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Class: I ;Sodium channel blocker
Subclass: IA
Prototype: Quinidine (Quinidex)
Action: prolong refractory period; decrease automaticity and contractility
Indications: Atrial arrhythmia; Long term use: Not For CODE
Side Effects: wide QRS, anticholinergic, cinhonism, GI upset, low platelets
Nursing Implications: give 1-2 hours after meals, check levels, no grapefruit juice, increases dig toxicity
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Class: I; Sodium Channel Blockers
Subclass: IB
Prototype: Lidocaine (Xylocaine)
Action: decreases action potential, cardiac only
Indications: Ventricular Arrhythmias; ESP. Acute
Side Effects: Sedation, seizures = toxicity
Nursing Implications: IV dose must be on pump, first pass effect
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Class: I ;Sodium Channel Blocker
Subclass: IC
Prototype: Propferone (Rhythmol)
Action: Slows depolarization and conduction
Indications: Ventricular Arrhythmias, long term
Side Effects: vertigo, metallic taste, constipation, heart block
Nursing implications: take with food
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Class: II
Subclass: Beta Blockers
Prototype: Atenolol (Terormin)
Action: cardio selective, blocks beta 1 receptors
Indications: Ventricular Arrhythmias, long term
Side Effects: decrease HR and BP, bronchoconstriction
Nursing Implications: Avoid in asthma and COPD, check apical pulse need grater than 60
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Class: III; potassium channel blocker
Subclass: antifib
Prototype: amiodarone (Cordarone)
Action: Prolongs refractory periods and action potential
Indications: recurrent life threatening Arrhythmias, v-tach
Side Effects: pulmonary toxicity; blue gray skin; corneal microdepisits, photo sensitivity, long half life
Nursing implications: watch for pulmonary problems, stay out of sun, 75% will experience symptoms
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Class: IV
Subclass: calcium channel blocker
Prototype: Verapamil (Calandra)
Action: Blocks influx of Ca+ into cells
Indications: SVTs, Slows vent rate in A-fib or A-flutter
Side Effects: hypotension, constipation, peripheral edema, palps, tachy, Brady, Dyspnea
Nursing implications: increases intake of H2O and fiber, limit caffeine, monitor edema
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Class: Other
Subclass: misc
Prototype: adenosine (Adenocard)
Action: inhibits SA and AV node, impulse conduction
Indications: SVT work as a chemical defibrillator
Side Effects: Heart block, flushing, SOB, few seconds of asystole
Nursing Implications: need MD present; Emergency equip available
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