Chapter 26: Antidysrhythmic Drugs
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice
MULTIPLE CHOICE
1. The Vaughan Williams classification categorizes amiodarone as a Class III drug. How does this drug
work?
a. By blocking slow calcium channels
b. By prolonging action potential duration
c. By blocking sodium channels and affecting phase 0
d. By decreasing spontaneous depolarization and affecting phase 4
ANS: B
These drugs control dysrhythmias by inhibiting repolarization and by prolonging refractoriness and the
action potential duration.
DIF: Cognitive Level: Knowledge
2. Which is an adverse effect associated with the use of procainamide (Procan SR®)?
a. Tinnitus
b. Shortened QT interval
c. Constipation
d. Diarrhea
ANS: D
Diarrhea is a potential adverse effect of procainamide therapy.
DIF: Cognitive Level: Comprehension
3. Which nursing diagnosis is appropriate for a patient receiving antidysrhythmics?
a. Risk for infection
b. Risk for injury to self
c. Excess fluid volume
d. Impaired skin integrity
ANS: B
Dizziness, fatigue, and orthostatic hypotension are possible adverse effects that may cause injury and
put the patient at risk for falls.
, DIF: Cognitive Level: Analysis
4. A patient will be discharged on quinidine sulphate (Apo-Quin-G®) extended-release tablets for the
treatment of ventricular ectopy.
What important information should the nurse give the patient about this medication?
a. The medication should be stopped once the cardiac symptoms subside.
b. Signs of cinchonism (such as tinnitus, loss of hearing, or slight blurring of vision)
may occur.
c. Because of increased photosensitivity, sunscreen products should be used when outside.
d. Any tablet or capsule visible in the stool indicates an absorption problem and should be
reported immediately.
ANS: B
Quinidine, a cinchona alkaloid, may cause the symptoms of cinchonism. The medication will need to be
continued even after symptoms subside, or the symptoms may return. Tablets or capsules that are
visible in the stool are actually the wax matrixes; the medication is extracted while in the intestines.
Photosensitivity occurs with Class III drugs but not with quinidine, which is a Class Ia drug.
DIF: Cognitive Level: Application
5. What is the drug of choice for acute ventricular dysrhythmias associated with myocardial infarction
(MI)?
a. diltiazem (Cardizem®)
b. metroprolol tartrate (Lopressor®)
c. amiodarone hydrochloride (Cordarone®)
d. adenosine (Adenocard®)
ANS: C
Amiodarone hydrochloride (Cordarone) is the drug of choice for ventricular dysrhythmias according to
the Advanced Cardiac Life Support guidelines. Recently, it has shown promise in the management of
atrial dysrhythmias that are difficult to treat with other, less toxic drugs. Metroprolol tartrate
(Lopressor)is a b-blocker commonly given after an MI to reduce the risk of sudden cardiac death. It is
also used in the treatment of hypertension and angina. Adenosine (Adenocard) is indicated for the
conversion of paroxysmal supraventricular tachycardia (PSVT) to sinus rhythm, and diltiazem is used for
treating dysrhythmias and controlling the ventricular response to atrial fibrillation and flutter by slowing
conduction and prolonging refractoriness of the atrioventricular node.
DIF: Cognitive Level: Knowledge
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice
MULTIPLE CHOICE
1. The Vaughan Williams classification categorizes amiodarone as a Class III drug. How does this drug
work?
a. By blocking slow calcium channels
b. By prolonging action potential duration
c. By blocking sodium channels and affecting phase 0
d. By decreasing spontaneous depolarization and affecting phase 4
ANS: B
These drugs control dysrhythmias by inhibiting repolarization and by prolonging refractoriness and the
action potential duration.
DIF: Cognitive Level: Knowledge
2. Which is an adverse effect associated with the use of procainamide (Procan SR®)?
a. Tinnitus
b. Shortened QT interval
c. Constipation
d. Diarrhea
ANS: D
Diarrhea is a potential adverse effect of procainamide therapy.
DIF: Cognitive Level: Comprehension
3. Which nursing diagnosis is appropriate for a patient receiving antidysrhythmics?
a. Risk for infection
b. Risk for injury to self
c. Excess fluid volume
d. Impaired skin integrity
ANS: B
Dizziness, fatigue, and orthostatic hypotension are possible adverse effects that may cause injury and
put the patient at risk for falls.
, DIF: Cognitive Level: Analysis
4. A patient will be discharged on quinidine sulphate (Apo-Quin-G®) extended-release tablets for the
treatment of ventricular ectopy.
What important information should the nurse give the patient about this medication?
a. The medication should be stopped once the cardiac symptoms subside.
b. Signs of cinchonism (such as tinnitus, loss of hearing, or slight blurring of vision)
may occur.
c. Because of increased photosensitivity, sunscreen products should be used when outside.
d. Any tablet or capsule visible in the stool indicates an absorption problem and should be
reported immediately.
ANS: B
Quinidine, a cinchona alkaloid, may cause the symptoms of cinchonism. The medication will need to be
continued even after symptoms subside, or the symptoms may return. Tablets or capsules that are
visible in the stool are actually the wax matrixes; the medication is extracted while in the intestines.
Photosensitivity occurs with Class III drugs but not with quinidine, which is a Class Ia drug.
DIF: Cognitive Level: Application
5. What is the drug of choice for acute ventricular dysrhythmias associated with myocardial infarction
(MI)?
a. diltiazem (Cardizem®)
b. metroprolol tartrate (Lopressor®)
c. amiodarone hydrochloride (Cordarone®)
d. adenosine (Adenocard®)
ANS: C
Amiodarone hydrochloride (Cordarone) is the drug of choice for ventricular dysrhythmias according to
the Advanced Cardiac Life Support guidelines. Recently, it has shown promise in the management of
atrial dysrhythmias that are difficult to treat with other, less toxic drugs. Metroprolol tartrate
(Lopressor)is a b-blocker commonly given after an MI to reduce the risk of sudden cardiac death. It is
also used in the treatment of hypertension and angina. Adenosine (Adenocard) is indicated for the
conversion of paroxysmal supraventricular tachycardia (PSVT) to sinus rhythm, and diltiazem is used for
treating dysrhythmias and controlling the ventricular response to atrial fibrillation and flutter by slowing
conduction and prolonging refractoriness of the atrioventricular node.
DIF: Cognitive Level: Knowledge
