What is the drug of choice for ventricular tachycardia?

Amiodarone is the drug of choice for the treatment of hemodynamically unstable VT that is refractory to other antiarrhythmic agents. Prehospital studies currently suggest that amiodarone is safe and efficacious for use in out-of-hospital cardiac arrest.

What is the contraindications for phenytoin?

Hypersensitivity to phenytoin or other hydantoins is a contraindication for using phenytoin. Pregnancy is another absolute contraindication for phenytoin use.

Why does phenytoin cause heart arrhythmia?

Intravenous phenytoin has been known to produce cardiovascular collapse when administered too quickly; however, this is thought to be related to toxicity from its diluent propylene glycol. In these cases, patients developed hypotension and bradyarrhythmias.

What is the treatment for stable v tach?

In stable patients with monomorphic VT and normal LV function, restoration of sinus rhythm is typically achieved with intravenous (IV) procainamide, amiodarone, or sotalol. Lidocaine may also be used, but this agent may have common and limiting side effects and, consequently, increase the overall mortality risk.

What is the first line treatment for ventricular tachycardia?

Anti-arrhythmic medications are the first-line therapy in emergency departments and CCUs, as discussed earlier. Amiodarone is most commonly used, along with lidocaine, and in some cases procainamide.

Which drug is used to treat atrial and ventricular tachycardia or fibrillation?

The class III drugs are used to treat primarily atrial fibrillation, however amiodarone is FDA approved only for the treatment of ventricular tachycardia. Amiodarone is very effective however amiodarone toxicity is a concern.

Who should not take phenytoin?

You should not use phenytoin if you are allergic to it, or if you have ever had: Tell your doctor if you have ever had: Some people have thoughts about suicide while taking phenytoin. Your doctor will need to check your progress at regular visits.

Is phenytoin contraindicated in pregnancy?

This drug should not be used during pregnancy unless the benefit outweighs the risk to the fetus. Comments: -If this drug is used during pregnancy, or if the patient becomes pregnant while taking the drug, the patient should be informed of the potential harm to the fetus.

How does phenytoin affect the heart?

In previous decades, several patients experienced adverse effects of intravenous phenytoin such as severe heart arrhythmias and decrease of blood pressure. These potential adverse effects caused a reluctance to use intravenous phenytoin which has also led to a search for safer antiepileptic drugs.

Can phenytoin cause heart problems?

Phenytoin is a frequently used antiepileptic medication for the treatment of seizure disorder. The common side effects include nausea, rash, gingival hypertrophy, osteomalacia, and confusion. The potential to cause cardiac rhythm disturbances, hypotension, and cardiac arrest is rarely recognized.

Do you give adenosine for stable Vtach?

Adenosine may be used as a diagnostic maneuver in stable monomorphic wide complex tachycardia in a dose of 6 mg IV fast push, may repeat with 12 mg. Adenosine is contraindicated in asthma, WPW, polymorphic Vtach, irregular Vtach or Vtach from ischemia.

How do you treat v tach without a pulse?

Medical treatment of pulseless VT usually is carried out along with defibrillation and includes intravenous vasopressors and antiarrhythmic drugs. 1 mg of epinephrine IV should be given every 3 to 5 minutes. Epinephrine can be replaced by vasopressin given 40 units IV once.

How is phenytoin used in the treatment of refractory ventricular arrhythmia?

Lessons from practice. Phenytoin has class IB antiarrhythmic drug properties and is a potential treatment option for patients with refractory ventricular arrhythmia when other agents have failed or are unavailable. However, phenytoin has a narrow therapeutic range and the potential for multiple drug interactions.

How is phenytoin used as a non-emergency therapy?

As non-emergency therapy, Dilantin should be administered more slowly as either a loading dose or by intermittent infusion. Because of the risks of cardiac and local toxicity associated with intravenous Dilantin, oral phenytoin should be used whenever possible.

How are phenytoin sodium injections related to barbiturates?

Dilantin (phenytoin sodium injection, USP) is a ready-mixed solution of phenytoin sodium in a vehicle containing 40% propylene glycol and 10% alcohol in water for injection, adjusted to pH 12 with sodium hydroxide. Phenytoin sodium is related to the barbiturates in chemical structure, but has a five-membered ring.

Is it safe to take phenytoin for VT?

Rapid loading of phenytoin for VT has been associated with fatal arrhythmogenic complications3 and should therefore be cautiously performed. Phenytoin, a commonly used drug in the treatment of status epilepticus, is an old but effective treatment option in patients with malignant VT or electrical storm.