Cardiac Meds & Txs

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Cardiac Meds & Txs
2012-10-31 20:55:15
Nur 214

Cardiac Meds & Txs
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  1. What does Atropine do?
    • It picks up the pace!
    • Increases HR
  2. Atropine
    • Anticholinergic
    • Used to increase HR in sinus brady and heart blocks
    • Increasing HR also increases cardiac demand and workload
    • Assess for CP after admin, monitor HR and rhythm
    • Allows SNS to increase HR
  3. What are the side effects of Atropine?
    • Drowsiness
    • Blurred vision
    • Tachycardia
    • Dry mouth
    • Urinary hesitancy
  4. What is the antidote to Atropine?
  5. When is Atropine contraindicated?
    Glaucoma and BPH
  6. What does Adenosine do?
    • Slows conduction through the AV node
    • Allows SA node to take back the control as the pacemaker
  7. What is Adenosine used for?
  8. Adenosine
    • Does not react w/ other antidysrhythmics, like Dig & BB
    • Give over 1-2 sec b/c half life of 10 sec
    • Flush with 20 mL of NS in 1-2 sec afterwards
  9. What is the major side effect of Adenosine?
    Bradycardia resistant to Atropine
  10. What is diltiazem (Cardizem)?
    • Calcium channel blocker
    • Used in a fib/flutter and SVT
  11. What does Cardizem do?
    • Slows conduction in SA and AV nodes
    • Decreases cell excitability
    • Negative chronotrop (decreases HR)
  12. What are the side effects of Cardizem?
    • Bradycardia
    • Hypotension
    • S/S HF
    • Peripheral edema
  13. What do all antiarrhythmics do?
    Sedate the heart
  14. Class 1 antiarrhythmics
    • Sodium channel blockers
    • Work primarily on ventricular dysrhythmias
    • Negative inotropes that decrease automaticity of the ventricles, delay ventricular depolarization, and decrease conduction velocity
    • Prolong QT segment
  15. Interactions w/ class 1 
    • Increase hypotension w/ anti-HTN, diuretics, and narcotics
    • Period blood tests necessary b/c of anemia, leukopenia, thrombocytopenia
  16. Class 1 A
    • Moderate
    • Quinidine, Pronestyl, Norpace
    • Lengthen QT and may predispose to Torsades, esp if pt is also taking Levita
  17. Class 1 B
    • Weak
    • Lidocaine, Mexitil, Tonocard
    • Cardiac depressant if used concurrently w/ Pronestyl, Inderal, Quinidine
  18. Class 1 C
    • Strong
    • Tambocor, Rhythmol
    • Contraindicated w/ AICDs (req more energy to get pts out of lethal arrhythmias)
  19. Class 2 antiarrhythmics
    • Beta blockers
    • Block excessive SNS activity
    • Can be cardio- or non-cardioselective
    • Used for atrial arrhythmias ONLY
  20. Side effects of Class 2 (Beta blockers)
    Can increase bradycardia if fiven with other negative chronotropics (synergistic effect)
  21. Class 3 antiarrhythmics
    • Potassium channel blockers
    • Prolong repolarization/refractory period
    • Proarrhythmic
    • Prolongs QT leading to VT or Torsades
    • FIRST line for VENTRICULAR arrhythmias: VT/VF/Torsades - Amiodarone
    • SECOND line for ATRIAL arrhythmias: Amiodarone, Tikosyn, Multaq (dose lower than for vent. arr.)
  22. Side effects of Amiodarone
    Monitor labs q. 6 mo. for hypothyroidism, elevated LFT