Emergency

Emergency Antiarrhythmics

Emergency & Critical Care

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Examples

amiodaronelidocaineadenosinemagnesium sulfateprocainamide

Prefix / Suffix: No single suffix

Physiology

Arrhythmias disrupt cardiac conduction and can reduce cardiac output. Emergency antiarrhythmics target abnormal electrical pathways or unstable rhythms.

Mechanism of Action

They alter ion movement or AV node conduction to slow, terminate, or stabilize abnormal rhythms depending on drug class.

Indications

  • Ventricular fibrillation or pulseless ventricular tachycardia
  • Stable narrow-complex SVT
  • Wide-complex tachycardia
  • Torsades de pointes
  • Selected atrial arrhythmias

Side Effects / Adverse Effects

  • Hypotension
  • Bradycardia or heart block
  • QT prolongation
  • Proarrhythmia
  • Flushing/chest pressure briefly with adenosine

Contraindications

  • Adenosine: second/third-degree AV block without pacemaker
  • QT-prolonging drugs in torsades risk unless indicated
  • Severe bradycardia or heart block for AV nodal blockers
  • Drug-specific allergy

Nursing Considerations

  • Confirm rhythm and patient stability before giving
  • Place on continuous ECG and frequent blood pressure monitoring
  • For adenosine: give rapid IV push followed by rapid flush and warn patient about brief uncomfortable sensation
  • Monitor QT interval when using QT-prolonging drugs
  • Prepare for cardioversion or defibrillation when unstable

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.