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amiodarone

cordarone

Amiodarone (Cordarone) class

Class III antidysrhythmic

Amiodarone (Cordarone) action

prolongs action potential and duration in cardiac tissues through sodium, potassium, and calcium channels; blocks A and B adrenergic receptors

Amiodarone (Cordarone) indications

ventricular tachycardia, ventricular fibrillation that is unresponsive to CPR, defibrillation, and vasopressor therapy

Amiodarone (Cordarone) contrindication

breastfeeding, bradycardia, high-grade heart block, hypersensitivity to medication

Amiodarone (Cordarone) doses

150.0-300.0 mg

Amiodarone (Cordarone) routes

IV

Amiodarone (Cordarone) adverse effects

hypotension, bradycardia, prolonged PR, QRS, and QT

Amiodarone (Cordarone) other

constant ECG monitoring

now first-line agent in ventricular fibrillation and tachycardia

Lidocaine

Xylocaine

Lidocaine (xylocaine) class

Class 1B Antidysrhythmic; Local Anesthetic

Lidocaine (xylocaine) action

amide-type local anesthetic; slows depolarization and automaticity

Lidocaine (xylocaine) indication

ventricular tachycardia, ventricular fibrillation that is unresponsive to CPR, defibrillation, and vasopressor therapy

Lidocaine (xylocaine) contraindication

should not be administered to patients receiving IV calcium channel blockers

Lidocaine (xylocaine) doses

1.0-1.5 mg/kg

Lidocaine (xylocaine) routes

IV

Lidocaine (xylocaine) adverse effects

hypotension, bradycardia, prolonged PR, QRS, and QT

Lidocaine (xylocaine) other

use with caution when administered with other antiarrhythmics

procainamide

pronestyl

procainamide (pronestyl) class

Class 1A antiarrhythmic; local anesthetic

procainamide (pronestyl) action

Ester-type local anesthetic; reduces automaticity and AV conduction

procainamide (pronestyl) indication

ventricular tachycardia with pulse, pre-excited atrial fibrillation

procainamide (pronestyl) contraindications

should not be administered to patients receiving IV calcium channel blockers

procainamide (pronestyl) doses

20.0-50.0 mg/min

procainamide (pronestyl) routes

IV

procainamide (pronestyl) adverse effects

drowsiness, slurred speech, confusion, seizures, hypotension

procainamide (pronestyl) other

carefully monitor ECG (QRS duration) during administration

phenytoin

dilantin

phenytoin (dilantin) class

class 1B antiarrhythmic; anticonvulsant

phenytoin (dilantin) actions

depresses automaticity and AV conduction; reduces voltage and spread of electrical discharges in motor cortex

phenytoin (dilantin) indication

life-threating arrhythmias from digitalis toxicity, seizures

Phenytoin (Dilantin) contraindications

bradycardia, high-grade heart block, hypersensitivity to medication

phenytoin (dilantin) doses

15.0-18.0 mg/kg

phenytoin (dilantin) routes

IV

phenytoin (dilantin) adverse effects

drowsiness, dizziness, headache, hypotension, arrhythmias, nausea, vomiting

phenytoin (dilantin) other

fosphenytoin preferred for seizure management

Adenosine

adenocard

adenosine (adenocard) class

nucleoside

adenosine (adenocard) action

slows AV conduction; short half-life

adenosine (adenocard) indications

supraventricular tachyarrhythmias

adenosine (adenocard) containdications

atrial fibrillation, Torsades des pointes, atrial fibrillation

adenosine (adenocard) doses

6.0 mg

adenosine (adenocard) routes

IV

adenosine (adenocard) adverse effects

facial flushing, headache, chest pain, nausea

adenosine (adenocard) other

should be given by rapid IV push followed by saline bolus; arrhythmias are common following administration

esmolol

brevibloc

esmolol (brevibloc) class

class II antiarrhythmic; beta blocker

esmolol (brevibloc) action

slows heart rate through selective blockade of B1 receptors; short half-life

esmolol (brevibloc) indications

tachycardia

esmolol (brevibloc) contraindications

asthma, heart block, bradycardia, cardiogenic shock

esmolol (brevibloc) doses

50.0-100.0 mcg/kg/min

esmolol (brevibloc) routes

IV

esmolol (brevibloc) adverse effects

bradycardia, hypotension, congestive heart failure, lethargy

esmolol (brevibloc) other

hypotension common but dose-related; should not be administered to patients receiving IV calcium channel blockers

labetalol

trandate, normodyne

labetalol (trandate, normodyne) class

class II antiarrhythmic; beta blocker

labetalol (trandate, normodyne) action

lowers blood pressure through nonselective blockade of B receptors (and limited blockade of A2 receptors)

labetalol (trandate, normodyne) indications

rapid ventricular rate associated with atrial fibrillation, stable narrow-complex tachyarrhythmias

labetalol (trandate, normodyne) contraindication

hypotension, congestive heart failure, cardiogenic shock, wide-complex ventricular tachycardia

labetalol (trandate, normodyne) doses

15.0-20.0 mg

labetalol (trandate, normodyne) routes

IV

Labetalol (Trandate, Normodyne) adverse effects

nausea, vomiting, dizziness, headache, hypotension

labetalol (trandate, normodyne) other

can be given as IV bolus or IV infusion; calcium chloride can reverse some of untoward effects

diltiazem

cardizem

diltiazem (cardizem) class

class IV antiarrhythmic; calcium channel blocker

diltiazem (cardizem) action

lowers blood pressure by relaxing vascular smooth muscle; slow AV conduction

diltiazem (cardizem) indications

rapid ventricular rate associated with atrial fibrillation; stable narrow-complex tachyarrhythmias

diltiazem (cardizem) contraindication

hypotension, congestive heart failure, cardiogenic shock, wide-complex ventricular tachycardia

diltiazem (cardizem) dose

15.0-20.0 mg

diltiazem (cardizem) routes

IV

diltiazem (cardizem) adverse effects

Nausea, vomiting, dizziness, headache, hypotension

diltiazem (cardizem) other

can be given as IV bolus or IV infusion; calcium chloride can reverse some of untoward effects

magnesium sulfate

no other name

magnesium sulfate class

mineral/electrolyte

magnesium sulfate action

physiologic calcium channel blocker; bronchodilator

magnesium sulfate indication

torsades des pointes, asthma, hypertensive disorders of pregnancy

magnesium sulfate contraindications

high-degree heart blocks, shock, dialysis, hypocalcemia, ventricular fibrillation/pulseless ventricular tachycardia in adult patients

magnesium sulfate doses

1.0-2.0 g

magnesium sulfate routes

IV

magnesium sulfate adverse effects

flushing, sweating, bradycardia, respiratory depression, hypothermia

magnesium sulfate other

can cause cardiac conduction problems in conjunction with digitals

nitroglycerin

nitrostat

nitroglycerin (nitrostat) class

nitrate

nitroglycerin (nitrostat) action

relaxes vascular smooth muscle, causing vasodilation, decreased cardiac work, and improved coronary blood flow

nitroglycerin (nitrostat) indication

chest pain, congestive heart failure

nitroglycerin (nitrostat) contraindications

hypotension, increased intracranial pressure

nitroglycerin (nitrostat) doses

0.4 mg

nitroglycerin (nitrostat) routes

SL (tablet or spray), IV

nitroglycerin (nitrostat) adverse effects

headache, dizziness, weakness, tachycardia, hypotension

nitroglycerin (nitrostat) other

tablets lose effectiveness after exposure to air; monitor BP closely

nitroglycerin paste

no other name

nitroglycerin paste class

nitrate

nitroglycerin paste action

relaxes vascular smooth muscle, causing vasodilation, decreased cardiac work, and improved coronary blood flow

nitroglycerin paste indications

chest pain, congestive heart failure

nitroglycerin paste contraindications

hypotension, increased intracranial pressure

nitroglycerin paste doses

0.5-1.0 inch

nitroglycerin paste routes

transdermal

nitroglycerin paste adverse effects

headache, dizziness, weakness, tachycardia, hypotension

nitroglycerin paste other

do not get paste on your finger because it can cause a headache. monitor BP closely

diphenhydramine

benadryl