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15 Cards in this Set

  • Front
  • Back
Positive Inotropic Agents
-Drugs that increase the force of Myocardial contractions
-Used for Heart failure
-Ex. Card. Glucosides (Digoxin)
-Phosphodiesterase inhibitors
Myocardial Deficiency and increased Workload: Common Causes..
-Myocardial Deficiency (MI, CAD, Cardiomyopathy, infection)
-Inadequate filling (A-fib,infection, tamponade, ischemia)
-Increased workload (Hypertension, outflow obstruction)
-Vol Overload (Hypervolemia, Congenital defects, anemia, thyroid disease)
Cardiac Glycosides
Digoxin, used to contol Afib and heart failure, also Digitoxin
Cardiac Glycosides Mech of action
-inc. Myocard. Contractility
-Change electrical conduction of heart (decrease rate, and prolong refractory period inbetween SA and AV node)
Cardiac Glycosides Drug effects
-inotropic positive, increases force or energ of muscle contractions
-Chronotropic Negative decreasing (HR)
-Dromotropic negative (Conduction of electrical impulses is decreased
-inc. SV
-reduction of heart size during diastole
-Decrease Venous BP
-incr. coronary circ.
-promotes diuresis via blood circ.
-palliation, of exertional and parooxysmal nocturnal dyspnea, cough, and cyanosis
Cardiac Glycosides Indications..
-Heart Failure
-SV dysrhythmias
Digoxin (Lanoxin)
-narrow therapeutic window
-monitor drug level and electrolytes
-low K+ increases its toxicity
Cardiac Glycosides Digoxin side effects..
-CV: Dysrhythmias (Brady and Tachy
-CNS: Headache, fatigue,Malaise, confusion, convulsions
- Eye: Colored vision, halo visio
-GI: nausea, anorexia,Vom Diarrhea
Digoxin toxicity:
Digoxin immune FAB (Digibind) therapy: Hyperkalemia (>5 mEq/L)
-Life threat dysphyth.
Phosphodiesterase Inhibitors..
-Do what as their name indicates.
-result in positive inotropic response, Vaso dilation (positive) lusitropic effect)
-Amrinone and Milrinone
Phosphodiesterase Inhibitors indications..
-Short term heart failure
-when digoxin not effective
-given weekly in 6 hr infusions
Phosphodiesterase Inhibitors,Amrinone and Milrinone side effects..
-Amrinone, Thrombocytopenia Dis Rhyth., nausea, hypotension
-Milrinone Disrhyth (Ventrical), Hypotension, angina, Hypo K+, tremor, and thrombocytopenia
Nursing implications
--Assess Health Hx, KDA, contraindic.
-BP, Ap. Pulse, Heart Sounds, Breath S., Weight, I&O, ECG, Serum Labs, K, Na, Mg, Ca, and renal and liver function studies
-Pulse <60 or >120 hold dose, tell Dr.
-Report any indication of toxicity
-Don't give with High Fiber foods
-report weight gain of 2 lb/day or 5/week
Use infusion pump with Amrinone and Milrinone,
IV amrinone
Do not mix with dextrose, it is yellow
Monitor Therapeutic effects..
incr. urine out
-decreased edema, shortness of breath, dyspnea, rales and fatigue
-resolves paroxysmal nocternal dyspnea
-better periferal pulses, skin color, and temp