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Stack #820247

CCC - Pharmacology Ch17

QuestionAnswer
affects force of myocardial contraction Inotrope
Alters the rate of impulse formation at the SA node (affects HR) Chronotrope
affects conduction of electrical impulses through the myocardium Dromotrope
S/S of amiodarone induced pulmonary toxicity Persistent nonproductive cough, dyspnea, chest pain c deep inhalation
Gold standard Med for tx heart failures & arrhythmias Digoxin
Patient teaching for Digoxin take with meals to decrease gastric irritation; take pulse and do not administer if pulse is less than 60; Report HR over 100 and/or any irregular rhythms; Monitor for toxicity; Consume foods high in potassium; Do not change brands without consulting HCP.
S/S of Digoxin toxicity visual disturbances (like halo around light), anorexia, bradycardia, HA, n/v, or disorientation
Tx of Digoxin toxicity digoxin immune Fab (Digibind)- binds with digoxin causing it to be excreted in the urine
Effects of Digoxin on heart reduces ventricular rate and improves cardiac efficiency. (+) inotrope, (-) chronotrope, (-) dromotrope
What class of drugs may predispose a pt to Digoxin toxicity diuretics other than potassium-sparing
Other predisposing factors to Digoxin toxicity hypokalemia, renal impairment, intravenous drug administration (may rapidly result in accumulation of toxic concentrations, which could cause severe toxicity and death).
Narrow therapeutic index for Digoxin 0.8-1.5ng/mL. Therapeutic blood level: 0.2-2ng/mL
Cardiac Glycosides all have a low therapeutic index. What is the % of pts toxicity can be life-threatening 10-20% of pts.
Cardiac Glycosides side effects Gastrointestinal distress (n/v, anorexia, diarrhea, excessive salivation, abdominal pain)
Neurological effects of cardiac glycosides restlessness, irritability, HA, weakness, lethargy, drowsiness, confusion, visual disturbances (blurred or colored vision, halo vision, amblyopia, diplopia)
Cardiac effects of cardiac glycosides dysrhythmia
Most common adverse effects of cardiac glycosides bradycardia, A-V block
Sign of toxicity of cardiac glycosides development of extrasystoles such as a bigeminal rhythm (extra beat after normal beat)
syndrome produced by quinine and quinidine. Serious reaction occasionally seen in some pts even after administration of a single dose. Cinchosim
Characteristics of Cinchosim ringing in the ears (tinnitus), nausea, HA, dizziness, impaired vision and vertigo. Quinidine can also cause skin rashes as well as life-threatening disorders, such as respiratory arrest, vascular collapse, hemolytic anemia, and agranulocytosis.
"Quinidine (Duraquin)Administration" either orally or parenterally. Oral - given with meals to reduce gastrointestinal distress. IV - undertaken with great caution bc rapid admin may cause a precipitous fall in arterial BP. It is advisable to administer a test dose of one quinidine tablet.
Quinidine Therapeutic effects Depressant of cardiac function. Reduces excitability of cardiac muscle to electrical stimulation, decreases the velocity of electrical conduction through the myocardium and prolongs the refractory time between consecutive cardiac contractions.
Verapmil (Calan) Adverse effects adverse effects of Na+ channel antagonists. Vasodilation produced by these agents may cause hypoTN, prphl edema, dizns, HA, brady, and pos dev of HF in pts with myocardial insuff. Other sides are constipation, diarrhea, nausea, and fatigue.
Drug that is contraindicated for a pt with asthma Beta-Adrenergic Blocking Agents such as propranolol because they can cause bronchoconstriction. Some beta blockers such as acebutolol and esmolol are okay because of their cardioselective action.
Created by: cjone102
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