Antidysrhythmic Medications Overview
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Questions and Answers

What is the primary action of Amiodarone?

  • It is a potassium channel blocker that also affects sodium and calcium channels. (correct)
  • It is primarily an anticholinergic agent.
  • It enhances platelet aggregation.
  • It acts by increasing heart rate.

    • Which condition is a contraindication for Adenosine?

  • Atrial flutter or fibrillation (correct)
  • Monomorphic wide complex tachycardia
  • Stable SVT
  • Symptomatic bradycardia

    • What is the maximum dosage of Atropine for symptomatic bradycardia?

  • 2 mg
  • 3 mg (correct)
  • 5 mg
  • 10 mg

    • Which of the following is a common side effect of Amiodarone?

    <p>Hypotension</p> Signup and view all the answers

    In what form can Aspirin be administered for acute coronary syndrome?

    <p>Orally</p> Signup and view all the answers

    What is NOT a precaution when using Atropine?

    <p>Hypotension</p> Signup and view all the answers

    What action does Aspirin perform at a cellular level?

    <p>Inhibits synthesis of prostaglandins</p> Signup and view all the answers

    What is the initial dosage of Adenosine for stable SVT?

    <p>6 mg</p> Signup and view all the answers

    What is the primary action of Labetalol?

    <p>Nonselective beta blocker with alpha-blocking activity</p> Signup and view all the answers

    Which of the following is a contraindication for the use of Lidocaine?

    <p>2nd and 3rd degree AV blocks</p> Signup and view all the answers

    What dosage of Magnesium Sulfate is indicated for Torsades de Point?

    <p>2 gm over 10 min</p> Signup and view all the answers

    What is a common possible side effect of Metoprolol?

    <p>Bronchospasm</p> Signup and view all the answers

    What class of medication does Fentanyl belong to?

    <p>Synthetic opioid</p> Signup and view all the answers

    Which condition is NOT indicated for Nitroglycerin use?

    <p>Severe bradycardia</p> Signup and view all the answers

    Which of the following is a potential side effect of Ketamine?

    <p>Increased intraocular pressure</p> Signup and view all the answers

    What is the maximum total dosage for Ketamine when used for pain management?

    <p>100 mg</p> Signup and view all the answers

    Which medication is listed as an Ib antiarrhythmic agent?

    <p>Lidocaine</p> Signup and view all the answers

    What class of medication does Nitroglycerin belong to?

    <p>Nitrates</p> Signup and view all the answers

    What action does Morphine Sulfate primarily have?

    <p>Inhibits ascending pain pathways</p> Signup and view all the answers

    Which medication should be used with caution in patients with hypotension?

    <p>Fentanyl</p> Signup and view all the answers

    What is a key action of Magnesium Sulfate in treating arrhythmias?

    <p>Blockade of Na+ currents</p> Signup and view all the answers

    What is a major concern when administering high doses of Ketamine?

    <p>Panic attacks and aggressive behavior</p> Signup and view all the answers

    Ondansetron primarily acts as which type of medication?

    <p>Antiemetic</p> Signup and view all the answers

    What is a contraindication for Morphine Sulfate?

    <p>Respiratory depression</p> Signup and view all the answers

    What is a possible side effect of administering calcium chloride rapidly?

    <p>Hypotension</p> Signup and view all the answers

    What is a common contraindication for the use of dopamine?

    <p>Hypersensitivity</p> Signup and view all the answers

    Which of the following medications stimulates both beta-1 and beta-2 adrenergic receptors?

    <p>Epinephrine</p> Signup and view all the answers

    What adverse effect is specifically associated with the extravasation of dopamine?

    <p>Tissue necrosis</p> Signup and view all the answers

    What is NOT a contraindication for ketamine administration?

    <p>Hyperkalemia</p> Signup and view all the answers

    Which medication is primarily used for cardiogenic/distributive shock?

    <p>Dopamine</p> Signup and view all the answers

    Which side effect is NOT associated with epinephrine administration?

    <p>Hypoglycemia</p> Signup and view all the answers

    What is the action of ketamine during pain management?

    <p>Blocks NMDA receptors</p> Signup and view all the answers

    Which symptom is most likely to occur as a side effect of digoxin toxicity?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is a major contraindication for the administration of Sodium Bicarbonate?

    <p>Severe pulmonary edema</p> Signup and view all the answers

    In what situation is EKG monitoring especially recommended?

    <p>Patients with electrolyte abnormalities</p> Signup and view all the answers

    What is the primary action of promethazine?

    <p>Antagonizes histamine H1 and dopamine receptors</p> Signup and view all the answers

    Which of the following side effects is not associated with Furosemide?

    <p>Sedation</p> Signup and view all the answers

    What is a potential consequence of administering promethazine to a patient on depressants?

    <p>Sedation and increased drowsiness</p> Signup and view all the answers

    What is the mechanism of action for Sodium Bicarbonate in treating metabolic acidosis?

    <p>It releases bicarbonate ions to neutralize hydrogen ions</p> Signup and view all the answers

    What condition can Furosemide potentially cause due to its action as a loop diuretic?

    <p>Hypokalemia</p> Signup and view all the answers

    Study Notes

    Amiodarone

    • Class III antidysrhythmic
    • Prolongs the QRS duration and QT interval
    • Inhibits automaticity
    • Can be used for VF and pulseless VT, Wide complex tachycardia in stable patients
    • Contraindications: Hypersensitivity, cardiogenic shock, long QT syndrome
    • Precaution: Avoid breastfeeding, Caution with Hepatic disease due to long half-life
    • Possible Side Effects: Hypotension, Bradycardia

    Adenosine

    • Antidysrhythmic, non-specific class
    • A naturally occurring nucleoside
    • Slows conduction through the AV node
    • Can be used for Stable SVT/monomorphic wide complex tachycardia
    • Contraindication: Hypersensitivity, atrial flutter or fibrillation, WPW
    • Possible Side Effects: Headache, CP

    Atropine

    • Anticholinergic, toxicity antidotes
    • Parasympathetic blocker
    • Can be used for symptomatic bradycardia
    • Contraindications: Hypersensitivity
    • RELATIVE CONTRAINDICATIONS: Narrow-angle glaucoma, GI obstruction, severe ulcerative colitis, thyrotoxicosis
    • Possible Side Effects: dilated pupils, tachycardia, dry mouth

    Aspirin

    • Antiplatelet agent, Non-steroidal anti-inflammatory drug (NSAID)
    • Inhibits synthesis of prostaglandin
    • Inhibits platelet aggregation
    • Can be used for Acute coronary syndrome
    • Contraindications: Hypersensitivity to NSAIDs, bleeding disorders, lactating mother, thrombocytopenia
    • Possible Side Effects: GI bleeding

    Calcium Chloride

    • Antidotes, other; Electrolyte
    • Essential for neurotransmission, muscle contraction, and many signal transduction pathways
    • Can be used for Hyperkalemia/Calcium channel blocker and Beta blocker OD
    • Contraindications: Hypercalcemia, Hypersensitivity, Hypokalemia
    • Possible Side Effects: Tissue necrosis at injection site, Bradycardia, and Hypotension

    Dopamine

    • Inotropic agent; catecholamine; pressor
    • Endogenous catecholamine
    • Low dose stimulates mainly dopaminergic receptors, renal and mesenteric vasodilation
    • Higher dose stimulates both beta-1-adrenergic and dopaminergic receptors
    • Large dose stimulates alpha-adrenergic receptors
    • Can be used for Cardiogenic/distributive shock
    • Contraindications: Hypersensitivity, ventricular fibrillation, Tachyarrhythmias
    • WARNING: Dopamine is a vesicant and can cause severe tissue damage if extravasation occurs
    • Possible Side Effects: Nervousness, headache, arrhythmias, CP, dyspnea, N/V

    Epinephrine

    • Alpha/beta adrenergic agonist
    • Strong alpha-adrenergic effects
    • Strong beta-1 effects
    • Moderate beta-2-adrenergic effect
    • Can be used for ROSC, Cardiac arrest, Bradycardia/Hypotension
    • Contraindications: Hypersensitivity
    • Possible Side Effects: Palpations, tachycardia, hypertension, N/V, anxiety

    Ketamine

    • General anesthetics, systemic
    • Produces dissociative anesthesia
    • Blocks NMDA receptors
    • Stimulates the sympathetic NS
    • Can be used for Pain management
    • Contraindications: Hypersensitivity
    • WARNING: Overdose may lead to panic attacks and aggressive behavior
    • Possible Side Effects: Tachycardia, Laryngospasm, hallucinations, increased intraocular pressure, and vomiting

    Labetalol

    • Beta-blockers, alpha activity
    • Nonselective beta blocker
    • alpha-blocker
    • Can be used for Severe hypertension/pre-eclampsia
    • Contraindications: Hypersensitivity, Bradycardia, Hypotension, myocardial damage, heart block, hypermagnesemia, hypercalcemia
    • Possible Side Effects: Bradycardia, hypotension, CHF, bronchial asthma, AV blocks

    Lidocaine

    • Ib antiarrhythmic and local anesthetic agent
    • Na+ channel blocker
    • Can be used for Pulseless VT/VF, Dangerous PVC’s
    • Contraindications: 2nd and 3rd degree AV blocks
    • Possible side effects: Hypotension, bradycardia, >70 y/o, Hepatic disease

    Magnesium Sulfate

    • Electrolyte
    • Demonstrates antiarrhythmic effects
    • A nonselective calcium antagonist
    • Can be used for Torsades de Point/refractory VF and pulseless VT
    • Contraindications: Hypersensitivity
    • Possible Side-effects: Hypotension, Bradycardia, Respiratory depression

    Metoprolol

    • Beta-blocker, beta-1 selective
    • Blocks response to beta-adrenergic stimulation
    • Can be used for Narrow complex tachycardias
    • Contraindications: Hypersensitivity, Bradycardia, Hypotension, AV blocks, cardiogenic shock, sick sinus syndrome severe peripheral vascular disease
    • WARNING: May cause 1st, 2nd, or 3rd degree AV block
    • Possible Side Effects: Hypotension, bradycardia, bronchospasm, CP, N/V, CHF

    Nitroglycerin

    • Nitrates, anti-anginal
    • Causes systemic vasodilation
    • Can be used for Cardiac ischemia/MI/Acute pulmonary edema
    • Contraindications: Hypersensitivity, Recent use of erectile dysfunction medications, Hypotension, bradycardia, and right ventricular infarction
    • Possible Side Effects: Headache, Hypotension, syncope, tachycardia, flushing

    Fentanyl

    • Synthetic opioid, opioid analgesics (Schedule II) (Pregnancy category C)
    • Narcotic agonist-analgesic
    • Can be used for Acute pain
    • Contraindications: Hypersensitivity
    • WARNING: Should be used with caution in the elderly and in patients with hypotension, suspected gastrointestinal obstruction, head injury, and concomitant CNS depressants
    • Possible Side Effects: Altered mental status, bradycardia, N/V

    Morphine Sulfate

    • Opioid analgesic
    • Opioid agonist
    • Can be used for Acute pain/Cardiac Ischemia/MI/CHF
    • Contraindications: Hypersensitivity, respiratory depression, acute bronchial asthma, upper air, GI obstruction, head injuries/ICP, brain tumors, deliriums tremens
    • Possible Side Effects: Respiratory depression, Hypotension, altered mental status, N/V, bradycardia

    Ondansetron

    • Antiemetic, selective 5-HT3 antagonist
    • Selective 5-HT3 receptor antagonist
    • May cause QT prolongation
    • Can be used for Nausea/vomiting
    • NOTE: EKG monitoring is recommended in patients who have electrolyte abnormalities, CHF, or bradyarrhythmia’s or who are also receiving other medications that cause QT prolongation
    • Contraindications: Hypersensitivity, coadministration with morphine, Long QT syndrome
    • Possible Side Effects: Headache, diarrhea, QT prolongation, fever

    Promethazine

    • Antiemetic
    • Histamine H1, dopamine, muscarinic, and NMDA receptor antagonist
    • Can be used for N/V
    • Contraindications: Pt. on depressants, hypersensitivity
    • Possible side-effects: Drowsiness, sedation, blurred vision, tachycardia, dizziness

    Sodium Bicarbonate

    • Antidote, other
    • Increases blood and urinary pH
    • Can be used for Metabolic acidosis/Hyperkalemia/tricyclic antidepressant (TCA) overdose
    • Contraindications: Documented hypersensitivity, severe pulmonary edema, known alkalosis
    • Possible Side Effects: Metabolic alkalosis, hypokalemia

    Digoxin

    • Has a positive inotropic and a negative chronotropic effect
    • Intracellular Na+ and Ca++ increases in the myocardial cells
    • Has a narrow therapeutic window
    • Can be used for the treatment of mild to moderate heart failure, To maintain control ventricular rate in adult patients diagnosed with chronic atrial fibrillation
    • Side effects: Toxicity can lead to N/V, visual changes, arrhythmias, and decreased renal function (causing electrolyte abnormalities)

    Furosemide

    • A loop diuretic
    • Can reduce body potassium levels
    • Can be used for Fluid overload with symptoms
    • Precautions: Will only work if the patient can produce urine
    • Side effects: Profound rapid diuresis, Hypotension

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    Description

    This quiz covers essential information about the class III antidysrhythmic Amiodarone, the non-specific antidysrhythmic Adenosine, and the anticholinergic Atropine. Participants will explore indications, contraindications, side effects, and precautions associated with these critical cardiovascular drugs. Test your knowledge on their clinical applications and safety considerations.

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