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Cardiac meds

Medications   (487 Views 6 Comments)
by teddy2009 teddy2009 (New) New Nurse

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Hi my question is Pt receiving amiodarone 200 mg and has a pacemaker. Bp 94/58. More experienced nurses tell me they would still give Med to pt. Same with BP meds without parameters. I always freak out. Cardizem, diltazem, carvedilol .... I am going to ask my fathers cardiologist when do you hold those meds. What irritates me there are no parameters and may be I am thinking too much... but if pacemaker set for pulse of 60 and bp below 100 would you still give it? Thank you for understanding 

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5 minutes ago, teddy2009 said:

... I am going to ask my fathers cardiologist when do you hold those meds. ...

Why don't you ask the prescribing physician? 

Don't you think that would be more helpful?

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I am talking in general . I always ask md if I should hold cardiac meds. Just wanted experienced nurses to see what they would do in situations like that. I

my fathers cardiologist - I just want to hear what the doctor will tell me

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I would ask for parameters next time.  Things you can do if you don't have them:  Look at past vitals before the med was given, and look to see how he tolerated it then.  General guidelines if you don't have any are SBP <100 and HR<60.  Having said that amiodarone has a really long half-life so skipping a dose may not have much of an effect on blood concentration anyway?

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kaylee. has 6 years experience and specializes in Stepdown . Telemetry.

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7 hours ago, teddy2009 said:

 ...if pacemaker set for pulse of 60 and bp below 100 would you still give it? 

Yes I would give it. I advise you learn about what these drugs actually do. It seems you are unclear on this. Amiodarone controls rhythm, and is not a rate control drug. It also has negligible affect on BP

It would be generally safe to give here. But do some research and learn about why its given etc. 

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20 hours ago, kaylee. said:

Yes I would give it. I advise you learn about what these drugs actually do. It seems you are unclear on this. Amiodarone controls rhythm, and is not a rate control drug. It also has negligible affect on BP

It would be generally safe to give here. But do some research and learn about why its given etc. 

It can cause atropine-resistant bradycardia and hypotension as it has non-competitive alpha and beta adrenergic antagonism.  This patient has been on it for a while it sounds and this is just a maintenance dose, so I doubt you would see these effects here, but I think parameters are important b/c as the nurse you could be blamed for an adverse event if hemodynamic compromise does occur for some reason and you gave a drug with "borderline" vitals.

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