Diferencia entre revisiones de «Antiarrhythmics»

(Created page with "==Lidocaine== ===Adult Dosing=== *Loading dose = 1-1.5 mg/kg **Additional boluses of 0.5-0.75 mg/kg q5-10min up to max of 3mg/kg **If effective start infusion of 2mg/min ===Pedi...")
 
Sin resumen de edición
Línea 4: Línea 4:
**Additional boluses of 0.5-0.75 mg/kg q5-10min up to max of 3mg/kg
**Additional boluses of 0.5-0.75 mg/kg q5-10min up to max of 3mg/kg
**If effective start infusion of 2mg/min
**If effective start infusion of 2mg/min
===Pediatric Dosing===


===Contraindications===
===Contraindications===
Línea 15: Línea 13:


===Mechanism of Action===
===Mechanism of Action===
*Class Ib antiarrhythmic
*Class Ib
**Binds to fast Na channels in inactive state thereby inhibiting recovery after repolarization
**Binds to fast Na channels in inactive state thereby inhibiting recovery after repolarization
**Acts preferentially on ischemic tissue
**Acts preferentially on ischemic tissue
***Elevates V-fib threshold
***Elevates V-fib threshold
***Suppresses ventricular ectopy
***Suppresses ventricular ectopy
*Little effect on vascular tone, contractility or cardiac output


===Adverse Drug Rxns===
===Adverse Drug Rxns===
*CNS
*CNS
**Abrupt change in MS, drowsiness, confusion, sz
**Abrupt change in MS, drowsiness, confusion, sz


===Kinetics===
===Kinetics===
Línea 30: Línea 28:
*Duration of action = 10-20min
*Duration of action = 10-20min


===Pregnancy/Lactation===
==Procainamide==
 
===Adult Dosing===
*Continuous infusion rate has fewer adverse effects
**20mg/min for 25-30min
***If effective start cont infusion of 1-4mg/min
 
===Contraindications===
*Not recommended for V-fib or pulseless V-tach (too long to dose)
*2nd or 3rd AV block
*Severe glycoside intoxication
*Prolonged QT
*Myasthenia gravis
 
===Indications===
*Wide-complex tachycardia of unknown type (in pts w/ preserved LV function)
*Stable V-tach
*
===Mechanism of Action===
*Class Ia
**Binds to fast Na channels in inactive state thereby inhibiting recovery after repolarization
**Prolongs action potential and reduces speed of impulse conduction
***Depresses myocardial conduction
**May act as negative inotrope, cause hypotension (peripheral vasodilation)
 
===Adverse Drug Rxns===
*Myocardial depression
*Watch for QRS/QT prolongation, V-tach, Vfib, complete AV block, torsades
===Kinetics===
*Onset of action = 5-10min


===Overdose Mgmt===
===Overdose Mgmt===


===Interactions===


===IV Info===


===Other===
 
 
 
 
===Adult Dosing===
===Contraindications===
===Indications===
===Mechanism of Action===
===Adverse Drug Rxns===
===Kinetics===
===Overdose Mgmt===
 
 
 
 
 
 
 


===Source===
===Source===

Revisión del 19:00 9 may 2011

Lidocaine

Adult Dosing

  • Loading dose = 1-1.5 mg/kg
    • Additional boluses of 0.5-0.75 mg/kg q5-10min up to max of 3mg/kg
    • If effective start infusion of 2mg/min

Contraindications

  • High SA or AV block

Indications

  • Treatment of ventricular arrhythmias and ectopy
    • Considered 2nd-line to amiodarone for tx of V-fib and pulseless v-tach

Mechanism of Action

  • Class Ib
    • Binds to fast Na channels in inactive state thereby inhibiting recovery after repolarization
    • Acts preferentially on ischemic tissue
      • Elevates V-fib threshold
      • Suppresses ventricular ectopy
  • Little effect on vascular tone, contractility or cardiac output

Adverse Drug Rxns

  • CNS
    • Abrupt change in MS, drowsiness, confusion, sz

Kinetics

  • Onset of action = 45-90s
  • Duration of action = 10-20min

Procainamide

Adult Dosing

  • Continuous infusion rate has fewer adverse effects
    • 20mg/min for 25-30min
      • If effective start cont infusion of 1-4mg/min

Contraindications

  • Not recommended for V-fib or pulseless V-tach (too long to dose)
  • 2nd or 3rd AV block
  • Severe glycoside intoxication
  • Prolonged QT
  • Myasthenia gravis

Indications

  • Wide-complex tachycardia of unknown type (in pts w/ preserved LV function)
  • Stable V-tach

Mechanism of Action

  • Class Ia
    • Binds to fast Na channels in inactive state thereby inhibiting recovery after repolarization
    • Prolongs action potential and reduces speed of impulse conduction
      • Depresses myocardial conduction
    • May act as negative inotrope, cause hypotension (peripheral vasodilation)

Adverse Drug Rxns

  • Myocardial depression
  • Watch for QRS/QT prolongation, V-tach, Vfib, complete AV block, torsades

Kinetics

  • Onset of action = 5-10min

Overdose Mgmt

Adult Dosing

Contraindications

Indications

Mechanism of Action

Adverse Drug Rxns

Kinetics

Overdose Mgmt

Source

Tintinalli

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