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heart failure

hrt failure

QuestionAnswer
Cardiac Glycosides Admin: apical pulse 1min @ least 60 bpm narrow theraputic range 0.8- 2ng/ml Preg Cat A monitor geri/pedi due to inadequate renal & hepatic metabolic enzymes
Cardiac Glycosides /Digoxin side/contraindictions Side: dysrhythmias hypokalemia n&v fatigue anorexia vision issues halos ylw-grn tinge blurring Con: no w pt that have AV block or ventricular dysrhythmias unrelated to HF pts w renal issues get lower doses use caution MI hypothyroidism core pulmonale
Cardiac Glycosides/ Digoxin teach: take pulse before dose reports any signs of toxicity (yellow halos) heart rate monitor- check their HR with steth apical for 1 min
lifespan for digoxin pediac safe-dose by age, safe in newborns and children not recom for breastfeed older adults- more senstive- excretes thru kidneys, liver- report n/v and halos
inotropic effect a change in contractility of the heart
preload the degree to which the myocardial fibers are stretched just prior to contraction increased preload will increase cardiac output
afterload the defree of pressure in the aorta that must be overcome for blood to be ejected from the l. ventricle affects cardiac output lower BP makes less afterload; less workload for heart
hrt failure the in ability of the ventricles to pump enough blood for body's needs weakening of hrt muscle due to aging or disease
cardiovascular disease coronary artery disease (CAD) Mitral stenosis Myocardial infarction (MI) chronic hypertension (HTN) Diabetes mellitus (DM) hyperthyroidism/ hypothyroidism
function of the l. side of heart bld fill in l. ventricle l. ventricle thickens/ enlarges (hypertrophy) cardiac remolding- changes of the myocardial cells (myocytes) cough/SOB result
function of the r. side of heart bld backs up into veins peripheral edema & organ engorgement less common than l. sided HF
pharmacologic mechanisms slows hrt rate increase contractility reducing myocardial workload
tx for hrt failure pt 1 ace inhibitors- lisinopril (drug of choice) excretion of sodium and water, lowers peripheral resistance, increase cardiac output ARBs- for those unable to tolerate ace inhibitors
tx for hrt failure pt 2 diuretics-given with other drugs increased urine reduce bld volume edema pulmonary congestion & cardiac workload beta blockers- metoprolol (reduce sx of HF & slow progression of disease) Slows heart rate reduce BP reduced workload of hrt inotropic effect
tx for hrt failure pt 3 Cardiac glycosides- digoxin (increase contractility or strength of contraction) increase course of heartbeat slows heart rate improved cardiac output. Use in combination with other drugs
tx for hrt failure pt 4 phosphodiesterase Inhibitors- milrinone (short-term therapy hrt failure) cause positive inotropic response & vasodilation increase contractility & decrease afterload, increasing myocardial contraction force and cardiac output.
Digoxin/ lanoxin cardiac glycoside- Reduces heart rate with forceful contractions improving cardiac output by inhibiting Na+ K+ ATPase exchanging sodium ions for potassium ions. Sodium accumulates and calcium ions are released action: HF
Cardiac Glycosides/ Digoxin interactions- drug/food herbal pt 1 Inter: given w diuretics/ Ca+ IV increase risk of dysrhythmia/hypokalemia. Ace/spironolactone/K+ supp- hyperkalemia & reduce action of digoxin. Other positive and on-topic drug increase of facts on heart contractility. Beta blockers result in brady
Cardiac Glycosides/ Digoxin interactions- drug/food herbal pt 2 Verapamil alprazolam quinidine decrease distribution and excretion of digoxin ^ risk of digoxon toxicity food- ginseng ^ the digoxin toxicity Ma huang and ephedra induce dysrhythmias.
Created by: bryant-41892