Drug classes & major adverse effects | |
Beta blockers |
|
ACE inhibitors |
|
Sulfonylureas |
|
Thyroid replacement |
|
*May occur if combined with alcohol. |
نمونه سوال:
The nurse reviews the ECG of a client. Which prescribed medication should the nurse suspect as the cause of the ECG findings?
1. Captopril
2. Carvedilol
3. Glipizide
4. Levothyroxine
This client has sinus bradycardia, a cardiac dysrhythmia with the same characteristics as normal sinus rhythm on ECG except for a rate of <60/min. Causes of sinus bradycardia include:
- Medications (eg, beta blockers [carvedilol], calcium channel blockers, digoxin) (Option 2)
- Vagal stimulation (eg, carotid sinus massage, Valsalva maneuver)
- Medical conditions (eg, hypothyroidism, myocardial infarction, increased intracranial pressure)
Sinus bradycardia may also occur normally in athletes due to increased vagal tone resulting from regular exercise and in clients in relaxed states (eg, sleeping). All clients with sinus bradycardia should be assessed for symptoms of inadequate perfusion (eg, chest pain, syncope, hypotension, shortness of breath). Asymptomatic clients may require no intervention except continued monitoring.
(Options 1, 3, and 4) Adverse effects of ACE inhibitors, sulfonylureas, and thyroid replacement therapy include tachycardia rather than bradycardia.
Educational objective:
Causes of sinus bradycardia include medications (eg, beta blockers), vagal stimulation, and certain medical conditions (eg, hypothyroidism, myocardial infarction). Sinus bradycardia may also occur normally in athletes due to increased vagal tone resulting from regular exercise and in clients in relaxed states (eg, sleeping). Sinus bradycardia may require no intervention unless the client experiences symptoms of inadequate perfusion.