antidysrythmias
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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.
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| Symptoms of dysrhythmias | Dizziness and weakness decrease exercise tolerance SLB painting palpitations or sensation that their heart has skipped a beat
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| 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
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| Cardioversion | electrical shocks to your heart through electrodes placed on your chest to restore normal heart rhytm
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| defibrillation | stopping of fibrillation of the heart by administering a controlled electric shock to restore normal rhythm
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| Fibrillation | Complete disorganization of rhythm
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| Sinus rhythm | Action potential approximately 75 times per minute under resting conditions with a normal range of 60 to 100 bpm
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| 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
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| 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
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| Anti-dysrhythmic drugs | Act by altering specific electrophysiological properties of the heart by blocking flow through ion channels (conduction) or altering autonomic activity (automaticity)
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| Antidysrhythmic drug classes | Class I: sodium channel blockers
class II: beta-adrenergic antagonists
class III: potassium channel blockers
class for calcium channel blockers
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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.
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| 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
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| 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
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| 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
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| 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
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