Drugs for treating heart failure
About this set
Created by:
baikunthji on February 13, 2010
Subjects:
Log in to favorite or report as inappropriate.
Order by
19 terms
Terms | Definitions |
|---|---|
 heart failure syndrom characteristics | signs of inadequate tissue perfusion (fatigue, shortness of breath, exercise intolerance) and/or signs of volume overload (venous distention, peripheral and pulmonary edema): increased preload; increased afterload; decreased CO; cardiac remodeling |
| Types of Drug therapy for HF | 1. diuretrics; 2. Drugs that inhibit RAAS; 3. Beta-adrenergic blockers; 4. inotropic agents; 5. vasodilators |
| 3 types of diuretics for HF | Thiazide diuretics: moderate diuresis; not effective if cardiac output /GFR (Glomirular filtration rate) is low Loop diuretics: profound diuresis; effective if cardiac output is low best bet to decrease preload Potassium sparing diuretics: mild diuresis; risk for hyperkalemia |
| ACE inhibitors | Block production of angiotensin II Dilate arterioles & veins * Decrease release of aldosterone |
| Angiotensin Receptor Blockers | can't use these with Ace inhibitors (one or the other) Reserved for use when patients cannot tolerate ACE inhibitors. Should NOT be used together with ACE. valsartan (Diovan) currently approved for HF |
| Beta-adrenergic blocking agents: Coreg | 1. Action: decreases force of contraction and CO (may make HF worse initially). 2.) Use: increases vasodilation and decreases peripheral resistance. 3. Side effects: Badycardia, decreased CO, AV block, rebound myocardial excitation, edema. 4. interactions: calcium channel blockers, antihypertensives, insulin. 6. misl: contraindicated in heart block, sinus bradycardia, asthma, diabetes, depression |
| Inotropic Agents: Digoxin (a cardiac glycoside) | Action: strengthens the force of contraction (+ inotropic), slows conduction (- dromotropic), slows HR (- chronotropic). 2. Use: manage symptoms of HF; treat atrial fibrillation or flutter. 3. Side effects: hypokalemia (causes digoxin toxicity). 5. labs and monitoring: digoxin level (normal= .5-.8 ng/ml); K+ (if low, risk of digoxin toxicity, if high, sub-therapeutic level of digocin; HR (less than 60= hold dose) |
| manifestations of Digoxin toxicity | norexia, N/V, abdominal pain, dysrhythmia, bradycardia, fatigue, weakness, yellow-green halos, diplopia, blurred vision |
| Digoxin antidote | digocin immune FAB given intravenously (digibind is the antidote antibody). 2. activated charcoal or cholestyramine given orally suppresses absorption from GI tract |
| Digoxin: Nursing responsibilites | 1. check apical pulse for one full minute prior to administration. 2. hold dose if less than 60 bpm and notify prescriber. 3. monitor electrolyte levels, especially potassium. 4. Assess drug blood levels (therapeutic range= .5-.8 ng/ml: long half life= 1.5 days, takes 6 days to reach therapeutic level) 5. IV or oral admin |
| Digoxin: patient teaching | Never stop the medication abruptly. Take your pulse before each dose. Monitor weight, swelling to legs. Wear a medic alert bracelet. Call if you experience irregular pulse; rapid weight gain; loss of appetite; nausea or vomiting; blurred or "yellow" vision (halos); unusual tiredness; or swelling in ankles, legs, or fingers. Seek help immediately for shortness of breath, chest pain. |
| Inotropic Agents: 2 major types | 1. Sympathomimetic Drugs (short term, for severe failure). 2. Phosphodiesterase inhibitors |
| Dopamine (intropin) | ( sympathomimetic Drug). Stimulation of beta-1 adrenergic receptor in the heart, dopamine receptors in the kidney and in high doses alpha1 adrenergic receptors in the blood vessels causes constriction, when heart is to low * Most common adverse effects: CV system effects (tachycardia) |
| Dobutamine (Dobutrex) | (sympathomimetic drug). Stimulation of beta - 1 adrenergic receptors only IV administration of both agents in acute care/ICU setting must go through a central line Volumetric flow device, continuous cardiac monitoring, invasive monitoring * Dosing is based on weight in mcg/kg/minute |
| Inocor and Primacor | (phosphodiesterase inhibitors). Increases myocardial contractility and promotes vasodilation Both considered short-term treatment of HF in patients who are not responding to other drug therapy IV administration only, mcg/kg/m not for regular med/surge floors |
| Intravenous vasodilators: 3 types | 1. nitroglycerin. 2. sodium nitropursside (nitropress). 3. nesiritide (natrecor) |
| Nitroglycerin | powerful venodilator that produces a dramatic reduction in venous pressure used to relieve acute severe pulmonary edema, in HF * Adverse effects: hypotension and resultant reflex tachycardia |
| Nitropress | use for hypertensive crisis dialates veins and arteriols arteriolar dilation reduces afterload, thereby increasing CO Venodilation reduces venous pressure, thereby decreasing pulmonary and peripheral congesion |
| Natrecor | only used in heart failure. very expensive given IV, usually it emits an amino acid Human B-type natriuretic peptide Direct dilation vascular smooth muscle of arterioles and veins: so fixes preload Suppression of sympathetic outflow from CNS suppresses renin secretion * decreases Aldosterone, decreases Sodium & water |
First Time Here?
Welcome to Quizlet, a fun, free place to study. Try these flashcards, find others to study, or make your own.