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Class iv drugs ccbs have limited usefulness in

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Class IV drugs (CCBs) have limited usefulness in treating tachydysrhythmias (dysrhythmiasinvolving tachycardia).Digoxin still has a place in dysrhythmia management, especially in the prevention of dangerousventricular tachydysrhythmias secondary to atrial fibrillation. Adverse effects common to mostantidysrhythmics include hypersensitivity reactions, nausea, vomiting, and diarrhea. Other commoneffects include dizziness, headache, and blurred vision. In addition, many antidysrhythmics arethemselves capable of producing new dysrhythmias (prodysrhythmic effect).The main toxic effects of the antidysrhythmics involve the heart, circulation, and central nervoussystem. Specific antidotes are not available, and the management of an overdose involvesmaintaining 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 activitywith warfarin (Coumadin®). Because many patients receiving antidysrhythmic therapy also needwarfarin, the international normalized ratio must be closely monitored and necessary adjustmentsmade to the warfarin dosage. This is especially true with amiodarone.
NURSING PROCESSAssessmentBefore administering any antidysrhythmic to a patient, conduct a thorough nursing assessmentand head-to-toe physical assessment, and complete a medical history and medication profile.Nursing actions for the various antidysrhythmics include skillful nursing assessment and closemonitoring 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 cardiovasculardisease remains complex due to anatomical, physiological, and genetic factors to health behaviourdifferences; delays in the response to symptoms; and the underuse of gold-standard testing andtreatments.Review any baseline electrocardiograms (ECGs) and interpret the results. Measure the patient’svital 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 ofdysrhythmia and a decrease in cardiac output) include apical–radial pulse deficits, jugular veindistension, 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 bloodpressure.

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