Critical Care: Emergency Medications

I. SODIUM CHANNEL BLOCKERS – ↓ conduction velocity in the atria, ventricles, His-Purkinje

  • Class 1A: Norpace/disopyramide, Pronestyl/procainamide, Quinora/quinidine
    – action: delays repolarization
    – effect on EKG: wide QRS, prolonged QT
  • Class 1B: Xylocaine/lidocaine, Mexitil/mexiletine, Dilantin/phenytoin
    – action: accelerates repolarization
    – effect on EKG: little to no effect
  • Class 1C: Tambocor/flecainide, Rythmol/propafenone
    – action: decreases impulse conduction
    – effect on EKG: pronounced prodysrhythmic actions, wide QRS, prolonged QT

II. BETA ADRENERGIC BLOCKERS

  • Tenormin/atenolol, Coreg/carvedilol, Brevibloc/esmolol, Lopressor/metropolol, Betapace/sotalol
    action: ↓ automaticity of SA node, ↓ conduction velocity of AV node,  atrial and ventricular contractility
    effect on EKG: bradycardia, prolonged PR, AV block

III. POTASSIUM CHANNEL BLOCKERS

  • Cordarone/amiodarone, Bretylol/bretylium, Tikosyn/dofetilide, Corvert/ibutilide, Betapace/sotalol
    action: delay repolarization, resulting in prolonged action potential and refractory period
    effect on EKG: prolonged PR and QT, wide QRS, bradycardia

IV. CALCIUM CHANNEL BLOCKERS

  • Cardizem/diltiazem, Calan/verapamil
    action: ↓ automaticity of SA node, delay AV node conduction, ↓ myocardial contractility
    effect on EKG: bradycardia, prolonged PR, AV block

V. OTHER

  • Adenocard/adenosine, Lanoxin/digoxin, Magnesium
    action: ↓ conduction through AV node, ↓ automaticity of SA node
    effect on EKG: prolonged PR, AV block
Image Source.
Content derived from Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 8th Edition.
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