Podcast
Questions and Answers
Class IA antidysrhythmic drugs block primarily which channels?
Class IA antidysrhythmic drugs block primarily which channels?
Sodium
Which antidysrhythmic drug is indicated for atrial dysrhythmia?
Which antidysrhythmic drug is indicated for atrial dysrhythmia?
Quinidine
Which antidysrhythmic drug is indicated for pulseless ventricular tachycardia?
Which antidysrhythmic drug is indicated for pulseless ventricular tachycardia?
Lidocaine
Match the subclass of antidysrhythmic to its corresponding mechanism of action.
Match the subclass of antidysrhythmic to its corresponding mechanism of action.
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What symptoms would the nurse include when teaching Mr. A about cinchonism related to quinidine toxicity?
What symptoms would the nurse include when teaching Mr. A about cinchonism related to quinidine toxicity?
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The presence of which disease process constitutes a contraindication for quinidine antidysrhythmic therapy?
The presence of which disease process constitutes a contraindication for quinidine antidysrhythmic therapy?
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What may be the result of a drug-drug interaction when quinidine and digoxin are administered concurrently?
What may be the result of a drug-drug interaction when quinidine and digoxin are administered concurrently?
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What adverse outcome should the nurse alert the healthcare provider about in a patient taking flecainide?
What adverse outcome should the nurse alert the healthcare provider about in a patient taking flecainide?
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Which ECG change will the nurse monitor for when a patient is being treated with quinidine?
Which ECG change will the nurse monitor for when a patient is being treated with quinidine?
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What therapeutic effect should the nurse monitor while administering quinidine?
What therapeutic effect should the nurse monitor while administering quinidine?
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What time frame after administration of flecainide would the nurse expect the onset of action to occur?
What time frame after administration of flecainide would the nurse expect the onset of action to occur?
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Which symptom, if reported by a patient recently started on quinidine, would the nurse find most concerning?
Which symptom, if reported by a patient recently started on quinidine, would the nurse find most concerning?
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While administering lidocaine, what adverse drug effect should the nurse monitor for?
While administering lidocaine, what adverse drug effect should the nurse monitor for?
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What teaching will the nurse provide regarding long, hot baths for a patient prescribed quinidine?
What teaching will the nurse provide regarding long, hot baths for a patient prescribed quinidine?
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The patient with which medical condition will most likely benefit from lidocaine administered intravenously?
The patient with which medical condition will most likely benefit from lidocaine administered intravenously?
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Before administering quinidine, what contraindication should the nurse assess the patient for?
Before administering quinidine, what contraindication should the nurse assess the patient for?
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Study Notes
Class I Antidysrhythmic Therapy Overview
- Class IA antidysrhythmic drugs primarily block sodium channels, slowing electrical impulses in the heart.
- Quinidine, a Class IA drug, is used for both atrial and ventricular dysrhythmias.
Indications for Use
- Lidocaine is indicated for pulseless ventricular tachycardia.
- Quinidine is contraindicated for patients with myasthenia gravis due to adverse effects from anticholinergics.
Subclass Mechanisms of Action
- Class IC: Prolong conduction with minimal effect on repolarization.
- Class IA: Slow conduction and prolong repolarization.
- Class IB: Slow conduction and shorten repolarization.
Monitoring and Adverse Effects
- Monitor for cinchonism symptoms (tinnitus, nausea, visual disturbances) in patients receiving quinidine.
- Heart failure and worsening arrhythmias may occur with flecainide; assess and alert healthcare providers.
- ECG changes from quinidine treatment include widening of the QRS complex and prolonged QT interval, which may indicate toxicity.
- Lidocaine can cause seizures; monitor patients closely for this effect.
Patient Management
- Advise patients on quinidine to avoid long, hot baths due to the potential for hypotension.
- Expect quinidine to decrease heart rate as a therapeutic effect.
- The onset of action for flecainide occurs approximately three hours after administration.
- Shortness of breath after starting quinidine therapy may suggest a pulmonary embolus and should be reported immediately.
Drug Interactions and Dosage Adjustments
- Concomitant use of quinidine and digoxin can lead to digoxin toxicity; it may require a reduction in digoxin dosage due to increased serum levels.
Specific Cases
- Patients with acute ventricular tachycardia are best treated with intravenous lidocaine.
- Assess for contraindications such as complete heart block before administering quinidine.
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Description
Test your knowledge on Class IA antidysrhythmic drugs and their mechanisms. This quiz covers key concepts about sodium channel blockers and their applications in treating atrial dysrhythmias. Perfect for medical students and healthcare professionals alike.
