Pharmacology Lecture 5
Terms
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Inotropic Agents
common -
CHF DRUG
most common: digoxin/lanoxin
Antidote – digibind -
Inotropic Agents
MOA -
increase cardiac contractility. Inhibits enzyme – sodium-potassium ATPase ->
promotes Ca accumulation, incr contractility -> incr CO. HR decrease, ventricular filling increases.
Slows down heart, increases contractility--- greater CO -
Inotropic Agents
IND - CHF, dysrhythmias
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Inotropic Agents
AE -
predisposing factor for toxicity:
Hypokalemia; low K increases digoxin toxicity. Digoxin & K bind at same sites
Signs of digoxin toxicity:
early S&S:
visual changes (changes in color, halos, yellowish or green caste), anorexia, n/v, fatigue.
late S&S:
ventr dysrhythmias b/c digoxin slows HR-can lead to AV block -
Inotropic Agents
DI -
diuretics b/c of risk of low K—so must be on K supplement
Quinidine (antidysrhythmic drug)
Verapamil- increases digoxin levels -
Inotropic Agents
NC -
Monitor/assess apical HR for one minute before giving.
Hold if HR<60
monitor serum K level, digoxin level -
Diuretics
common -
CHF DRUGS
Loop (lasix most common), thiazide diuretics
Patients frequently on lasix, digoxin and K -
Diuretics
MOA -
Increase renal excretion of water, Na, other e-lytes.
Increase urine output, decrease fluid overload – decr pulmonary & peripheral edema. -
Ace Inhibitors
MOA -
block enzyme that converts angiotensin I to angiotensin II -reduces aldosterone
Causes:
vasodilation – dec BP
decrease blood volume since it reduces retention of Na and H2O
reverses pathological changes in heart and blood vessels -
Ace Inhibitors
AE - some patients w/kidney issues cannot take