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Dysrhythmias Abnormalities of electrical conduction or rhythm in heart. A defect of electrical impulses across myocardium and can occur in both healthy and heart may decreased cardiac output. Persistent or severe this with increased risk of stroke and heart.
Symptoms of dysrhythmias Dizziness and weakness decrease exercise tolerance SLB painting palpitations or sensation that their heart has skipped a beat
Diseases/conditions associated with dysrhythmias HTN cardiac valve disease such as aortic stenosis coronary artery disease medications such as digoxin low potassium or magnesium levels myocardial infarction stroke diabetes mellitus heart failure
Cardioversion electrical shocks to your heart through electrodes placed on your chest to restore normal heart rhytm
defibrillation stopping of fibrillation of the heart by administering a controlled electric shock to restore normal rhythm
Fibrillation Complete disorganization of rhythm
Sinus rhythm Action potential approximately 75 times per minute under resting conditions with a normal range of 60 to 100 bpm
Electrocardiogram (ECG) Graphic recording device to measure the way of electrical activity across the myocardium. Used to diagnose many types of heart conditions. Changes to wave patterns or timing reveal certain pathologies
Nonpharmacological therapies for dysrhythmias Cardioversion/defibrillation- electrical shock to allow us a note to regain control catheter ablation- identify/destroy apparent cardiac cells cardiac pacemaker- paces heart at set rate implantable cardioverter defibrillator- pacemaker/defibrillator
Anti-dysrhythmic drugs Act by altering specific electrophysiological properties of the heart by blocking flow through ion channels (conduction) or altering autonomic activity (automaticity)
Antidysrhythmic drug classes Class I: sodium channel blockers class II: beta-adrenergic antagonists class III: potassium channel blockers class for calcium channel blockers
procainamide Class: sodium channel blockers block sodium ion channels and suppress the topic activity to correct atrial and ventricle dysrhythmias. Action: class IA antidysrhythmic Admin: supine position IV admin due to severe hypotension. Preg Cat C
procainamide side/contraindictions side: N&V abdominal pain hypotension H/A confusion psychosis Con: patients with complete AV block severe HF myasthenia gravis blood dyscrasias
procainamide warning/interactions warning: increased tire of anti-nuclear antibodies lupus like syndrome reserved for life-threatening dysrhythmias new/worsen dysrhythmias agranulocytosis bone marrow depression neutropenia hypoplastic anemia thrombocytopenia d/c if blood dyscrasias
procainamide interactions Drug: additive cardiac the present effects if administered with other anti-dysrhythmias anticholinergic side effects will occur if given lapse:^ AST, ALT, ALP, LDH, serum bilirubin. False positive Coombs test & ANA titers may occur
amiodarone/ Cordarone Class: potassium channel blockers delay repolarization in less than refractory period stabilizes dysrhythmias. To treat resistant ventricular tachycardia atrial dysrhythmias with heart failure. Action: Class III anti-dysrhythmic
amiodarone/ Cordarone admin/side Admin: hypokalemia and hypomagnesemia corrected prior to therapy Preg Cat D Side: pulmonary toxicity elevated liver enzymes thyroid dysfunction bluegray scan word vision rashes photosensitivity anorexia fatigue dizziness hypotension N&V
amiodarone/ Cordarone warning Warning: (oral form only) pneumonia like syndrome in the lungs assessment of lung function amiodarone has probed this rhythmic action and calls bradycardia cardiogenic shock or AV block. Mild liver injury.
amiodarone/Cordarone conraindictions/labs con: Bradycardia cardiogenic shock sick sinus syndrome severe sinus node dysfunction third-degree AV block Labs: ^ levels of ANA ALT AST ALP TSH T4
amiodarone/Cordarone interactions-drug/food Inter: ^ serum digoxin levels block metabolism of warfarin requires lower dose of anticoagulant beta blocker/CCB worsen sinus bradycardia sinus arrest or AV block ^ phenytoin levels herbal: echinacea ^ hepatotoxicity aloe ^ effect of med
lifespan of antidysrhythmics As patients metabolize antidysrhythmics differently monitor ethnically diverse patients frequently to ensure optimal therapeutic effects and to minimize adverse effects older adults hypotension
pt teaching for antidysrhythmics Record peripheral pulse 1 min before taking abnormal call dr BP if below 90/60 in different positions take first dose at bedtime pulmonary toxicity signs of HF report immediately report vision changes wear protective clothing dr more 1 dose missed
Created by: bryant-41892