Question

Atrial fibrillation is the most common dysrhythmia treated in the US. Warfarin, enoxaparin, and rivaroxaban are all used at-home care for patients who have or at risk of developing atrial fibrillation.

A) Why are the most commonly used medications for treating patients with a-fib not antidysrhythmic drugs (i.e., they are not intended to alter the rhythmicity of the heart)?

B) What are the notable differences in patient education a nurse should provide to patients discharged with prescriptions for warfarin, enoxaparin, and rivaroxaban (i.e., what is particularly different about these three medications that a patient should know about to correctly take and monitor the side effects of each drug)?

Answer 1

A) Commonly used antidysrhythmic drugs are : procainamide (Pronestyl); disopyramide (Norpace); flecainide acetate (Tambocor); propafenone (Rythmol); sotalol (Betapace); dofetilide (Tikosyn) and amiodarone (Cordarone).

B) Nurses education to be given to patient with prescription of warfarin, enoxaparin, and rivaroxaban :

• Do not take warfarin if you cannot take it on time every day. Warfarin increases your risk of severe or fatal bleeding, especially if you have certain medical conditions, if you are 65 or older, or if you have had a stroke, or bleeding in your stomach or intestines.
• If you miss or forget a dose, call your healthcare provider for advice. Don't take a double dose.
• Don't walk barefoot, and avoid activities that have a risk of injury, such as contact sports.
• Take care not to cut yourself when using knives and other sharp objects.
• Call your healthcare provider right away if you have any signs of unusual bleeding or bruising such as bleeding from a cut that doesn't stop, bleeding gums, pink or brown urine, red or dark-colored stool, heavier-than-normal menstrual bleeding or abnormal vaginal bleeding, a nosebleed, or coughing up or vomiting blood.