Pharmacology test 2 review 2023/2024

Pharmacology test 2 review 2023/2024 Positive inotropic drugs - ANSWER-Phosphodiesterase inhibitors, e.g., milrinone Cardiac glycosides, e.g., digoxin B-type natriuretic peptides Other drugs used in heart failure - ANSWER-ACE-inhibitors e.g., 'pril' Angiotensin II receptor blockers (ARBs) e.g., 'sartan' ß-Blockers e.g., 'olol' Diuretics e.g., furosemide, spironolactone Inotropes - ANSWER-Inotropy -Force of muscular contractions Chronotropy -Heart rate Dromotropy-Conduction of electrical impulses MOA: directly inhibits Na-K ATPase à indirect inhibition of Na/Ca exchanged = leads to increased Ca2+ into the cell causing INCREASED CONTRACTILITY of the heart Indicated for Heart failure Supraventricular dysrhythmias (A fib and A flutter) Adverse Effects: Early signs: Nausea, vomiting, anorexia; Later signs: arrhythmias, AV heart block, blurry yellow vision, HYPERKALEMIA Cardiac glycoside is added late: digoxin (Lanoxin)-hypokalemia increases risk of toxicity, Toxicity tx: antidote: digibind , anti-digoxin Fab bran binds to digoxin, digoxin = 0.6-1.2 nmol/L, loading dose or digitalizing to initiate therapy Digoxin: Nursing implications - ANSWER-•Monitor for toxicity as evidence by: nausea, vomiting, anorexia, halo vision, confusion, bradycardia and heart blocks . •Do not administer if pulse is less than 60 bpm •Should be caution in patient with hypothyroidism and hypokalemia. •Antidote : Digi-bind •Phenytoin is the drug of choice to manage digitalis-induced arrhythmia. CONTINUES...