Acute Flashcards

Question

CLASSIFICATION OF: PROPAFENONE (Rhythmol)

Answer 1

* Class 1 Antiarrhythmics | * Class 1C- Sodium channel blockers

Answer 2

* Life-threatening ventricular arrhythmias * Paroxysmal atrial fibrillation * Paroxysmal supraventricular tachycardia

Answer 3

*Slows conduction in cardiac tissues by altering transport of ions across cell membranes and depress depolarization

Answer 4

* CHF * Less severe ventricular arrhythmias * Heart blocks * Sick sinus syndrome **Use CAUTIOUSLY in potassium imbalances

Answer 5

* CNS: dizziness, shaking, weakness * EENT: blurred vision * CV: supraventricular arrhythmias, ventricular arrhythmias, conduction disturbances, angina, hypotension, bradycardia * GI: Altered taste, constipation, dry mouth * DERM: rash * MS: Joint pain

Answer 6

* PO (Adults): 150 mg q8 hours. | * May be gradually increased at 3-4 day intervals as required up to 300 mg q8-12 hours

Answer 7

* Therapy should be initiated in a hospital with facilities for cardiac rhythm monitoring as most serious side effects are seen within the first 2 weeks of therapy * Monitor BP and pulse periodically throughout therapy * May cause prolongation of PR or QT intervals * Assess client for signs of CHF. May require reduction of d/c of therapy

Answer 8

AMIODARONE

Answer 9

Class III Antiarrhythmics

Answer 10

* Control of supraventricular and ventricular dysrhythmias unresponsive to less toxic agents * Management and prophylaxis of recurring ventricular fibrillation and unstable ventricular tachycardia unresponsive to other drug therapy

Answer 11

* Prolongs action potential and refractory period; inhibits adrenergic stimulation by preventing the release of norepinephrine from the sympathetic nerve sites * Slows the sinus rate, increases PR and QT intervals, and decreases peripheral vascular resistance (vasodilates)

Answer 12

* Bradycardia * Sinus node dysfunction * Second and third degree AV block * Cardiomegaly *Used cautiously in liver, pulmonary and thyroid disease

Answer 13

* CNS: peripheral neuropathy, tremors, paresthesia, headache, malaise, fatigue, insomnia, abnormal taste and smell * CV: CHF, hypotension, bradycardia * DERM: blue-gray skin discoloration * ENDO: thyroid dysfunction * GI: abnormal liver function

Answer 14

* IV: 150 mg over 10 minutes, followed by 360 mg over the next 6 hours and then 540 mg over the next 18 hours. Continue infusion at 0.5 mg/minute until oral therapy is initiated * ACLS guidelines for pulseless VTACH/VFIB: 300 mg IVP, may repeat once after 3-5 minutes with 150 mg IVP * PO: 400 mg/day

Answer 15

* When giving to a client on Digoxin, be aware that the dose of Digoxin should be reduced by 50% * Hypokalemia should be corrected before therapy * Instruct client to avoid sun exposure * IV administration should occur through a central line. IV solution must be administered using glass bottles and a filter.

Answer 16

Class IV Antiarrhythmics (Calcium channel blockers)

Answer 17

* Treatment of supraventricular tachyarrhythmias and rapid ventricular rates in atrial fibrillation or flutter * Management of all forms of angina pectoris * Treatment of mild to moderate hypertension

Answer 18

* Inhibits the transport of calcium into myocardial and vascular smooth muscle cells. * Systemic vasodilation resulting in decreased BP. * Coronary vasodilation resulting in decreased frequency and severity of angina. * Suppression of dysrhythmias.

Answer 19

* Hypersensitivity * Sick sinus syndrome * Second and third degree AV block * Blood pressure <90mmHG * Recent MI * Pulmonary congestion * CHF * Cardiogenic shock * Wolff-Parkinson-White syndrome

Answer 20

* CV: sympathetic and orthostatic hypotension, bradycardia, conduction disturbances, heart failure, edema * DERM: flushing, sweating * CNS: headache, tremors * GI: esophageal reflux, constipation * GU: urinary retention

Answer 21

PO- Adults: 30-120 mg, 3-4 times/day or 60-120 mg BID as SR capsules or 180-240 mg daily as CD or XR capsules IV-Adults: 0.25 mg/kg. May repeat in 15 minutes with a dose of 0.35 mg/kg. May follow with a continuous infusion at 10 mg/hour (range 5-15mg/hr) for up to 24 hours

Answer 22

* Client must be on EKG monitor. * Monitor BP and pulse before and frequently during administration. * Assess for signs of CHF. * Report bradycardia or prolonged hypotension promptly. * Do not open, crush, break, or chew sustained release capsules/tablets. * Direct IV may be administered undiluted. * Monitor digoxin levels for toxicity.

Answer 23

Miscellaneous Antiarrhythmics

Answer 24

* Conversion of paroxysmal supraventricular tachycardia (PSVT) to normal sinus rhythm (NSR) when vagal maneuvers are unsuccessful * Diagnostic agent to assess myocardial perfusion defects * ACLS: First-line drug therapy in ACLS protocol for PSVT

Answer 25

* Slows AV conduction and interrupts re-entry through accessory pathways. Also produces coronary artery vasodilation. * Has extremely short half-life of <10 seconds * Onset- Immediate * Peak-within seconds * Duration: 1-2 minutes

Answer 26

* Hypersensitivity * Sick sinus syndrome * Second and third degree AV block * Use with caution in asthma

Answer 27

* CNS: dizziness, headache, apprehension, blurred vision, tingling, numbness * CV: palpitations, chest pain, hypotension, transient dysrhythmias, bradycardia * DERM: facial flushing, sweating, burning sensation * RESP: dyspnea, bronchospasm in asthmatics, hyperventilation * GI: metallic taste, tight throat

Answer 28

IV-Adults: 6mg by rapid IV bolus. If no result, repeat 1-2 minutes later as 12 mg rapid bolus. This dose may be repeated (single dose not to exceed 12 mg)

Answer 29

* Client must be on EKG monitor. * Administer over 1-2 seconds via direct IV or into proximal IV line. Follow with rapid NSS flush to ensure injection reaches systemic circulation. * Crystals may form when the drug is refrigerated; warm to room temperature to dissolve. * Give undiluted.

Answer 30

Miscellaneous Antiarrhythmics

Answer 31

Treatment of CHF, tachyarrhythmias, atrial fibrillation or flutter with rapid ventricular response; paroxysmal atrial tachycardia

Answer 32

* Increases the force of myocardial contraction (Positive Inotrope) * Prolongs refractory period of the AV node and slows conduction through the SA and AV nodes (Negative Chromotrope)

Answer 33

* Bradycardia * Ventricular tachycardia or fibrillation * AV block * Constrictive pericarditis **Use with caution in electrolyte imbalance (Hypokalemia, Hypomagnesemia, Hypercalcemia) ***Use with caution in renal failure due to decreased renal excretion of the drug

Answer 34

* CV: arrhythmias, bradycardia * CNS: fatigue, headache, weakness * EENT: blurred vision, yellow vision, HALO APPEARANCE (A HALLMARK SIGN OF DIGOXIN TOXICITY) * GI: anorexia, nausea, vomiting

Answer 35

* Digitalizing dose: for rapid effect, a larger initial loading dose should be given in several divided doses over 12-24 hours * IV- ADULT: 0.6-1 mg given as 50% of the dose initially and additional fractions given at 4-8 hour intervals * PO- ADULT: 0.75-1.25 mg given as above * Maintenance dose: Adult PO 0.063-0.5 mg/day **NORMAL THERAPEUTIC BLOOD LEVEL: 0.5-2

Answer 36

* Monitor apical pulse for 1 full minute before administration, hold and notify physician if pulse<60 bpm in an adult * Notify physician before giving dose if client has electrolyte imbalances; (hypokalemia, hypomagnesemia, or hypercalcemia) May make client more susceptible to digitalis toxicity * IV doses may be given undiluted over 5 minutes * Y-site incompatible with propofol, amphotericin B and fluconazole

Answer 37

Miscellaneous Antiarrhythmics

Answer 38

* Multiple uses; also an anticholinergic drug * IV: treatment of sinus bradycardia and heart block * IM: pre-op use is to decrease oral and respiratory secretions * PO: adjunctive therapy in the management of peptic ulcer disease and irritable bowel syndrome

Answer 39

* Blocks the effect of stimulation of cholinergic receptors by acetylcholine * Inhibits the effects of stimulation of the parasympathetic nerves, thus permitting the effects of the sympathetic nervous system to predominate

Answer 40

* Narrow-angle glaucoma * Asthma * Urinary or GI obstruction * Intestinal atony * Paralytic Ileus * Myasthenia Gravis * Ulcerative Colitis * Hiatal Hernia * Serious hepatic and renal disease

Answer 41

* CNS: Ataxia, restlessness, confusion * CV: tachycardia, palpitations, hypertension * GI: Dry mouth, constipation * GU: urinary hesitancy, retention * EENT: blurred vision, increased intraocular pressure * DERM: decreased sweating, flushing, rash, elevated body temperature

Answer 42

* IV-ADULTS: 0.5-1.0 mg; may repeat as needed q 5 minutes; (q3-5 minutes in ACLS guidelines) May administer via endotracheal tube- use 2-10 times the IV dose * IV-CHILD: 0.01-0.03 mg/kg (range is 0.1-0.5 mg in child or up to 1 mg in adolescents); May repeat q 5 minutes up to a total dose of 1 mg in child (2mg in teens)

Answer 43

* Direct IV may give undiluted or dilute in 10 ml sterile water. * Do not add to IV solution. * Administer as a rate of 0.6 mg over 1 minute. * When given over 1 minute, may cause paradoxical bradycardia, which usually resolves in approximately 2 minutes.

Answer 44

PROCAINAMIDE

Acute Flashcards

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