17: Antidysrhythmic Drugs
- Page ID
- 90331
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)- 17.0: Introduction
- This page discusses the heart's role in the cardiovascular system, detailing the normal sinus rhythm and its regulation by the sinoatrial node. It highlights the interplay between sympathetic and parasympathetic inputs in maintaining heart function and outlines how medications affect heart rate and rhythm, particularly in conditions that disrupt normal cardiac activity.
- 17.1: Introduction to Dysrhythmias
- This page covers cardiac dysrhythmias, which are heart rate and rhythm abnormalities caused by impulse generation or conduction issues. It details various types such as bradycardia, tachycardia, and ventricular fibrillation, along with treatment strategies like cardioversion. Additionally, it highlights special considerations for older adults and pediatric patients, including the importance of monitoring drug interactions and dosing when managing dysrhythmias.
- 17.2: Class I- Sodium Channel Blockers
- This page provides an overview of sodium channel blocker drugs, classified as Class I antidysrhythmic agents for treating dysrhythmias. It details subcategories IA, IB, and IC, including key drugs like quinidine, lidocaine, and flecainide, alongside their mechanisms, uses, and side effects.
- 17.3: Class II- Beta Adrenergic Blockers
- This page addresses the use of beta-adrenergic blockers, particularly esmolol and metoprolol, in treating dysrhythmias. It outlines their effects on heart rate and contractility, nursing considerations, key safety alerts like monitoring for bradycardia, and the risks of abrupt discontinuation. Clients are advised on precautions against orthostatic hypotension, respiratory effects, and the masking of hypoglycemia symptoms.
- 17.4: Class III- Potassium Channel Blockers
- This page covers potassium channel blockers as class III antidysrhythmic drugs, detailing their function in prolonging action potential and the necessity for ECG monitoring due to proarrhythmic risks. Key drugs include amiodarone, dronedarone, dofetilide, ibutilide, and sotalol, with specific patient education, dosing guidelines, and monitoring requirements discussed.
- 17.5: Class IV- Calcium Channel Blockers
- This page discusses calcium channel blockers (CCBs) for treating dysrhythmias, detailing their characteristics, mechanisms, and nursing considerations. CCBs, like diltiazem and verapamil, lower heart rate and AV node conduction, aiding conditions such as atrial fibrillation. It outlines FDA indications, dosages, drug interactions, and emphasizes safety monitoring of heart rate and blood pressure.
- 17.6: Unclassified Antidysrhythmics
- This page discusses the characteristics and nursing considerations for unclassified drugs used to manage dysrhythmias, including atropine, digoxin, and adenosine. It highlights their uses, potential adverse effects, and the importance of monitoring renal function and heart rate to avoid complications. Client education is emphasized, detailing specific side effects and the necessity for adherence to prescribed dosages, particularly for digoxin.
- 17.7: Chapter Summary
- This page discusses common arrhythmias and the antidysrhythmic drugs used for their treatment, organized by the Vaughan Williams classification. It outlines five drug classes: class I (sodium channel blockers), class II (beta-adrenergic blockers), class III (potassium channel blockers), class IV (calcium channel blockers), and unclassified drugs, with a focus on their primary mechanisms of action.
- 17.8: Key Terms
- This page covers heart rhythm disorders, categorizing them by heart rate and origin, highlighting terms like atrial fibrillation, bradycardia, and tachycardia. It explains cardioversion to restore normal rhythms, the risk of proarrhythmia from medications, and specific conditions such as torsade de pointes. Treatment options like vagal maneuvers and the Vaughan Williams classification for antidysrhythmic drugs are also discussed.
- 17.9: Review Questions
- This page provides an overview of medications used in arrhythmia management, highlighting their effects and side effects. It covers metoprolol overdose, verapamil’s role in worsening heart failure, and the importance of monitoring the QT interval with drugs like procainamide. The page also addresses the management of atrial fibrillation and potential interactions between antidysrhythmic medications and statins, emphasizing the need for careful monitoring and management of these treatments.