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32 Cards in this Set
- Front
- Back
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What is a cardiac glycoside agent?
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Cardiac glycosides increase the force and velocity of myocardial systolic contraction (positive inotropic action); the drugs also decrease conduction velocity through the atrioventricular (AV) node and prolong the effective refractory period of the AV node.
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When are cardiac glycoside used?
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Tx of CHF and A-fib
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Name 2 things that happen to a patient with CHF.
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decrease in CO which causes a decrease in perfusion of organs
Kidneys respond by decreasing filtration of H20 and waste |
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What does cardiac glycoside agent with a "positive inotropic" do?
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increases the force of myocardial contraction
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What does cardiac glycoside agent with a "negative chronotropic" do?
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decreases heart rate
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What does a cardiac glycoside agent with a "Negative dromotropic" do?
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decerases conductivity
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What is Digoxin primary and secondary effecton the heart?
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increases myocardial contraction.
slows down heart rate, slows electrical impulse to SA node |
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Name 4 results when using Digoxin.
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decrease heart size during diastole(fill)
decreased venous BP increased corinary circulation increased kidney perfusion |
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What is the therapeutic range for digoxin?
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VERY NARROW RANGE
0.5-2 ng/ml |
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Name the side effects with digoxin.
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N,V,D,HA, fatigue, maliase, anorexia
confusion, convulsions arrhythmias green/yellow halo, flickering lights |
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What is the antidote for digoxin?
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Digibind
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What electrolyte should be monitored when giving digoxin?
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Potassium normal level is 3.5-5 mmol/L
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What is the half life and action of Digoxin?
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half life: 33-44 hours
action: 2-4 days |
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Name 3 types of drugs that cause drug interations with digoxin.
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diuretics
antacids anticholergics |
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explain the interaction diuretics with digoxin.
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diuretics->drop in K->Dig toxicity
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explain the interaction: Antacids with digoxin.
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antacids-> less dig absorption-> less effect
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explain the interaction: Anticholinergic with digoxin.
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(atropine, Dramamine) cause increased absorption-> dig toxicity
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Arrhythmias (heart blocks) can ______ with digoxin
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increase
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Name 3 disorders that can cause poor clearance of digoxin.
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renal dz, hypothyroidism, respiratory dz
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Name 7 Nsg considerations with a patient using digoxin
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check order carefully
check last dose check pulse check labs check daily i & o's do respiratory assessment don't give with an antacid |
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What is the action of Angiotensin Converting Enzyme (ACE inhibitor)?
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inhibits angiotensin I from converting to Angiotensin II
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WHat is angiotensin ?
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Angiotensin, a protein, causes blood vessels to constrict, and Angotensin drives blood pressure up. It is part of the renin-angiotensin system, which is a major target for drugs that lower blood pressure.
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What is angotensin II?
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a potent vasconstrictor, it stimulates aldosteron which stimulates water & Na reabsorbtion
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What is the effect of a ACE on the heart and renal system??
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decreases stroke volume resistance
decreases afterload prevents h20 and Na reabsorbtion Vit K doesn't get reabsorbed |
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When do they use ACE inhibitors?
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HTN
CHF |
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What are the Side effects of ACE?
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HA
dizziness dry non productive cough hypotension |
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Names of ACE inhibitors?
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- - - - - -pril
captopril enalapril lisinopril etc.... |
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How does Beta blockers work on the heart?
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slows the heart rate
decreases contractility lowers BP |
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What is the action of Beta Blockers?
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They act by blocking the beta 1 and 2 receptors in the heart and on the blood vessels
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BEta Blcokers can slow cardiac contractility so you should start _____and at a ____ dose
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start slowly with a low dose
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Name of Beta Blockers.
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- - - - -prolol
except for Coreg (caredilol) ++toprol-XL (metoprolol) Inderal (propranolol) lopressor (metroprolol) tenormin (atenolol) |
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Name 7 Beta Blocker SIde Effects.
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Bradycardia
CP Edema Fatigue hypotension Heart block Worsening of CHF |
