Mindanao State University – Iligan Institute of Technology Student: Bianca Mikaela F.

Dosdos
Block: 262

PHARMACOLOGY

DRUG STUDY

Brand Name: Tambocor Generic Name: Flecainide Drug Classification: Anti-arrhythmics

Dosage, Route & Frequency

Drug-Drug & Drug-Food Side Effects Adverse Reactions (By
Recommende Drug Action Indications Contraindications
Prescribed Interactions (By System) System)
d
Ventricular  Slows Drug-Drug:  Life-threatening  Hypersensitiv CNS: CNS:
Tachycardia conduction in qrisk of arrhythmias with ventricular ity dizziness, anxiety, dizziness, anxiety,
PO (Adults): cardiac tissue other antiarrhythmics, arrhythmias,  Cardiogenic fatigue, headache, fatigue, headache,
100 mg q 12 hr by altering including calcium channel including shock mental depression. mental depression.
initially,qby 50 transport of blockers. Disopyramide, ventricular EENT: EENT:
mg twice daily ions across cell beta blockers, tachycardia. blurred vision, visual blurred vision, visual
until response membranes. orverapamilmay have Supraventricular disturbances. disturbances.
is obtained or qmyocardial depressant tachyarrhythmias CV: CV:
maximum effects; combination use including: ARRHYTHMIAS, CHEST ARRHYTHMIAS, CHEST
total daily should be undertaken Paroxysmal PAIN, HF. GI:anorexia, PAIN, HF. GI:anorexia,
dose of 400 cautiously. Amiodarone supraventricular constipation, drug- constipation, drug-
mg is reached. doubles serum flecainide tachycardia induced hepatitis, induced hepatitis,
Some patients levels (pflecainide dose by (PSVT), nausea, stomach pain, nausea, stomach pain,
may require q 50%).qserum digoxin levels Paroxysmal atrial vomiting. vomiting.
8 hr dosing. by a small amount (15– fibrillation/flutter Derm: Derm:
Renal 25%). Concurrent beta (PAF). Unlabeled rash. rash.
Impairment blocker therapy may Use: Single dose Neuro: Neuro:
PO (Adults): causeqlevels of beta treatment of tremor. tremor.
CCr 35 blocker and flecainide. atrial fibrillation.
mL/min—100 Alkalinizing agents
mg once a day promote
or 50 mg q 12 reabsorption,qblood levels,
hr initially; and may cause toxicity.
further dosing Acidifying agentsqrenal
on the basis of elimination and
frequent blood maypeffectiveness of
level flecainide (if urine pH 5).
monitoring.
PSVT/PAF PO
(Adults): 50 Drug-Food:
mg q 12 hr Foods thatqurine pH to
initially,qby 50
mg twice daily 7 result inqlevels (strict
until response vegetarian diet). Foods or
is obtained or beverages thatpurine pH to
maximum 5qrenal elimination and
total daily mayp effectiveness of
dose of 300 flecainide(acidic juices)
mg is reached.
Some patients
may require q
8 hr dosing.
Atrial
Fibrillation
(unlabeled) PO
(Adults): 200
mg or 300 mg
single dose.
Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment Patient/Family Teaching
● Monitor ECG or Holter monitor prior to and periodically duringtherapy. May cause ● Instruct patient to take medication around the clock as directed at evenly spaced intervals, even if
QRS widening, PR prolongation, and QT prolongation. feeling better. Take missed doses as soon as remembered if within 6 hr; omit if remembered later.
● Monitor BP and pulse periodically during therapy. Gradual dose reduction may be necessary.
● Monitor intake and output ratios and daily weight. Assess patient for signs of HF ● May cause dizziness or visual disturbances. Caution patient to avoid driving and other activities
(peripheral edema, rales/crackles, dyspnea, weight gain, jugular venous distention). requiring alertness until response to medication is known.
● Lab Test Considerations: Evaluate renal, pulmonary, and hepatic functions and CBC ● Advise patient to notify health care professional of medication regimen prior to treatment or surgery.
periodically on patients receiving long-term therapy. Flecainide should be discontinued ● Instruct patient to notify health care professional if chest pain, shortness of breath, or diaphoresis
if bone marrow depression occurs. occurs.
● May causeqin serum alkaline phosphatase during prolonged therapy. ● Advise patient to carry identification describing disease process and medication regimen at all times.
● Toxicity and Overdose: Therapeutic blood levels range from 0.2 to 1.0 mcg/ mL. Evaluation/Desired Outcomes
Monitor plasma trough levels frequently during dose adjustment in patients with ● Decrease in frequency of life-threatening ventricular arrhythmias.
severe renal or hepatic disease or in patients with HF and moderate renal ● Decrease in supraventricular tachyarrhythmias.
impairment.Potential Nursing Diagnoses
Decreased cardiac output (Adverse Reactions)
Implementation
● Do not confuse Tambocor with Pamelor.
● Previous antiarrhythmic therapy (except lidocaine) should be withdrawn 2– 4 half-
lives before starting flecainide.
● Therapy should be initiated in a hospital setting to monitor for increase in
arrhythmias.
● Dose adjustments should be at least 4 days apart because of the long half-life of
flecainide.
Sources:

https://davisplus.fadavis.com/3976/meddeck/pdf/flecainide.pdf

https://www.webmd.com/drugs/2/drug-6109/flecainide-oral/details

https://reference.medscape.com/drug/tambocor-flecainide-342300