Pharmacologic Profile

General Use

Suppression of cardiac arrhythmias.

General Action and Information

Correct cardiac arrhythmias by a variety of mechanisms, depending on the group used. The therapeutic goal is ↓ symptomatology and ↑ hemodynamic performance. Choice of agent depends on etiology of arrhythmia and individual patient characteristics. Treatable causes of arrhythmias should be corrected before therapy is initiated (e.g., electrolyte disturbances, other drugs). Antiarrhythmics are generally classified by their effects on cardiac conduction tissue (see the following table). Adenosine, atropine, and digoxin are also used as antiarrhythmics.

Contraindications

Differ greatly among various agents. See individual drugs.

Precautions

Differ greatly among agents used. Appropriate dosage adjustments should be made in elderly patients and those with renal or hepatic impairment, depending on agent chosen. Correctable causes (electrolyte abnormalities, drug toxicity) should be evaluated. See individual drugs.

Interactions

Differ greatly among agents used. See individual drugs.

Nursing Implications

Assessment

• Monitor ECG, pulse, and BP continuously throughout IV administration and periodically throughout oral administration.

Potential Nursing Diagnoses

• Decreased cardiac output (Indications)
• Deficient knowledge related to disease processes and medication regimen (Patient/Family Teaching)

Implementation

• Take apical pulse before administration of oral doses. Withhold dose and notify physician or other health care professional if heart rate is <50 bpm.

Patient/Family Teaching

• Instruct patient to take oral doses around the clock, as directed, even if feeling better.
• Instruct patient or family member on how to take pulse. Advise patient to report changes in pulse rate or rhythm to health care professional.
• Caution patient to avoid taking OTC medications without consulting health care professional.
• Advise patient to carry identification describing disease process and medication regimen at all times.
• Emphasize the importance of follow-up exams to monitor progress.

Evaluation/Desired Outcomes

• Resolution of cardiac arrhythmias without detrimental side effects.