Class Basics
What routes can we use to administer Propranolol?
PO and IV
What can lidocaine be used to treat?
Ventricular tachycardia
What are some side effects of Calcium Channel Blockers?
Dizziness, headache, fatigue, nausea
Your pt on digoxin says, "A negative chronotropic med?? What's that??" What would you explain to them?
Digoxin = Negative chronotropic = decreases heart rate
What are some contraindications for beta blockers?
Severe bradycardia, hypotension, respiratory conditions (COPD, asthma)
What drug is a class 1a sodium channel blocker?
Procainamide (Quinidine)
What are calcium channel blockers used to treat?
Atrial arrhythmias
What symptom are you at biggest risk for when taking Procainamide (Quinidine)?
Used for atrial arrhythmias, delays repolarization phase (allows heart adequate time to rest); can cause anticholinergic effects, bradycardia, hypotension
What are some contraindications for Calcium Channel Blockers?
Heart block, profound bradycardia, hypotension
What potassium channel blocker lengthens the QT phase?
Sotolol
What abnormal rhythm can magnesium be administered to treat?
Torades de pointes
What are some side effects that can occur with beta adrenergic antagonists?
Decreased CO, bradycardia, hypotension, dizziness, smooth muscle relaxation
Your patient on propranolol asks, "What do beta blockers even do?" What do you tell them?
What are the dosage differences for lidocaine when used as an antiarrhythmic vs an anesthetic?
Antiarrhythmic: lower dose (1%)
Anesthetic: higher dose (2%) + usually contains epinephrine
What calcium channel blocker medication is only given PO?
Nifedipine (ProCardia)
What do potassium channel blockers prevent?
Prevents re-entry tachycardia (early firing from the AV node)
What can you expect to see in a pt who has just been given emergent adenosine?
Your pt on sotalol asks, "Does this stuff have any side effects?" What would you tell them?
Sotalol can cause ventricular arrhythmias as a result of over-lengthening the QT interval
What is another use for atropine that we have discussed before in class?
Atropine is also used in end of life care to reduce secretions
What are 3 dosing considerations with Diltizaem (Cardizem) and Verapamil (Calan SR)?
Only given PO/IV, weight based dosage and give a bolus dose initially
What are class 2 beta adrenergic antagonists used for?
Slowing the HR down
What are the 6 P's of Amiodarone side effects?
Prolongs action potential, photosensitivity of the skin, pigmentation of the skin, peripheral neuropathy, pulmonary fibrosis and peripheral conversion of T4 to T3 is inhibited
Your pt on nifedipine (Procardia) is terrified of needles and asks, "Do I need an IV for this medication? I hate needles!" What would you tell them?
Nifedipine is an oral medication, and is not given intravenously
Your pt on amiodarone wants to go suntan for a prolonged period of time-- why might this not be a good idea?
A side effect of amiodarone is photosensitivity; pt's should be cautioned against prolonged sun exposure