ADH 3; CHF/shock Rx, Anticlot Rx Flashcards
Inotropes
Digoxin; used for? what does it do?
positive inotropic effect; INC contractility of heart
HF also hypotensive A-fib
- strengthens myocardial contraction
- slows impulse conduction of SA & AV nodes
Digoxin is used for…
levels, antidote
(0.5 - 2.0) if high, hold dose
Digi-bind
Digoxin risk factors
3 (think eldery)
3 (electrolytes)
impaired renal function drug interactions (antidysrhythmics) hypothyroidism hypokalemia (3.5 5) need K for Dig to work! hypercalcemia (8.5- 10.5) hypomagnesium (1.8- 2.5)
Digoxin side effects
GI: N/V/A/D
CNS: dizziness, h/a,confusion, blurred vision, halos
CV: bradycardia, heart block, arrhythmia
Digoxin
WWND?
- take HR for 1 min; monitor
- check K/Mg levels
- check Dig levels
- I/O’s daily weights; INC weight
- RR, lung sounds
Digoxin
PT teaching?
- check pulse/HR
- don’t double up
- s/s toxicity
- f/u blood work
Inotropes
Primacor, used for? therapeutic effect?
in combination w/other inotropes for short-term CHF/shock MGMT
- Therapeutic effect: INC cardiac output
- DEC systemic vascular resistance w/o INC HR/O2 demand
Primacor
DOSE
- WT base drug, need to know WT
- IV bolus 50 mcg/kg over 10 min
(0. 375 - 0.75 mcg/kg/min)
Primacor
WWND?
hypotension, monitor BP
thrombocytopenia, monitor PPT for low levels
Diuretics; 3 classes used for
CHF, hypertension, renal/liver dz (ascites), pulmonary edema
- Loop diuretics
- Thiazides
- Potassium sparing
Loop Diuretic; Lasix (POTENT diuretic)
used for?…works by…?
- CHF, hypertension, pulmonary edema
- inhibits Na & Cl reabsorption in loop of Henle
- INC renal excretion of water & electrolytes
Loop Diuretic; Lasix
Nx 6
- need K supplement
- check BP prior to admin, hold if too low
- give in AM to allow PT to urinate during day
- monitor BUN/creatinine
- Na & K levels
- fluid statux, I/Os
Loop Diuretic; Lasix
what are some risks?
3
hypotension
elderly at risk for falls
tinnitus/ottotoxicity
Thiazides; Hydrochlorothiazide
works by…
- INC excretion of Na & H2O by inhibiting enzymes (Na, K, Cl) reabsorption in the distal tubule
- relaxes arteries
Thiazides; Hydrochlorothiazide
Nx (same as loop diuretic) +2
- check BP
- can increase uric acid levels