Lecture Notes: Anti-Dysrhythmic Medications

Overview

• Discussion on anti-dysrhythmic medications: Classes 3, 4, 5
• Includes anticholinergic, anti-muscarinic medication for dysrhythmias

Class 3 Anti-Dysrhythmic Medications

• Potassium Channel Blockers
  • Key Medication: Amiodarone
    • Used for severe dysrhythmias (e.g., ventricular fibrillation, ventricular tachycardia)
    • Serious side effects:
      • Hypotension
      • Bradycardia
      • Pulmonary toxicity
      • Liver toxicity
      • Thyroid dysfunction
    • Black box warning for cardiac, liver, pulmonary toxicity
    • Memory Aid: "Amy owes me $100, but she’s in hospital with V-fib on amiodarone drip"
    • Avoid grapefruit juice when taking
  • Sotolol
    • Officially class 3 but a non-selective beta blocker
    • Important to focus on amiodarone

Class 4 Anti-Dysrhythmic Medications

• Calcium Channel Blockers
  • Includes Verapamil and Diltiazem
  • Treats atrial fibrillation, atrial flutter, supraventricular tachycardia
  • Side effects:
    • Hypotension
    • Peripheral edema
    • Bradycardia
    • Headache
    • Constipation
  • Monitoring: EKGs, vital signs; teach slow position changes

Class 5 Anti-Dysrhythmic Medications

• Adenosine
  • Used for supraventricular tachycardia
  • Memory Aid: "Den of sin causing tachycardia, needing adenosine"
  • Side effects:
    • Arrhythmias
    • Shortness of breath
    • Hypotension
• Other Class 5 Medications
  • Digoxin
  • Magnesium Sulfate
  • Monitoring: EKG rhythm; teach slow position changes

Anticholinergic/Anti-Muscarinic Medication

• Atropine
  • Used for sinus bradycardia, heart block, decrease secretions during surgery
  • Memory Aid: "Atropine is the trampoline to increase heart rate"
  • Mode of action: Inhibits acetylcholine sites, decreases vagal stimulation
  • Side effects:
    • Anticholinergic effects:
      • Blurred vision
      • Dry mouth
      • Urinary retention
      • Constipation
      • Tachycardia
  • Monitoring: Watch for urinary retention, increase fiber and fluid intake

Conclusion

• Summary of anti-dysrhythmic medications and key monitoring points
• Anticipate more videos on related topics.