Heart Failure, angina, dysrhythmias Flashcards
This drug is for heart failure and atrial fibrillation
Digoxin
MOA of digoxin
releases acetylcholine by stimulating vagal nerve to help with atrial fibrillation and inhibit enzymes in cardiac cells to increase calcium which helps with heart failure
Low potassium levels can increase effects of digoxin and high potassium level can make digxin ineffective
What should the levels for digoxin be ?
0.5-2
.5-1 for heart failure and 1-2 for atrial fibrillation
what are some high yield concepts for digoxin?
- narrow therapeutic index
- GI disturbances: anorexia, N/V
- Visual disturbances: blurred, yellow vision with halos around objects + headache, confusion
- Bradydysrhythmias : syncope, death, dizziness, fatigue
Client has adverse effect and is showing signs of bradydysrhythmias: dizziness, fatigue, fainting (syncope), possibly death. What is the client at risk for and how can you stop it?
Digoxin toxicity the antidote is digoxin immune fab (Side effect is hypokalemia)
Before administration of digoxin check apical pulse for 1 min and hold dose if under 60bmp.
what are the 4 adrenergic agonist
epinephrine, dopamine, dobutamine, norepinephrine
What are the common used for epinephrine, dopamine, dobutamine, and norepinephrine?
epinephrine = severe allergic reactions (anaphylaxis)
dopamine = patients with extremely low BP, or helps with renal perfusion
dobutamine = short-term treatment for heart attack
norepinephrine = common treatment for severe hypotension or shock
What are some high yield concepts for epinephrine, dopamine, dobutamine and norepinephrine?
cardiac complications: tachycardia, hypertensive crisis, heart attack. Patients should be on a heart monitor
Necrosis: given through central line and higher doses can cause vasoconstriction which can cause them to lose too much blood and have necrosis
what are some nitrates and what are they used for?
Nitroglycerin and isosorbide are angina medications
what are some high-yield concepts for nitroglycerin and isosorbide?
they can cause orthostatic hypotension, headache, and drug interaction with erectile dysfunction medication (life-threatening hypotension)
What should a patient know about sublingual nitroglycerin administration?
take it at the START of chest pain, place the tablet under their tongue and let it dissolve. If the pain isn’t relieved after 5 minutes they should call 911 and take another tablet. They can have a maximum of 3 total tablets
How should nitrates be stored?
they should be kept from moisture and checked for the expiration date
What are nitrate-free intervals?
It is when a client must have 8 drug-free hours of nitrate every day for transdermal formulations
What are some dysrhythmia medications?
amiodarone and adenosine
what are the high-yield concepts for amiodarone?
it can cause toxicity since it is very lipid soluble and has a long half-life of 100 days. Patients taking this medication should check for lung, liver, thyroid, or eye problems.
It could also cause worsen dysrhythmias
