Anti Dysrhythmic Drugs

Adenosine can "chemically cardiovert" PSVT to a normal sinus rhythm. It has a half-life of 10sec and does not cause hypotension

- Narrow, complet paroxysmal supraventricular tachycardia refractory to vagal maneuvers

• - 2nd & 3rd degree heart block
• - sinus node disease
• - asthma

• - may cause transient dysrhythmias especially asystole
• - COPD

• - 6mg rapidly (1-2sec) IV, flush line w/ NS rapidly
• - If ineffective, give 12mg IV (1-2 min). May be repeated

• Amiodarone is an anti-dysrhythmic that prolongs the durations of the action potential and refractory period
• -relaxes smooth muscles, reducing peripheral vascular resistance and increasing coronary blood flow

• - life threatening ventricular and supraventricular dysrythmias
• - frequent atrial fibrillation

• - cardiogenic shock
• - severe sinus bradycardia
• - advanced heart block

• - 150-300 mg IV over 10 minutes
• - then 1mg/min over next 6hours

Bretylium suppresses ventricular tachydysrhythmicas including VFIB with re-entry mechanisms

• - Digitalized patients
• - Digitalis-induced dysrhythmias

- 5mg/kg IV, then 10mg/kg/15-30 min, to a max of 30mg/kg

• - Lidocaine is an anti-dysrhythmic that suppresses automaticity and raises stimulation threshold of the ventricles.
• - Also causes sedation, anti-convulsant, and analgesic effects

• - Pulseless ventricular tachycardia
• - Ventricular fibrillation
• - Ventricular tachycardia (with pulse)

• - Hypersensitivity to amide-type local anasthetics
• - Supraventricular dysrhythmias
• - Stokes-Adams syndrome
• - 2nd & 3rd degree heart blocks
• - Bradycardia

• - Hepatic or renal impairment
• - CHF
• - Hypoxia
• - Respiratory depression
• - Hypovolemia
• - Myasthenia gravis
• - shock
• - elderly

Cardiac Arrest : 1-1.5mg/kg IV, repeated every 3-5min up to 3mg/kg

Ventricular Tachycardia (with pulse) : 1-1.5mg/kg slow IV. May repeate at one-half dose every 5-10min until conversion up to 3mg/kg