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27 Cards in this Set
- Front
- Back
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HF
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inability of heart to pump sufficient blood to meet req of tissues
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HF: cardiac causes
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CAD, HT, heart valve lesions, cardiomyopathy(dilated, restricted, obstructive)
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HF: extracardiac causes
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Thyrotoxicosis – anemia
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HF: types
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LV failure(pulm/resp), RV failure(edema), biventricular/congestive
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HF: manifestations
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exertional dyspnea, fatigue, cough, dep edema, enlarged heart(cardiomegaly)
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HF: nonpharm treatment
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mod lifestyle (bed rest acute, gradual exercise), surgical treatment (coronoary revasc/transplant)
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HF: pharm treatment
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diuretics, RAS inhibitors (ARB, ACEi, aldosterone ant), vasodilators, positive intotropic agents(cardiac glycosides/digitalis)
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digitalis: source
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foxglove: digoxin/digitoxin, stophanthus: ouabain
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digitalis: structure
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sugar/glycone: water/lipid sol, non-sugar: aglycone/genin/pharm activity
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digitalis: mech
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targets/inhibits NaKATPase enzyme, which decreases Na out/K in, incr Na means NaCa pump activates, intracell Ca incr, incre myo contractility/+ve inotropic
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digitalis: effect
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incr myo contractility: decr heart size, decr venous congestion, decr edema, incr renal perfusion, decr HR due to SA node, decr conduction AV node
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digitalis: indication
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congestive HF, tachyarrhythmia (esp atrial flutter/fib)
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digitalis: drug interactions K
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incr K = decr digitalis activity, competes for NaKATPase, K losing diuretics/decr K = incr activity(toxic)
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digitalis: drug interactions Ca IV
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Hypercalcemia = incr risk of dysrhythmia, incr contractility
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digitalis: drug interactions Quinidine
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Q is antiarhythmic, displaces digoxin from tissues = incr level/toxicity (digitalis in blood)
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digitalis: drug interactions Antibiotics
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Erythromycin = inhibit gut flora that inactivate digoxin = incr level/toxicity
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digitalis: adverse GI
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anorexia, NV, diarrhea
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digitalis: adverse CNS
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headache, fatigue, depression, confusion, hallucination, convulsion
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digitalis: adverse Visual
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disturbances
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digitalis: adverse CV
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HR slow, sinus brady, AV block(prevention of signals reaching vent), vent dysrythmia/vtach
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digitalis: toxicity
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narrow theraputic range, accumulates in body, esp olds/drug iactions, early sign: GI, dager sign: Vfib
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digitalis: toxicity treatment
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stop, digitalis(fab) antibodies, measure plasma digoxin level
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digitalis: plasma level ranges
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ther range: 0.8-0.16ng/ml, tox range 2.4ng/ml,
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digitalis: plasma level clinical importance
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indicates if pt received recently, checks compliance, if toxicity suspected, drug iaction suspected
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digitalis: pharmacokinetics
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Abs 70%, onset 1-2 hrs, peak 6-8 hrs, half life 40h, duration 3 days, metab liver 14%, eliminate kidney
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digitalis: admin
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oral/IV: rapid 1-1.5 mg loading dose, 0.125mg maintenance dose, no loading unless acute
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digitalis: preparations
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tab, caps, elixir, ampoules
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