Antiarrhythmics
This mnemonic helps remember the order of antiarrhythmic drug classes.
What is “Sure Beats Picking Corn”?
Rationale: The mnemonic represents Class I–IV antiarrhythmics and helps organize learning of complex drug classes.
Chest pain caused by decreased oxygen delivery to cardiac cells is known as this.
What is angina pectoris?
Rationale: Angina occurs when myocardial oxygen demand exceeds supply, often due to CAD.
Verapamil and diltiazem belong to this antiarrhythmic class.
What is Class IV?
Rationale: These CCBs slow AV node conduction and reduce contractility.
This ECG interval must be monitored when giving certain antiarrhythmics.
What is the QT interval?
Rationale: Prolongation increases risk for lethal arrhythmias
A patient reports chest pain and has nitroglycerin ordered PRN.
What is assess blood pressure first?
Rationale: Nitrates can cause severe hypotension if BP is low.
These antiarrhythmics work by blocking sodium channels.
What are Class I antiarrhythmics?
Rationale: Class I drugs slow depolarization by blocking sodium channels, affecting conduction velocity.
This medication class relieves angina by causing vasodilation.
What are nitrates?
Rationale: Nitrates decrease preload and myocardial oxygen demand through vasodilation.
Calcium channel blockers reduce angina primarily by decreasing this.
What is myocardial oxygen demand?
Rationale: CCBs reduce afterload and myocardial workload.
Digoxin is classified as this type of cardiac medication.
What is a cardiac glycoside (inotrope)?
Rationale: Digoxin increases contractility and slows AV conduction.
A patient on amiodarone develops shortness of breath.
What is assess lung function?
Rationale: Pulmonary toxicity is a known adverse effect.
Metoprolol and propranolol belong to this antiarrhythmic class.
What are Class II (beta-blockers)?
Rationale: Beta-blockers decrease heart rate and conduction by blocking beta‑1 receptors.
This beta‑blocker effect helps treat angina by reducing myocardial oxygen demand.
What is decreased heart rate?
Rationale: Lower HR reduces cardiac workload and oxygen consumption.
This adverse effect is commonly monitored when administering CCBs.
What is hypotension?
Rationale: Vasodilation can significantly lower blood pressure.
This lab value must be monitored closely in patients on digoxin.
What is potassium?
Rationale: Hypokalemia increases risk for digoxin toxicity.
A patient on digoxin has nausea, blurred vision, and bradycardia.
What is hold the medication and notify the provider?
Rationale: These are classic signs of digoxin toxicity
This potassium-channel–blocking drug is widely used but has many systemic toxicities.
What is amiodarone?
Rationale: Amiodarone is a Class III antiarrhythmic associated with pulmonary, thyroid, liver, and ocular toxicity
This medication treats angina by blocking sodium channels without affecting heart rate or blood pressure.
What is ranolazine (Ranexa)?
Rationale: Ranolazine improves myocardial oxygen efficiency and is used when other agents are insufficient.
This cardiac conduction area is directly affected by non‑dihydropyridine CCBs.
What is the AV node?
Rationale: These agents slow conduction through the AV node, useful in arrhythmias.
This administration rule reduces the risk of injury when a patient receives sublingual nitroglycerin.
What is having the patient sit or lie down?
Rationale:
Nitroglycerin can cause orthostatic hypotension, dizziness, and syncope. Sitting or lying down helps prevent falls and injury during administration.
A patient reports chest pain rated 8/10 and has PRN nitroglycerin ordered. The blood pressure is 88/54 mmHg.
What comes first?
What is holding the nitroglycerin and notifying the provider?
Rationale:
Nitroglycerin is contraindicated in hypotension. Giving it could cause cardiovascular collapse. Patient safety and provider notification take priority.
What is a dangerous adverse effect associated with antiarrhythmic drugs?
QT Prolongation
This type of angina is caused by coronary artery vasospasm
What is variant (Prinzmetal) angina?
Rationale: Vasospasm reduces coronary blood flow and responds well to nitrates and CCBs.
Combining CCBs with beta‑blockers increases the risk of this complication.
What is bradycardia or heart block?
Rationale: Both drug classes suppress AV conduction and HR.
When a patient is receiving an ACE inhibitor such as lisinopril, the nurse must closely monitor this lab value due to the risk of a serious electrolyte imbalance.
What is potassium?
Rationale:
ACE inhibitors decrease aldosterone production, which can lead to potassium retention (hyperkalemia). Elevated potassium levels increase the risk for dangerous cardiac dysrhythmias, making routine monitoring essential—especially in patients with renal impairment
A patient with chest pain receives one dose of sublingual nitroglycerin.
What comes first?
What comes second?
What is reassessing pain and blood pressure?
Administer another dose (if persistent chest pain)
Rationale:
Nitroglycerin may be repeated, but reassessment is required between doses to evaluate effectiveness and monitor for hypotension before giving another dose.