Class iv drugs ccbs have limited usefulness in

• • Class IV drugs (CCBs) have limited usefulness in treating tachydysrhythmias (dysrhythmias
involving tachycardia).
• • Digoxin still has a place in dysrhythmia management, especially in the prevention of dangerous
ventricular tachydysrhythmias secondary to atrial fibrillation. Adverse effects common to most
antidysrhythmics include hypersensitivity reactions, nausea, vomiting, and diarrhea. Other common
effects include dizziness, headache, and blurred vision. In addition, many antidysrhythmics are
themselves capable of producing new dysrhythmias (prodysrhythmic effect).
• • The main toxic effects of the antidysrhythmics involve the heart, circulation, and central nervous
system. Specific antidotes are not available, and the management of an overdose involves
maintaining adequate circulation and respiration.
• • Significant interactions are those that can result in dysrhythmias, hypotension or hypertension,
respiratory distress, or excessive therapeutic or toxic drug effects.
• • One particular potential interaction common to many antidysrhythmics is anticoagulant activity
with warfarin (Coumadin ® ). Because many patients receiving antidysrhythmic therapy also need
warfarin, the international normalized ratio must be closely monitored and necessary adjustments
made to the warfarin dosage. This is especially true with amiodarone.

NURSING PROCESS
Assessment
• • Before administering any antidysrhythmic to a patient, conduct a thorough nursing assessment
and head-to-toe physical assessment, and complete a medical history and medication profile.
• • Nursing actions for the various antidysrhythmics include skillful nursing assessment and close
monitoring of heart rate, blood pressure, heart rhythms, general well-being, skin colour,
temperature, and heart and breath sounds.
• • Gender-based differences in the pattern and outcomes of the presentation of cardiovascular
disease remains complex due to anatomical, physiological, and genetic factors to health behaviour
differences; delays in the response to symptoms; and the underuse of gold-standard testing and
treatments.
• • Review any baseline electrocardiograms (ECGs) and interpret the results. Measure the patient’s
vital signs with attention to blood pressure, postural blood pressure, heart sounds, and heart rate,
rhythm, and quality.
• • Other signs and symptoms that are related to decreased cardiac functioning (as a result of
dysrhythmia and a decrease in cardiac output) include apical–radial pulse deficits, jugular vein
distension, edema, prolonged capillary refill (longer than 5 seconds), decreased urinary output,
activity intolerance, chest pain or pressure, dyspnea, and fatigue.
• • Document any changes in level of alertness, increase in anxiety levels, syncope, or dizziness.
With the use of lidocaine, assess the cardiovascular system, with attention to heart rate and blood
pressure.