PHARMACOLOGY HESI REVIEW 1

PHARMACOLOGY HESI REVIEW 1Cardiac Drugs/Diuretics • Digoxin – o Positive inotrope (increases force of contraction); o Negative chronotrope (decreases heart rate).  How do you assess for this? (Always take AP for a full minute!) • Client with long hx of daily digoxin and furosemide (Lasix) use; o Creates a high risk for dig toxicity  (Lasix can cause hypokalemia, which can lead to dig toxicity) • Digoxin toxicity – know normal digoxin level (0.5 – 2 ng/mL); o Serum potassium (K+) level (3.5 to 5.0 mEq/L); • Low potassium or magnesium levels may o  risk for digoxin toxicity; • S/S of dig toxicity include: o anorexia o bradycardia o headache, o dizziness o confusion o nausea o visual disturbances (blurred vision, yellow vision, and/or halo vision);  Hold digoxin if AP less than 60. • Labetalol (beta blocker) for HTN and Severe HTN emergencies: blocks alpha and beta receptors o Notify prescriber for low pulse rate and do not give med; o SE is weight gain (fluid retention) – pulmonary assessment (which is… pulm edema crackles). o Remember monitoring weight is one of the best indicators of fluid gain or loss o 1 kg (2.2 lb) = 1,000 mL fluid gain or loss in 24 hrs. • Nitroglycerin transdermal patch Tx chest pain (angina) – o Remove at night to allow 8 hours without patch (can produce tolerance in 24 hours); o May use SL nitro when wearing patch if patient having chest pain • Why wear gloves when applying nitroglycerin paste or patch?  (Severe vasodilation, ↓BP, intense HA [may give acetaminophen for HA]) • Angina – for chest pain