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Cardiac pharm1
Stimulants and Depressants part 1
| Question | Answer |
|---|---|
| Cardiac Glycosides | Digoxin (Lanoxin) |
| Digoxin is used in the treatment of | heart failure and cardiac dysrhythmias (atrial fibrillation) |
| Positive inotropic | (increases the force of ventricular contraction thus increases cardiac output) |
| Drugs that increase the force of myocardial contractions have what type of effect? | Positive inotropic |
| Drugs that decrease the heart rate by decreasing the rate of impulse formation at the SA node are? | Negative chronotropics |
| Cardiac glycosides act by? | Releasing free calcium within cardiac muscle to potentiate actin and myosin. |
| Do not administer digoxin if pulse is less than how many beats per minute? | 60 beats per minute for adults, 70 beats per minutes for children up to adolescence, 90 beats per minute for infants |
| All orally administered cardiac glycosides tend to cause what? | gastric irritation |
| Digoxin is the most popular cardiac glycoside in the US because of what? | Digoxin has a shorter duration of action than digitoxin and similar agents,therefore results in lesser possibility of having a cumulative developement of toxic effects. |
| What is the therapeutic blood level of digoxin (Lanoxin)? | 0.5-2ng/mL |
| Most common toxicity effects of cardiac glycosides on G.I. system are: | Nausea, vomiting, anorexia, and or diarrhea. |
| Most common toxicity neurological effects of cardiac glycosides are? | Restlessness, irritability, headache, weakness, lethargy, drowsiness, and or confusion. Visual; CLASSIC SYMPTOM IS YELLOW VISION, halo vision, amblyopia, diplopia. |
| Most common toxicity cardio effects of cardiac glycosides are? | Virtually every known cardiac dysrhythmia. Extrasystoles-extra beats.Bradycardia and primary A-V block most common adverse cardiac effects. |
| Successful treatment of cardiac glycoside toxicity can often be best accomplished by what? | Withdrawal of the drug. |
| Dopamine and dobutamine are used in the treatment of what? | Shock |
| For clients receiving IV atropine sulfate or nitroprusside, the nurse should monitor: | Blood pressure every 15 minutes. |
| The route of administration for adenosine is: | IV |
| What classification do Quinidine and procainamide belong to? | Class 1A antiarrhythmic |
| For a client being discharged home with a prescription of digoxin, what should they be taught? | Client needs to be taught how to monitor the radial pulse. |
| Adenosine is the drug of choice for which cardiac dysrhythmia? | Supraventricular tachycardia |
| The cardiac dysrhythmia, supraventricular tachycardia is treated by the drug choice of what drug? | adenosine |
| Serum digoxin level would be appropriate for client with what symptoms? | A client complaining with nausea, vomiting, and anorexia. |
| For a client receiving digoxin, the nurse should monitor the potassium level and report levels: | Less than 3.5 mmol/L |
| Cardiac hypertrophy and sodium and fluid retention are characteristics of what condition treated with digoxin? | Heart failure |
| Releasing free calcium within cardiac muscle to potentiate actin and myosin is how: | Cardiac glycosides act. |
| When administering IV verapamil HCl, the nurse should: | Stop the infusion if the systolic blood pressure is less thatn 70-80mm Hg |
| Shock is treated by what agents? | Dopamine and dobutamine |
| What drugs are classified as adrenergic agonists? | epinephrine(Adrenaline):catecholaminedopamine(Intropin): catecholaminedobutamine(Dobutrex): catecholamine |
| What classification are the following?epinephrine(Adrenaline):catecholaminedopamine(Intropin): catecholaminedobutamine(Dobutrex): catecholamine | adrenergic agonists? |
| Dopamine(Intropin) is used to treat shock by what pharmacologic actions? | Vasoconstriction of blood vessels, and renal blood vessel dilation. |
| Dopamine(Intropin) increases the heart rate and rate of conduction through the: | AV node. |
| Catecholamine adrenergic agonists CAN NOT be taken how? | ORALLY |
| Catecholamine adrenergic agonists do NOT cross: | the blood-brain barrier |
| Heart failure and shock are treated by what drug? | dopamine(Intropin) |
| dopamine(Intropin)moderate and high dose, dobutamine(Dobutrex)both cause what pharmacologic action? | raise the heart rate, myocardial contractility, and the rate of conduction through the AV node |
| dopamine(Intropin) can cause what side/adverse effects? | necrosis can occur from extravasation of high doses dopamine(Intropin). |
| What nursing action should be taken if necrosis occurs with dopamine(Intropin)? | Discontinue the infusion at first sign of irriation. |
| Factors predisposing a patient to cardiac glycoside toxicity are: | Hypothyroidism, Hypokalemia, Renal impairment. |
| Thyroid function needs to be assessed with measurements of T3, T4, and TSH can help avoid? | Cardiac glycoside toxicity |
| Cardiac glycoside toxicity can help being avoided in a patient with hypokalemia by? | reviewing nutrition, fluid and electrolytes. |
| An agent that binds with digoxin to neutralize it's effect is given for what reason? | If digoxin toxicity gets to life-threatening levels. |
| Signs and symptoms of hypokalemia | weakness, fatigue, cardiac arrhythmias |
| Hypokalemia can be caused by what? | Taking amphortericin B, large amounts of glucose and insulin being administered. |
| Herbs causing hypokalemia are? | Aloe, Buckthorn bark/berry, cascara sagrada bark, german chamomile flower, Iceland moss, icy leaf, licoricde, marshmallow root, rhubarb root, and senna pod/leaf. |
| Ginseng does what to digoxin? | increases levels of digoxin. |
| St. John's wort increases the renal excretion of what? | Digoxin, thus decreasing the serum level. |
Created by:
vpf24
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