. contractility 2. cardiac rate and/or rhythm 3. blood pressure |
| As a nurse, you assess which 6 things for a pt on antidysrhythmics | 1. apical heart rate and rhythm 2. B/P 3. peripheral edema 4. activity intolerance 5. respiratory status 6. ECG |
| Alternative Treatment for very fast heart rate: | carotid sinus massage valsalva maneuver |
| Alternative Treatment for very slow heart rate: | pacemaker |
| non-allopathic drugs are: | omega 3 fatty acids- unclear or conflicting evidence mistletoe- used in other countries for heart palpatations; no scientific evidence |
| deficient knowledge of self care while taking antidysrhythmic drugs r/t inadequate teaching interventions? | 1. activity intolerance 2. take in regular spaced intervals 3. suppresses CNS response 4. stay away from caffeine 5. the purpose is to keep HR down 60-65 |
Created by:
Black88cat
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