Page 365 - Cardiac Nursing

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Full therapeutic effect may take up to 5 days digoxin levels. c Drug Interactions: Cimetidine, amiodarone, propranolol in- crease flecainide levels Additive negative inotropic effects with -blockers, Ca 2
blockers, disopyramide a a Prolongs QT interval: up to 6% incidence of torsades. Proarrhythmia usually oc- curs within 40 minutes. Monitor ECG continuously during administration and at least 4 hours after Conversion to NSR usually occurs within 20–30 minutes of infusion Do not give other Drug interactions:
Hypotension, VT, torsades, bundle- branch block, AV block, nausea, headache Side effects relatively rare CNS: lightheadedness, dizziness, tremor, agitation, tinnitus, blurred vision, convulsions, respiratory depression and arrest CV: bradycardia, asystole, hypotension, shock CV: hypotension, bradycardia, heart block, cardiac arrest CNS: weakness, drowsiness, peripheral neuromuscular blockade, absent deep tendon reflexes respiratory rate, respiratory Other: T paralysis Hypotension, bradycardia,
IV infusion of 1 mg over 10 minutes May repeat same dose in 10 minutes if needed 60 kg: 0.01 mg/kg In patients 6 hours Half-life For VT: 1 mg/kg IV bolus over 3 minutes followed by infusion at 2–4 mg/min. Repeat bolus of 0.5–0.75 mg/kg in 10 minutes to maintain therapeutic level. May repeat to total of 3 mg/kg For VF or pulseless VT: 1.5 mg/kg IV bo- lus. May repeat with same amount and follow with infusion at 2–4 mg/min May be given down ET tube during car- diac arrest if no IV available. 1.4–

Conversion of atrial fib or flutter to sinus Treatment of ventricular arrhythmias: VT, VF Effective for PVC suppression but PVC suppression not usually recommended May be useful for treatment or prevention of both supraventricular and ventricular arrhythmias after MI or cardiac surgery. Treatment of choice for TdP and may be useful in VF or pulseless VT refrac- tory to other drugs Ventricular rate control in atrial fib/ flutter Slow conduction through AV node in AVNRT and CMT Acute and chronic trea

Ibutilide (Corvert) (Class III antiarrhythmic) Lidocaine (Xylocaine) (Class IB antiarrhythmic) Magnesium Metoprolol (Lopressor) -blocker) (Cardioselective Mexiletine (Mexitil) (Class IB antiarrhythmic)

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