Podcast
Questions and Answers
Which of the following drugs is classified as a cardiac glycoside?
Which of the following drugs is classified as a cardiac glycoside?
What is a negative dromotropic effect associated with cardiac glycosides?
What is a negative dromotropic effect associated with cardiac glycosides?
Which arrhythmias are primarily treated by class 1B antiarrhythmics such as lidocaine?
Which arrhythmias are primarily treated by class 1B antiarrhythmics such as lidocaine?
What effect do cardiac glycosides have on heart rate?
What effect do cardiac glycosides have on heart rate?
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Which part of the heart do class 1B antiarrhythmics specifically target?
Which part of the heart do class 1B antiarrhythmics specifically target?
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Which of the following adverse reactions is specifically associated with Class II antiarrhythmics?
Which of the following adverse reactions is specifically associated with Class II antiarrhythmics?
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What is a primary nursing consideration when administering Class 1C antiarrhythmics?
What is a primary nursing consideration when administering Class 1C antiarrhythmics?
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Which of the following is a life-threatening condition that requires careful monitoring when using Amiodarone?
Which of the following is a life-threatening condition that requires careful monitoring when using Amiodarone?
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Which nursing action should be prioritized before administering a beta-blocker?
Which nursing action should be prioritized before administering a beta-blocker?
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What common adverse effect should be monitored for patients on Class IV antiarrhythmics?
What common adverse effect should be monitored for patients on Class IV antiarrhythmics?
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When administering Class 1C antiarrhythmics, which precaution should be taken to prevent new or aggravated arrhythmias?
When administering Class 1C antiarrhythmics, which precaution should be taken to prevent new or aggravated arrhythmias?
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Which of the following is NOT an adverse reaction of Class II antiarrhythmics?
Which of the following is NOT an adverse reaction of Class II antiarrhythmics?
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What is an important nursing consideration when administering Amiodarone?
What is an important nursing consideration when administering Amiodarone?
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Study Notes
Inotropic Drugs
- Increase the force of cardiac muscle contraction.
- Cardiac glycosides, like digoxin, are examples.
- Digoxin slows heart rate (negative chronotropic effect).
- Digoxin slows electrical conduction through the AV node (negative dromotropic effect).
- Anticoagulation may be performed before treatment.
Class 1B Antiarrhythmics
- Example: Lidocaine.
- Primarily affects Purkinje fibers and ventricular myocardial cells.
- Treats acute ventricular arrhythmias, such as ventricular tachycardia and ventricular fibrillation.
- Adverse Reactions: Drowsiness, lightheadedness, hypotension, bradycardia.
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Nursing Considerations:
- Monitor for adverse reactions.
- Monitor serum lidocaine levels for toxicity.
- Monitor electrolytes, BUN, and creatinine.
- Use an infusion pump, do not exceed 4 mg/minute.
- If administered IM, use the deltoid muscle.
Class 1C Antiarrhythmics
- Example: Propafenone HCl.
- Treats life-threatening ventricular arrhythmias.
- Decreases excitability, conductivity, and automaticity in the AV node, His-Purkinje fibers, and intraventricular tissue.
- May cause or worsen arrhythmias.
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Nursing Considerations:
- Administer with food to reduce GI upset.
- Report any increase in the QRS complex by more than 25%.
- Monitor ECG and digoxin levels if used with digoxin.
Class II Antiarrhythmics
- Beta-blockers are included in this class.
- Example: Propranolol.
- Indications include atrial flutter/fibrillation and paroxysmal atrial tachycardia.
- Adverse Reactions: Arrhythmias, bradycardia, heart failure, hypotension, bronchoconstriction.
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Nursing Considerations:
- Check apical pulse before administration.
- Administer with meals.
- Do not abruptly discontinue the drug.
- Report adverse reactions to the prescribing physician.
Class III Antiarrhythmics
- Example: Amiodarone.
- Indications include ventricular arrhythmias and suppression of supraventricular tachycardia (SVT).
- Adverse Reactions: Hypotension, nausea, anorexia, and severe pulmonary toxicity.
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Nursing Implementations:
- This drug is associated with significant, potentially life-threatening complications and should only be used for patients with documented life-threatening, recurrent ventricular arrhythmias.
Class IV Antiarrhythmics
- Calcium channel blockers are part of this class.
- Examples: Verapamil, Diltiazem.
- Indications include SVT with rapid ventricular response, angina, and hypertension.
- Restore normal sinus rhythm.
- Adverse Reactions: (Mild) Dizziness, headache, hypotension, constipation, nausea. (Serious) Heart failure, bradycardia, AV block, pulmonary edema.
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Nursing Implementations:
- Fluid and sodium intake might need restriction to minimize edema.
- Withhold the medication if systolic blood pressure falls.
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Description
Test your knowledge on inotropic drugs and Class 1 antiarrhythmics. This quiz covers the effects, examples, and key nursing considerations associated with these important cardiac medications. Ensure you understand their mechanisms and contraindications.
