Atropine Sulfate

anticholinergic

Competes w/ Ach receptor sites @ SA & AV nodes causing incr'd HR by incr'g cond'n @ nodes. Inhibits secretions by decreasing PNS effects on salivary, bronchial, sweat, heart, GI tract.

Ind: Symptomatic bradycardia  0.5 mg IVP, q 3-5 min (max 3 mg)

Organophophate OD  2 mg IVP q 3-5 min till effective

CI: AMI; Myasthenia Gravis; closed-angle glaucoma; high deg AV block

SE: tachycardia; blurred vis or dilated pupils w/ subsequent photophobia; hot, dry, flushed skin; paradoxical bradycardia if admin'd too slowly or in too small a dose

Metoprolol (Lopressor, Toprol XL)

B blocker (class II antiarrhythmic)

Procainamide (Pronestyl)

Class 1a antiarrhythmic

Cardizem (Diltiazem)

Class IV antiarrhythmic: Non-DHP Ca++ channel blocker

Blocks Ca++ from moving into myocardial cells, which prolongs conduction of electrical impulses through the AV node, controlling ventricular rate.

Ind: Vent contr in AF, af (>170 bpm if vent >160 bpm); MAT; SVT refractory to adenosine; chem-induced tachycardia (e.g. meth, coke, energy drinks, diet pills)

Dose: 0.25 mg/kg SIVP (2 mins), may repeat @ 0.35 mg/kg after 15 mins. Stop if BP drops or Pt gets dizzy.

CI: HypoTN; AV blocks; CHF

SE: dramatic drop in BP; bradycardia; syncope; dizziness; SOB

SPINS: Drug of choice for AF, af. Extreme caution in B blocker Pts d/t potentiation of effects/toxicity.

Procainamide (Pronestyl)

Verapamil (Isoptin)--Non-DHP Ca++ channel blocker;

Cardizem (Diltiazem)--Non-DHP Ca++ channel blocker