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15 Cards in this Set
- Front
- Back
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what do positive inotropic agents
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Increase the force of myocardial contraction
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what are the two main inotropic drugs
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Cardiac glycosides-dioxin amd lanoxin
Phosphodiesterase |
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what is heart failure/dysrhythmias
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Right – pedal edema, jugular venous distention, ascites, hepatic congestion
Left – pulmonary edema, dyspnea Ejection fraction is decreased Physical defects – cardiac or defect outside the heart |
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what is digitalis
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inotropic cardiac glycosides
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what does digitalis do
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Increase in myocardial contractility
Increase diastolic filling Reduce heart rate Increase stroke volume Reduce heart size during diastole Decrease blood pressure Increase coronary circulation |
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what is the toxcitiy managment of introphic drugs
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Digibind to form antibody-antigen complex
Use Digibind if have hyperkalemia, life-threatening dysrhythmias, life-threatening overdose of Digitoxin Dosed on patient’s serum digoxin level in conjunction with weight. Each milligram can neutralize 15 mgs of digoxin or digitoxin. Blood levels will elevate because of the free digoxin and that bound by the Digibind Assess based on symptoms at not lab work at this point |
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what is the intropic drug-lanoxin/lanixicaps
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I V- Give a loading dose of .25 mg/.5 mg
Give .125 mg/.25 mg every 2-4 hours up to 1 mg in 24 hours. Therapeutic levels between .5 and 2ng/ml. Side effects – seeing yellow halos, N/V, dysrhythmias, bradycardias Many drug interactions with Cardiac Glycosides, i.e. steriods, laxatives, antacids, see page 350 |
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what are phosphodiesterase inhibitiors
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Amrinone
Milrinone (Primacor) |
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what phosphodiesterase inhibitiors do
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Results in more calcium being available for muscle contraction
Results in dilation of blood vessels Decreases the work load of the heart Used for short term treatment of heart failure Must be on Heart Monitor!! |
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what is amirone
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Most worrisome side effect is thrombocytopenia
Dysrhythmias Nausea/hypotension Long term use elevations in liver enzymes Classified as Class III drug, which means it prolongs the action potential duration |
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what is thrombocytmias
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low platelets- quick flow of blood treat with heprine
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what is milrinone
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Side effect dysrhythmias
Ventricular in origin Hypotension Angina Hypokalemia Tremor thrombocytopenia IV loading dose – 50mcg/kg IV continuous infusion of 0.375-.75 mcg/kg/min |
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what are in the interactions of milrinone and amirone
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Do not mix with Lasix – will precipitate immediately
Do not use glucose-containing solution to mix amrinone |
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what is the drug natrecor
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Last line drug for acutely decompensated heart failure in patients with dyspnea at rest or with minimal activity
Must be in ICU Recombinant drug using DNA technology |
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what are nursing implantations of inotropic drugs
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Count pulse for one full minute – if lower than 60 beats or great than 120 beats – notify physician before giving drugs that affect heart rate
Watch for toxicity – anorexia, nausea, vomiting, diarrhea, visual disturbances such as yellow halos with Lanoxin Don’t give diogxin with foods high in fiber Give IV .25mg/min over more than 5 minutes IM is painful and not indicated DO NOT mix with any other drug in syringe Digibind is the antidote – give IV over 30 minutes for Lanoxin overdose IV amrinone & Primacor are clear yellow I&O, heart rate, BP, daily weights, and respirations should be monitored Use Infusion pumps Monitor for increased urinary output, decreased edema, decreased shortness of breath, decreased fatigue, and improved peripheral pulses, skin, color, and temperature Expect a headache because of vasodilation effect Monitor electrolytes – hypokalemia can predispose to digitalis toxicity |
