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Pharm 6 Cardiac

Glycosides, Antianginals, Antihypertensives

QuestionAnswer
Chronotropic agent does what? What would a positive or negative agent do? An agent that influences the heart rate. Increases HR> Negative decreases HR.
Inotropic agent does what? What would a positive or negative agent do? An agent that influences the force or energy of muscular contraction, particularly contraction of the heart muscle. + increases myocardial contraction. - decreases it.
Dromotropic agent does what? What would a positive or negative agent do? Effects conduction of the heart cells. + increases conduction. - decreases it.
What is the main purpose of a cardiac glycoside and what is an example of one? Causes cardiac muscle to contract more efficiently. Digoxin (lanoxin)acts by increasing the force and velocity of myocardial systolic contraction.
What are the mechanisms of action of a cardiac glycoside? Positive inotropic action, negative chronotropic action and negative dromotropic action. By inhibiting the Na and K+ pump, resulting in intracellular Na. Increase results in an influx of calcium so the cardiac muscle fibers contract more efficiently.
What is left sided heart failure? What does this cause? When the ventricle doesn't contract sufficiently enough to pump the blood returned from the lungs and lt. atrium out through the aorta into peripheral circulation. Causes excessive amounts of fluid to back up in lung tissue - SOB and dyspnea.
What is right sided heart failure? What does this cause? Occurs when the heart doesn't sufficiently pump blood returned into the rt. atrium from systemic circulation. Blood and its constituents are backed up into peripheral tissues, causing peripheral edema.
What are some non-pharmacologic measures to treat heart failure? Limit salt intake to 2g/day- 1 tsp. Alcohol should be 1 drink/day, Smoking should be avoided Obesity may increase cardiovascular problems. Mild exercise like biking or walking is suggested.
What is digitoxin prescribed for? What are some lab tests associated with digitoxin? HF, CHF, cardiac disrhtymias, a-fib, a-flutter,
How is digoxin administered? How is it eliminated? What is the half life? What is the therapeutic level? Orally or IV. Renal. 36 hours. 0.5 - 2.0 ng/ml.
What are some S/E? bradycardia, cardiac disrthymia, headache, drowsiness, fatigue, confusion, anorexia, N/V/D, blurred vision (yellow, green halos), diplopia, photophobia
What is a serious adverse reaction to digoxin? Cardiotoxicity.
What promotes the loss of potassium from the body? How does low potassium enhance the effects of digoxin? What drugs can cause hypokalemia? Potent diuretics (lasix, hydrodiuril). Enhances the effects of digoxin at myocardial cell sites of action -resulting in dig toxicity. Loop & thiazide diuretics, cortisone and laxatives.
What is a nursing treatment for toxicity? Discontinue drug, begin continuous telemetry monitoring, treat arrythmias per order, check digoxin and potassium levels, admin potassium supplements if needed, per order, administer digibind, per order.
Nursing implications - Monitor for S/S of CHF. I&O, daily weights, edema, breath sounds, monitor labs for potassium and digoxin levels.
What is the #1 thing to do before digoxin administration? Check apical pulse for one full minute and withhold digoxin if pulse is less than 60bpm.
What are some antianginal agents? Nitrates, beta-blockers and calcium channel blockers.
What is angina pectoris? Caused by insufficient coronary blood flow that doesn't meet the needs of the O2 demand of the myocardium.
Causes of angina? May result from a spasm of the coronary arteries or from an obstruction of coronary arteries due to arthrosclerosis. Sudden, severe, pressing substernal pain radiating to arm, neck, back and jaw.
What is the therapeutic effect of antianginal agents? Minimize the frequency of attacks, and decrease the duration and intensity of anginal pain. To improve functional capacity with few side effects. Prevent or delay MI.
What is the goal of antianginal agents? Increase blood supply to ischemic tissue, decrease myocardial o2 demand, or both.
What is the nitrate mechanism of action? Reducing the workload of the heart by decreasing coronary vasoconstriction or spasm and increasing perfusion of the myocardium by relaxing the coronary arteries.
S/E of nitrates? N/V/D, headache, postural HTN.
Created by: 639611154
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