Term
| What class of drugs has been the tx of choice for many years? |
|
Definition
|
|
Term
| Cardiac glycosides can provide insight into what? |
|
Definition
|
|
Term
| What is the prototype drug for cardiac glycosides? |
|
Definition
|
|
Term
| What is a inotropic effect? |
|
Definition
|
|
Term
| What is a chronotropic effect? |
|
Definition
|
|
Term
| What is a dromotropic effect? |
|
Definition
| Conduction of heart cells. |
|
|
Term
| What are the 4 effects of digitalis? |
|
Definition
1. Positive (+) inotropic effect.
2. Negative (-) chronotropic effect.
3. Negative (-) dromotropic effect.
4. Increased SV. |
|
|
Term
| What are the 5 effects of positive inotropic effect? |
|
Definition
| 1. Increases CO. 2. Decreases preload. 3. Improved blood flow to kidneys & periphery. 4. Decreases peripheral and lung fluid retention. 5. Increases fluid excretion. |
|
|
Term
| What are the 4 therapeutic effects/uses of digitalis? |
|
Definition
1. Treat HF.
2. Corrects A-fib.
3. Corrects atrial flutter.
4. Corrects atrial tachycardia. |
|
|
Term
| What is the digoxin dosage via PO for adults? |
|
Definition
1. Initial - 0.5-1mg intially in 2 divided doses.
2. Maintenance - 0.125-0.5mg/day. |
|
|
Term
| What is the digoxin dosage for elderly? |
|
Definition
|
|
Term
| What is the digoxin dosage for adults via IV? |
|
Definition
| Same as PO dose given over 5 min. |
|
|
Term
| How is digoxin given to children? |
|
Definition
| Pediatric doses usually ordered in mcg elixir form. |
|
|
Term
| What is the therapeutic serum level for digoxin? |
|
Definition
|
|
Term
| What is the pharmacokinetics of digoxin? |
|
Definition
1. Absorption - oral: 60-100%.
2. Distribution - PB 25%.
3. Metabolism - t 1/2 30-45 hrs.
4. Excretion - 70% urine & 30% by liver metabolism. |
|
|
Term
| What drug interactions with digoxin results in increased serum digoxin levels? |
|
Definition
1. Quinidine.
2. Verapamil.
3. Flecainide. |
|
|
Term
| What drug interactions with digoxin results in decreased serum digoxin levels? |
|
Definition
1. Antacids.
2. Colestipol. |
|
|
Term
| What drug interactions with digoxin results in increased risk for digoxin toxicity? |
|
Definition
| Thiazide & loop diuretics. |
|
|
Term
| What 3 conditions can increase digoxin toxicity? |
|
Definition
1. Hypokalemia.
2. Hypomagnesemia.
3. Hypercalcemia. |
|
|
Term
| What are the adverse reactions/side effects of digoxin toxicity? |
|
Definition
1. Bradycardia.
2. Atrioventricular block.
3. Cardiac dysrhythmmias.
4. N/V.
5. Headache.
6. Blurred vision.
7. Visual illusions.
8. Confusion.
9. Delirium. |
|
|
Term
| The serum level of what enhances digoxin action? |
|
Definition
|
|
Term
| Vasodilators help to do what 4 things in regards to the heart? |
|
Definition
1. Decrease venous blood return to heart.
2. Decrease cardiac filling.
3. Decrease preload.
4. Decrease oxygen demand. |
|
|
Term
| What 4 things do ACE inhibitors do? |
|
Definition
1. Dilates venules and arterioles.
2. Moderately decrease the release of aldosterone.
3. Reduces sodium and fluid retention.
4. Can increase potassium. |
|
|
Term
| For clients who can't tolerate ACE inhibitors you can use what? |
|
Definition
| Angiotensin II Receptor Blockers. |
|
|
Term
|
Definition
1. It is a 3rd generation Beta receptor antagonist.
2. Blocks B1, B2, A1 receptors.
3. Antioxidant protects against free radicals causing damage to nucleic acids, proteins, and lipids.
4. Slows progression of CHF. |
|
|
Term
| Potassium sparing diuretics inhibit what? |
|
Definition
|
|
Term
| Where do potassium sparing diuretics work? |
|
Definition
| Work primarily in the collecting duct renal tubules and late distal tubule. |
|
|
Term
| Use of potassium sparing diuretics can lead to what imbalance? |
|
Definition
| Hyperkalemia, therefore potassium supplements are not needed. |
|
|
Term
| What is a prototype drug for potassium sparing diuretics? |
|
Definition
| Spironolactone (Aldactone). |
|
|
Term
| What do carbonic anyhdrase inhibitors do? |
|
Definition
1. Inhibit action of carbonic anhydrase.
2. Promotes excretion of Na, K, and HC03 in proximal renal tubule. |
|
|
Term
| Prolonged use of carbonic anhydrase inhibitors can lead to what condition? |
|
Definition
|
|
Term
| Carbonic anhydrase inhibitors can be used for what 5 things? |
|
Definition
| 1. Primary use is to decrease IOP in open-angle (chronic) glaucoma. 2. Metabolic alkalosis. 3. Epilepsy. 4. Edema 2nd degree to CHF. 5. Altitude sickness. |
|
|
Term
| What are the side effects & adverse reactions of carbonic anhydrase inhibitors? |
|
Definition
1. Fluid & electrolyte imbalances.
2. Metabolic acidosis.
3. N/V, anorexia.
4. Confusion.
5. Orthostatic hypotension.
6. Hemolytic anemia.
7. Renal calculi. |
|
|
Term
| What is a contraindication of carbonic anhydrase inhibitors? |
|
Definition
|
|
Term
| What type of diuretics are contraindicated in HF? |
|
Definition
|
|
Term
| Osmotic diuretics increase the excretion of what? |
|
Definition
|
|
Term
| What is a prototype drug for osmotic diuretics? |
|
Definition
|
|
Term
| What are the 4 uses of Mannitol? |
|
Definition
1. To reduce intracranial pressure
2. To reduce intraocular pressure.
3. Cisplatin chemotherapy.
4. To prevent kidney failure. |
|
|
Term
| What are the 4 side effects of Mannitol? |
|
Definition
1. Fluid and electrolyte imbalance.
2. Pulmonary edema.
3. Nausea.
4. Vomiting. |
|
|
Term
| What are the 2 contraindications of Mannitol? |
|
Definition
1. HF.
2. Pulmonary edema. |
|
|
Term
| Under what conditions do you not administer Mannitol? |
|
Definition
| When crystals are present. To prevent crystallization do not expose vial to low temperatures. |
|
|
