Class IA antidysrhythmics Disopyramide In addition to sodium and potassium channel blockade, disopyramide is a muscarinic antagonist. Documented ventricular dyshythmias, atrial dysrhythmias in patients with hypertrophic cardiomyopathy unlabeled use Dosages: Dose adjustment is gradual; mg orally every 6 hours; reduced dosage frequency recommended in renally impaired patients Metabolism: Atrial dysrhythmias at 2.
Cardioselective beta blockers act more strongly on the beta1 receptor, which decreases the heart rate but avoids bronchoconstriction. Examples of nonselective beta blockers are propranolol Inderalnadolol Corgardand pindolol Visken.
These drugs decrease the heart rate and can cause bronchoconstriction. Sites should be rotated to prevent skin irritation.
The drug should be continued if headache occurs, as tolerance will develop. Sublingual nitroglycerin should be used to treat chest pain. Which assessment finding indicates that the nitroglycerin has been effective? Which assessment finding will cause the nurse to take action?
This would prompt the nurse to Antidysrhythmic drugs. Headache and flushing are common side effects of nitroglycerin. If no relief from chest pain is obtained after one tablet, they should seek medical assistance and take up to two more tablets.
All other responses demonstrate a good understanding by the patient. Absence of chest pain Decreased swelling in the ankles and feet Patient denies dizziness. Patient states that she feels stronger. With less strain, the patient should have fewer incidences of angina as afterload is decreased.
Measure blood urea nitrogen and creatinine.
Monitor level of consciousness. It is important to assess blood pressure before administering. It should also not be locked up and must be kept away from light, not in a clear plastic bag.
Three doses can be taken 5 minutes apart. The tablet should be placed under the tongue to dissolve. The medication should be kept in a readily accessible location for immediate use should chest pain occur. Use the fingers to spread the ointment evenly over a 3-inch area. Apply the ointment to a non-hairy part of the upper torso.
Massage the ointment into the skin. Cover the application paper with ointment before use. The upper torso is the preferred site of application. The nurse should wear gloves and squeeze the ointment onto the application patch. Massaging in the ointment is not appropriate. The paper should not be covered with ointment.
The ointment is measured as one straight line on the nitroglycerin paper and is then gently spread around and applied, but not rubbed, into the skin.
Stop the nitroglycerin infusion for 1 hour and then restart. Because it is short-acting, decreasing the infusion rate will allow the blood pressure to rise.
Administer ordered dose of digoxin. Hold future digoxin doses. Call the health care provider.
The patient should receive the next dose to bring the level into therapeutic range.Proarrhythmia due to prior drugs for VT should be suspected if the VT morphology is different from a prior VT form, especially if prior drugs or changes have been prescribed, with a prolonged QT (see figure 94) interval, or if the new VT has a polymorphic or torsades de pointe configuration (see fig).
Chapter Drug Actions and Body Responses(FREE) Chapter Safely Preparing and Giving Drugs(FREE) Chapter Teaching Patients About Drug Therapy(FREE). Classification of antidysrhythmic drugs. According to the Vaughan Williams classification scheme, the antidysrhythmic drugs fall into five groups (Table 49–1).
As the table shows, there are four major classes of antidysrhythmic drugs (classes I, II, III, and IV) and a fifth group that includes adenosine and digoxin.
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