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Cardiac

QuestionAnswer
Digoxin (Lanoxin) Cardiac glycoside Treats heart failure & atrial fibrillation Not a first line drug Half life = 30-40 hours Therapeutic serum level = 0.8-2 ng/mL Route = PO or IV Pediatric – elixir form or IV Antidote
Digoxin (Lanoxin) Toxicity Blood levels above 2 ng/mL Bradycardia Nausea/vomiting Headache Blurred vision Visual illusions Confusion
Angiotensin Converting Enzyme Inhibitors (-pril) Mechanism of action – inhibits the formation angiotensin II and blocks release of aldosterone Side effects – dry cough; hypotension; hyperkalemia Neutropenia Lisinopril (Zestril); captopril (Capoten); enalapril (Vasotec); benazepril (Lotensin)
Beta Adrenergic Blockers (-olol, -ilol) Mechanism of action – block the sympathetic nervous system response to decrease basal sympathetic tone Non-selective Propranolol (Inderal), carvedilol (Coreg) Cardioselective Atenolol (Tenormin), metoprolol (Lopressor) Don’t stop abruptly
Angiotensin Receptor Blockers (-sartan) Mechanism of action – block angiotensin II & release of aldosterone Side effect – hypotension; hyperkalemia Adverse effect - angioedema Losartan (Cozaar); valsartan (Diovan)
Nitrates Generalized vascular & coronary vasodilation Indications – angina (treatment & prophylaxis) Side effects – Hypotension; headaches; dizziness; syncope; flushing. Drug Interaction: Erectile dysfunction Large first pass effect
Nitrate routes & training SL Cannot be exposed to light or heat If no relief after 5 minutes, call 911 & may take a second tablet; max of 3 tablets in 5 minute increments Place under tongue; do not swallow or chew Oral (PO) Translingual Spray IV solution
Nitrate Topical Instructions Topical (ointment, patch) Wear gloves Remove old ointment; don’t massage in Apply to upper arms or chest (non-hairy) Rotate sites; Remove at bedtime
Digoxin and Potassium Normal potassium levels 3.5-5 mEq/L Hypokalemia increases the effects of digoxin Low potassium levels = dig. toxicity Drugs that cause hypokalemia Potassium wasting diuretics Cortisone preparations Eat foods high in potassium
Calcium Channel Blockers
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