- Body system
- Cardiovascular
- Drug cards
- 1 in this guide
Drugs in this class
Other examples: Adenosine, Lidocaine, Sotalol, Flecainide, Procainamide, Dronedarone.
How antiarrhythmics work
Grouped by the Vaughan Williams classes: I (sodium channel blockers), II (beta blockers), III (potassium channel blockers such as amiodarone and sotalol), IV (calcium channel blockers). Adenosine briefly blocks the AV node.
Uses
- Atrial fibrillation and flutter
- Supraventricular tachycardia (adenosine)
- Ventricular tachycardia and fibrillation (amiodarone, lidocaine)
Adverse effects
- New or worsened dysrhythmias
- QT prolongation
- Bradycardia and hypotension
- Organ toxicity with amiodarone (lungs, liver, thyroid, eyes, skin)
Nursing considerations
- Continuous ECG monitoring when starting or giving IV.
- Monitor potassium and magnesium: low levels increase dysrhythmia risk.
- Adenosine is given as a rapid IV push followed immediately by a rapid saline flush; warn the patient about brief chest discomfort and a short pause in the heartbeat.
Patient teaching
- Learn to check your pulse.
- Report palpitations, fainting or shortness of breath.
- Keep all follow-up tests.
Antiarrhythmics NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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How is adenosine given for supraventricular tachycardia?
Show answer
Answer C: Rapid IV push followed immediately by a rapid saline flush Adenosine has a half-life of seconds, so it must reach the heart quickly: rapid push close to the heart, then a fast flush.
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A patient on long-term amiodarone reports a new dry cough and shortness of breath. What does the nurse suspect?
Show answer
Answer C: Pulmonary toxicity Pulmonary toxicity is one of amiodarone's most serious adverse effects and must be reported.
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Which ECG change is most important to monitor with many antiarrhythmics?
Show answer
Answer C: QT prolongation QT prolongation can lead to torsades de pointes, a life-threatening ventricular rhythm.
Frequently asked questions
What are antiarrhythmics?
Antiarrhythmics restore or control heart rhythm. Many can also cause dysrhythmias, so ECG monitoring (especially the QT interval) is central to nursing care.
How do antiarrhythmics work?
Grouped by the Vaughan Williams classes: I (sodium channel blockers), II (beta blockers), III (potassium channel blockers such as amiodarone and sotalol), IV (calcium channel blockers). Adenosine briefly blocks the AV node.
What are examples of antiarrhythmics?
Amiodarone, Adenosine, Lidocaine, Sotalol, Flecainide, Procainamide and Dronedarone.
What are the nursing considerations for antiarrhythmics?
Continuous ECG monitoring when starting or giving IV. Monitor potassium and magnesium: low levels increase dysrhythmia risk.