CAN YOU IDENTIFY these antiarrhythmic drugs used to maintain sinus rhythm in adults with atrial fibrillation? Match the medications in Section I with the description in Section II.

Section I

_____ 1. Cordarone (Wyeth Pharmaceuticals)

_____ 2. Tikosyn (Pfizer Laboratories)

_____ 3. Rythmol (GlaxoSmithKline)

_____ 4. Betapace AF (Bayer HealthCare Pharmaceuticals)

Section II

a. amiodarone. This drug has predominantly Vaughan Williams Class III effects. It has a boxed warning for several potentially fatal toxicities, including hepatic and pulmonary toxicity. Teach patients to avoid grapefruit juice due to the increased risk of toxicity.

b. dofetilide. This drug shows Vaughan Williams Class III antiarrhythmic activity. QT interval prolongation and the risk of ventricular dysrhythmias are directly related to plasma concentrations of dofetilide, so monitor creatinine clearance results closely.

c. propafenone. Precautions for this Class 1C antiarrhythmic drug include provoking overt heart failure and possible agranulocytosis or granulocytopenia. Instruct patients to immediately report any signs of infection such as fever, sore throat, or chills.

d. sotalol. This drug has both beta-adrenoreceptor blocking (Vaughan Williams Class II) and cardiac action potential duration prolongation (Vaughan Williams Class III) antiarrhythmic properties. It can cause serious ventricular dysrhythmias, primarily torsade de pointes. Teach patients to notify their healthcare provider right away or call 911 if they feel new fast heartbeats with lightheadedness or fainting.

Resources available upon request.

ANSWERS: 1a, 2b, 3c, 4d