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Unit 5 Heart Failure

LCC NURS 200 unit 5 Drugs for Heart Failure

Cardiac Glycosides Prototype Digoxin (Lanoxin)
Cardiac Glycosides MOA Increase intracellular calcium (increases myocardial contractility, decreases rate of electrical conduction).
Cardiac Glycosides Secondary Effects Increase in coronary perfusion, promotion of dieresis, relief of symptoms of heart failure.
Digoxin Indications Heart failure, tachydysrhythmias. NEVER for ventricular dysrhythmias.
Digoxin Adverse Effect Very narrow therapeutic window, Hypokalemia increases it’s toxicity.
Digoxin Nursing Implictions Take at the same time each day, Don’t switch brands.
Digoxin Toxicity GI -Anorexia, nausea, vomiting, diarrhea. CV – Bradycardia, Heart blocks. CNS – Confusion, Visual disturbances (green or yellow halo’s) headaches, fatigue, malaise, convulsions.
Digoxin Toxicity treatment Digoxin immune fab (Digibind).
Digoxin Contraindications/Cautions Bradycardia (HR less than 60), Hypokalemia, Ventricular tachycardia or fibrillation.
Digoxin Interactions – LOTS, loop and thiazide diuretics, calcium channel blockers.
Three Types of Angina Stable (predictable and manageable), Unstable (unpredictable, occur even at rest), Prinzmetals (spasms of coronary arteries that occur randomly, often in the middle of the night).
Nitrates Prototype Nitroglycerin (Nitrobid, Nitrostat, etc.)
Nitrates MOA Cause systemic vasodilation, potent dilating effect on coronary arteries.
Nitrates Indications Acute relief of ischemia/angina, prophylaxis in situations that may provoke angina, Long-term prophylaxis of angina.
Nitrates Adverse Effects Headaches, decreased blood pressure, tachycardia, orthostatic hypotension.
Nitrates Contraindications/Cautions Hypotension, Dehydration, Head trauma.
Nitrates Interactions sidenafil citrate (Viagra), other drugs that cause a decrease in blood pressure.
Created by: npeters519