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Cardiac Glycosides and Heart Failure (chapter 21- ATI)
Terms in this set (14)
What medications are classified as cardiac glycosides?
digoxin (Lanoxin, Lanoxicaps, Digitek)
What is the pharmacological action of cardiac glcyosides?
Positive inotropic effect= increased force of myocardial contraction leading to increased force and efficiency of myocardial contraction which improves the heart's effectiveness as a pump, improving stroke volume and cardiac output.
Negative chronotropic effect= decreased heart rate. digoxin slows the rate of SA node depolarization and the rate of impulses through the conduction system of the heart. The decreased heart rate gives the ventricles more time to fill with blood coming from the atria, which leads to increased SV and increased CO.
What are the therapeutic uses of cardiac glycosides?
Treatment of heart failure, dysrhythmias (afib)
What are the adverse effects of cardiac glycosides?
dysrhythmias, cardiotoxicity, GI effects, CNS effects.
How do you manage digoxin toxicity?
See page 275
What medications are classified as adrenergic agonists?
Catecholamines: epinephrine (Adrenaline), dopamine (Inotropin), dobutamine, Isoproterenol
Where are alpha 1 receptors and what does activating them do?
They are located in the arterioles of skin, viscera, and mucous membranes, and veins leads to vasoconstriction
Where are beta1 receptors and what does activating them do?
Heart stimulation leads to increased heart rate, increased myocardial contractility, and increased rate of conduction through the AV node. Activation of receptors in the kidney lead to the release of renin
Where are beta2 receptors and what does activating them do?
Receptors are in the arterioles of the heart, lungs, and skeletal muscles. Activating leads to vasodilation.
Bronchial stimulation leads to bronchodilation.
Activation of receptors in uterine smooth muscle causes relaxation.
Activation of receptors in the liver causes glycogenolysis.
Skeletal muscle receptor activation leads to muscle contraction.
What does epinephrine do to alpha1, beta1, and beta1 receptors and what is the therapeutic use?
ALPHA1: vasoconstriction --> manage bleeding, increase bp, slow the absorption of local anesthetics
BETA1: increased hr, increased myocardial contractility, increased rate of conduction through the AV node--> treatment of AV block and cardiac arrest
BETA2: bronchodilation--> asthma
What does dopamine do to alpha1, beta1, and beta1 receptors and what is the therapeutic use?
Low dose --> renal blood vessel dilation
Moderate dose--> renal blood vessel dilation, increased HR, increased myocardial contractility, increased rate of conduction through the AV node
High dose --> renal blood vessel constriction, increased HR, increased myocardial contractility, increased rate of conduction through the AV node, vasoconstriction
dopamine is used to treat shock and heart failure
What does dobutamine do to beta1 receptors and what is it's therapeutic use?
Increased HR, increased myocardial contractility, increased rate of conduction through the AV node.
Used to treat heart failure
What are the potential adverse effects of epinephrine?
Vasoconstriction from the activation of alpha 1 receptors- can lead to a hypotensive crisis
beta1 receptor activation in the heart can lead to dysrhythmias. It also increases the workload of the heart and increased oxygen demand--> angina
What are the potential adverse effects of dopamine?
Beta1 receptor activation in the heart can cause dysrhythmias (same as epinephrine)
Necrosis can occur from extravasation of high doses of dopamine
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