Antidysrhythmic Medication - Drug Therapy
Class I: Sodium Channel Blockers
Disopyramide Phosphate
●
Monitor BP and HR; hypotension and bradycardia can occur
Lidocaine
●
Monitor for arrhythmias; these agents affect conduction patterns, sometimes increasing
the frequency or severity of dysrhythmias.
●
Monitor for CNS side effects such as dizziness, anxiety, ataxia, insomnia, confusion,
seizures, and GI distress; may require dose reduction or discontinuation
●
Monitor for signs of heart failure; can cause HF.
Propranolol
●
Monitor HR and BP; bradycardia and decreased BP are expected effects.
Acebutolol
●
Assess for wheezing or shortness of breath; can cause bronchospasm.
Esmolol
●
Assess for insomnia, fatigue, and dizziness; may require dose reduction or discontinuation
Mexiletine hydrochloride
Flecainide acetate
Propafenone hydrochloride
Class II: Beta Blockers
Sotalol
● Assess ventricular arrhythmias, can
have proarrhythmic effects.
Class III: Potassium Channel Blockers - Delays repolarization and prolongs the QT interval.
Sotalol
●
For all class III potassium channel blockers:
atrial and ventricular dysrhythmias.
●
Monitor BP and HR. hypotension and bradycardia can occur.
●
Monitor for arrhythmias. agents affect conduction patterns, sometimes increasing the
frequency or severity of dysrhythmias.
●
Continually monitor ECG rhythm during infusion. bradycardia and AV block can occur.
●
This drug can cause serious toxicities (lung damage, visual impairment).
Approval is limited to use for life-threatening dysrhythmias. However, because of
efficacy, use remains very common.
●
Corneal pigmentation occurs in most patients, generally does not interfere with vision.
●
Teach patient to take with meals and avoid grapefruit juice. better absorbed with food.
Grapefruit juice alters the effect.
●
Teach patient to notify provider with signs of HF. contraindicated for pts with HF.
●
Stop infusion as soon as the dysrhythmia is terminated or in the event of VT. may
cause potentially fatal dysrhythmias.
●
Assess potassium and magnesium levels before infusion because electrolyte balance
must be corrected prior to and during use.
●
Teach patient to change positions slowly. Orthostatic hypotension is a side effect.
Verapamil
●
Monitor HR and BP; bradycardia and hypotension are common side effects.
Diltiazem
●
Teach patients to change position slowly when receiving oral therapy. orthostatic
hypotension can occur.
●
Teach patients to report dyspnea, orthopnea, distended neck veins, or swelling of the
extremities. HF can occur, necessitating a decrease in dosage or discontinuation.
●
Assess apical HR before administration; decreased HR is an expected response.
●
Teach patient to report nausea, vomiting, diarrhea, paresthesias, confusion, or visual
disturbance. can indicate digoxin toxicity.
●
Monitor HR and rhythm after administration. increased heart rate is expected.
Adenosine
● paroxysmal SVT
●
Be sure to have emergency equipment readily available!. Significant bradycardia with
pauses, nausea, and vomiting.
Nursing Safety Priority !
●
Facial flushing, shortness of breath, and chest pain are common side effects.
Amiodarone
● atrial and ventricular dysrhythmias.
Dronedarone
● AF and atrial flutter.
Ibutilide
● AF and atrial flutter
Dofetilide
● AF and atrial flutter
Class IV: Calcium Channel Blockers
Class: Other
Digoxin
●
AF and atrial flutter.
Atropine
● Bradycardia