Wednesday, April 4, 2012


·         Prevents dysrhythmias by inhibiting abnormal pathways of electrical conduction to the heart
·         Indication:
o    Prevention of cardiac dysrhythmias
·         Contraindication:
o    Liver disorder, heart failure, cardiogenic shock, second or third heart block


Class I

Fast (Sodium) Channel Blockers I
o    disopyride (Norpace®, Napamide®)
o    procainamide (Procan®, Pronestyl®)
o    quinidine, pylogalacturonate, gluconate (Quinidex®, Cardioquin®)

Fast (Sodium) Channel Blockers IB
o    lidocaine (Xylocaine®)
o    mexiletine (Mexitil®)
o    tocainide (Tonocard®)

Fast (Sodium) Channel Blockers IC
o    flecainide (Tambocor®)
o    propafenone (Rythmol®)

Other Class I
o    moricizine (Ethmozine®)

Class II
Beta-Adrenergic Blockers
o    acebutolol (Sectral®)
o    esmolol (Brevibloc®)
o    propanolol (Inderal®)

Class III
Prolong Repolarization
o    adenosine (Adenocard®)
o    amiodarone (Cordarone®)
o    bretylium tosylate (Bretylol®)
o    dofetilide (Tikosyn®)
o    sotalol (Betapace®)

Class IV
Calcium Channel Blockers
o    verapamil (Calan®, Isoptin®)
o    diltiazem (Cardizem®)

o    phenytoin (Dilantin®)
o    digoxin (Lanoxin®)
o    ibutilide fumarate (Corvert®)

 Side Effects:

·         Quinidine: nausea and vomiting, diarrhea, confusion and hypotension, heart block, neurologic and psychiatric symptoms
·         Procainamide: less cardiac depression than quinidine
·         Lidocaine, mexiletine and tocainide:cardiovascular depression, bradycardia, hypotension, seizures, blurred vision and double vision
·         Beta-blockers: bradycardia and hypotension
·         Bretylium and amiodarone: nausea and vomiting, hypotension and neurologic problems
·         Calcium channel blockers: nausea and vomiting, hypotension, bradycardia
·         Adenosine frequently causes asystole for a few seconds however this adverse effect effect is short lived as the drug has an extremely short half life and effect may last less than a minute.

Nursing Considerations:

ü  Monitor vital signs. Hypotension can occur.
ü  Administer drug as prescribed.
ü  Monitor ECG and report abnormal patterns.
ü  Provide patient teachings:
o    Provide specific instructions for each drug and instruct patient that drug compliance is essential.
o    Instruct the patient to report side effects.
o     Advise patient to avoid the following:
§  Alcohol- can increase hypotensive reaction
§  Caffeine- increases catecholamine level
§  Tobacco- promotes vasoconstriction

No comments:

Post a Comment