med surg ECG MEDS

class 1 antidysrhythmics

blocks sodium channels in myocardial cells

class 2 antidysrhythmic

beta blockers ( blocks beta 1 or/and 2)

class 3

potassium channel blocker

class. 4

calcium channel blocker

Class 5

variable meds

Quinindine

class 1-A

blocks Na/K and slows rapid arrhythmias

Uses for Quinidine (Quinidex)

SVT, V tach ( not a A-fib/A flutter)

side effects/adverse effects of Quinidine (Quinidex)

diarrhea + dysrhythmias ( AV block, V tach, Asystole)…… and Quinidine can potentiate (increase the effects of) digoxin

Iidocaine (Xylocaine)

class 1-B

slows conduction in atria and ventricles

accerlates repolarization

uses for Iidocaine (Xylocaine)

ventricular dysrhythmias

adverse effects of lidocaine (Xylocaine)

CNS effects ( drowsiness, confusion, seizures) + dangerous to those with liver failure ( it metabolizes in the liver)

propranolol and carvedilol

noncardioselective ( blocks B1 and 2)

metoprolol and atenolol

cardioselective (blocks b1)

action on beta blockers

decreases HR

decreases contracility (limits Ca in myocardial cells)

uses for beta blockers

HTN

MI

tachycardia

side effects/adverse effects on beta blockers

beta 1: bradycardia, hypotension, heart failure, AV block

beta 2: bronchoconstriction, and hypoglycemia

amiodarone

class 3

lengthens repolarization phase

amidoarone uses

treats A fib, and v tach/fib

side effects/adverse effects

n/v, headache,

dysrhythmias (prolonged QT)

pulmonary fibrosis

liver toxicty

if v tach is unresponsive to amiodarone, what is the next drug to try?

procainamide

verapamil (calan) and diltriazem ( cardizem)

ca+ channel blockers

actions: lengthens depolarization phase

SA and AV nodes and decerases contracilitiy

vasodilation

uses for Verapamil (Calan) and diltriazem (Cardizem)

atrial fibrillation/flutter, SVT, Vtach

Side effects/ adverse effects of verapamil (Calan) and diltriazem ( Cardizem)

hypotension, bradycardia, AV block, and peripheral edema

adenosine (adenocard)

variable mechanism

adenosine (Adenocard) actions

blocks calcium influx in SA/ AV node

very short half life: 1.5 -10 seconds

first give 6 mg, then give 12 mg

adenosine (Adenocard) uses

Paroxysmal supraventricular tachycardia (SVT)

Adenosine (Adenocard) side effects/adverse effects

bradycardia and dyspnea, CP

digoxin ( Lanoxin) action

activates the vagus nerve (PNS)

Decreases AV confuction; SA automaticity

increases contractility of ventricles

digoxin (lanoxin) uses

atrial dysrhythmias ( A fib, SVT)

congestive HF

Digoxin ( Lanoxin) side effects

n/v, GI upset most common s/e

CNS effects: depression, hallucinations

bradycardia, arrhythmias ( V tach/ V fib)

atropine sulfate

cholinergic blockers

Atropine sulfate action

muscarinic antagonist (turns off parasympathetic NS)

atropine sulfate use

symptomatic bradycardia

atropine sulfate adverse effects

tachycardia, CP, dry mouth, urinary retention, restlessness, anxiety (turning on SNS) and HTN

epinephrine (Adrenalin) action

A1, B1, B2 agonist

uses for epinephrine (Adrenalin)

v-tach, V-fib (1:10,000 concentration)

cardiac arrest (asystole/PEA) (1:10,000 concentration)

anaphylaxis ( 1:1000 concentration)

side effects/ adverse reactions of epinephrine (Adrenalin)

tachycardia, HTN, hyperglycemia

Dopamine is treated for

shock

dopamine action

high infusion rate, activates A1 receptors

moderate infusion rate: activates B1 recepotrs

dopamine uses

treat hypotensive shock states

increase HR (if atropine fails)

dopamine s/e

n/v

tachycardia

dysrhythmias

MI

Dobutamine action

powerful B1 agonist

Dobutamine uses

shock due to heart failure (cardiogenic)

dobutamine side effects/adverse effects

tachycardia, palpitations

n/v

hyper or hypotension

CP

Dysrhymias ( v tach, A fib)