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Cardio Glycosides
digoxin
| Question | Answer |
|---|---|
| What is the prototype drug for cardiac Glycosides | digoxin (lanoxin) |
| What is the effect of cardiac glycosides on the heart | increase contractility and slow heart rate (makes the heart more effective) |
| what does it mean to increase contractility | to make the heart pump STRONGER not FASTER |
| What effect does cardiac glycosides (digoxin) have on SV and CO | stroke volume and cardiac output are increased |
| What conditions are cardiac glycosides (digoxin) used for | heart failure, atrial dysrhythimas, atrial fibrillation |
| Before you can give digoxin what has to be done first | you must assess the pulse rate. adult-60...child-70...infant-90 |
| Can digoxin (cardiac glycoside) be used to treat ventricular distrubances | NO...cardiac glycosides slow the atria which can prevent ventricular dysrhythmias but it does not directly treat ventricular problems. |
| If a patient has heart disease and is on digoxin what should you look for | hypokalemia, HD patients are usually on lasix, which can cause a decreased K+ level.low K+ increases the effects of digoxin. (may require a K+ supplement) |
| What are the S/S of hypokalemia | muscle cramps, weakness, nausea |
| What are some foods high in potassium | advacado, bananas, cantaloupe, oranges,raisins, strawberries...potatoes, carrots, mushrooms, spinach, tomatoes...all meat except chicken. |
| What is the normal level for digoxin | 0.5 - 2.0 ng/mL |
| Teach patients who are taking cardiac glycosides (digoxin) to watch for and report | S/S of hypokalemia, changes in pulse rate (early, extra, fast, slow beats, and S/S of digoxin toxicity |
| Patients taking cardiac glycosides (digoxin)should be encouraged to eat | foods high in potassium to prevent hypokalemia |
| What are the signs of digoxin toxicity | GI -anorexia, N/V, abdominal pain.. CNS-fatigue, weakness, diplopia (double vision), blurred vision, yellow-green halos |
| When is it contraindicated to use digoxin | pregnancy, ventricular disturbances, 2nd & 3rd heart block |
| How is digoxin eliminated from the body | through the kidneys |
| Use caution and monitor frequently if a pt taking digoxin has | hypokalemia, partial AV block, advanced HF, or renal insufficiency |
| What effect does increased K+ levels have on digoxin | decreased the effects of the drug |
| What effect does decreased K+ levels have on digoxin | increases the effects of the drug |
| What drugs interact with cardiac glycosides (digoxin) and effect K+,what is the effect | diuretics & cortisone preparations(can cause hypokalemia,and (increase the effects of digoxin)ACE inhibitors & ARB's can cause hyperkalemia, and (decrease the effects of digoxin) |
| How does cortisone cause hypokalemia | promotes Na+ retention which causes K+ loss and increase the effects of digoxin (possible toxic) |
| How do Sympathomimetics (dopamine)effect digoxin | by adding to the increased contractility effects...this can be good, or it can cause tachydysrhythmias |
| extremly high risk of digoxin toxicity when taken with what drug | Quinidine |
| What specific drug increases the amount of digoxin in the blood, & counteracts its effects, making it less effective | Verapamil (BP drug) |
| If digoxin and verapamil are taken together what should be done | the digoxin dose should be decreased |
| What should you do is pt has digoxin toxicity | stop digoxin,assess for K+ of <3.5 if present give K+ IV or PO, treat dysrhythmia with dilantin, treat bradycardia with atropine. |
| What if the patient has excessive overdose | use activated charcoal, cholestyramine, or digibind |
| Should you give K+ straight | NO...always dilute K+ (straight K+ can kill) |
| How do you know that digoxin is working | S/S of Heart Failure will be under control, as evidenced by: Decreased HR, decreased or reduced crackles, & no cardiac dysrhythmias |
| Are there any herbs that should not be taken with digoxin | YES..ginseng, goldenseal,st.johns wort,metamucil,licorice,hawthorn,aloe, ma-huang |
| Which herbs decrease digoxin effects | goldenseal,st johns wart, metamucil |
| Which herbs increase digoxin effects | licorice, hawthorn, aloe, ma-hung |
| How does ginseng effect digoxin | shows false elevation in digoxin levels |
| inotropic means | effects contractility (pumping action) |
| chronotropic means | effects heart rate |
| if a drug has a positive inotropic or chronotripic action,this means | it increases contractility or heart rate |
| if a drug has a negative inotropic or chronotropic action, this means | it decreases contractility or heart rate |
| What drugs when taken with digoxin (cardiac glycoside) increase the action of digoxin | diuretics & cortisone products |
| What drugs when taken with digoxin (cardiac glycoside) decrease the action of digoxin | ACE inhibitors & ARB's |
| What is a common example of a diuretic | thizide (lasix) |
| What occurs when Verapamil (BP drug) & digoxin are taken together | Verapamil increases the amount of digoxin in the blood, & counteracts its effects, making it less effective |
Created by:
leseanne
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