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Medications for Dysrhythmias

N4 EKG day 2 - RX management of dysrhythmias
by

Sarah Fry

on 12 September 2016

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Transcript of Medications for Dysrhythmias

62
ECG
bpm
Review of electrical conduction
Action
Action Potential is dependent on the opening of sodium ion channels.
Sodium Channel Blockers
Side Effects: ?
Beta-adrenergic blockers
Action: slow the heart rate and decrease conduction velocity through the AV node; reduces automaticity; prolongs refractory period.
Calcium Channel Blockers
Action: reduce automaticity in SA node; slow impulse conduction through AV node; Slows heart rate; prolongs refractory period.
Sodium Channel Blockers
N4 - Sarah Fry, MSN, RN, PHN
Medications for Dysrhythmias
Blocking channels will prevent depolarization.
The spread of action potential across the myocardium will slow, and areas of ectopic pacemaker activity will be supressed.
Adams, Holland, & Urban (2014). Pharmacology for Nurses. Pearson
Subgroups
1A: Delays repolarization; slows conduction velocity (reduces automaticity); increases duration of action potential (Ex: procainamide)

1B: Accelerates repolarization; slows conduction velocity; decrease duration of action potential (Ex: lidocaine)

1C: No effect on repolarization; slows conduction velocity (Ex: propafenone)
Side Effects: ??
Example: Propranolol
Example: Verapamil (also dilates coronary arteries)
Side Effects: ??
Verapamil should be used with extra caution in patients with which cardiovascular condition?
a. hypertension
b. tachycardia
c. heart failure
d. angina
Potassium Channel Blockers
Action: delay repolarization of myocardial cells; lengthen refractory period
Example: Amiodarone
Side Effects: ??
A patient is started on amiodarone for a dysrhythmia. The patient is also on digoxin, warfarin, and insulin. What is a priority teaching for this patient?
Miscellaneous dysrhythmics
Adenosine: nucleoside - Slows conduction through the AV node and decreases automaticity of the SA node
Digoxin: cardiac glycoside: - decreases automaticity of the SA node and slows conduction through AV node
A patient with a history of COPD and tachycardia has recently been placed on propranolol to control tachydysrhythmia. What is the priority for the nurse in monitoring this patient?
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