[Solved]: Xavier University College of Nursing NURS 472…

Xavier University College of Nursing NURS 472 Directions: Use this document to review the medications that we will cover in class. You are not expected to turn in this document. We will highlight the important points in class. The drugs that we will spend the most time on during class, and that you may be tested on, are indicated with an asterisk (*), so be sure to spend adequate time reviewing these. Antidysrhythmic Medications -Pro-dysrhythmic Effects of Antidysrhythmics: drugs used for dysrhythmias can worsen existing dysrhythmias or create new ones Class I: Sodium Channel Blockers -Three classes of sodium channel blockers: IA, IB, IC -All drugs in this class block cardiac sodium channels resulting in a decrease in conduction velocity in the atria, ventricles, and His-Purkinje system Medication Mechanism of Action/ Indications Contraindications/ Precautions Major Adverse Effects Nursing Considerations Class IA: Quinidine Others: procainamide Moderate blockade of the sodium channels in the myocardium and bundle of His, bundle branches, and Purkinje fibers, reducing the amount of sodium that can enter. This decrease in sodium slows impulse conduction and decreases automaticity of the ventricles. The refractory period is lengthened, which is the resting period after stimulus during which time a cell is unable to respond to another stimulus Used for atrial fibrillation, and supraventricular and ventricular tachycardia Quinidine: don’t take if allergic, have severe heart failure, hypotension, or thyrotoxicosis Procainamide: don’t take if allergic, also called procaine, or yellow dye number 5, have low WBC, or myasthenia gravis or SLE Both contraindicated in presence of bundle branch block, or a widened QT wave, severe heart block, or Torsades de pointes GI symptoms – N/V/Hypotension Widen QRS complex and prolong QT interval. When used for atrial fibrillation, tiny clots can dislodge when atrial fibrillation is converted to sinus rhythm Cinchonism: tinnitus, visual disturbances, headache, and N/V Monitor for GI symptoms, BP, and pulse rate, and keep patient supine during IV therapy when hypotension is most problematic Monitor ECG periodically If cardiac effects occur, withhold sodium channel blocker and contact physician Monitor for s/s of pulmonary embolism Monitor for s/s of Cinchonism