Cardiac Glycosides and Heart Failure Flashcards
What are the normal compensatory mechanisms the body has for someone in heart failure?
RAA system - increase in volume and vasoconstriction helps perfusion
Sympathetic stimulation - increases contractility and HR
What is the bad thing about the compensatory mechanisms our body has for heart failure?
In the long run our body wont be able to keep up these mechanisms and they will just end up making the heart failure worse.
What are some drug classifications that we use to treat heart failure? And if these fail to treat the heart failure what do we turn to? Why?
ACE inhibitors
ARBS
Diuretics
Beta-Blockers
If these dont work then we turn to cardiac glycosides, they are a last resort because of the risk for adverse effects
Where is digoxin originally derived from?
the foxglove/digitalis plant
What is the therapeutic action of cardiac glycosides?
increases the force of contraction, decreases the rate and conduction of the SA node
Decrase HR = Increased filling time = increased pre-load = increased contractility
How can digoxin be administered?
PO or IV
If digoxin is given IV, how long should it be pushed?
Infuse over 5 minutes
Other than treatment of heart failure, what other thing do cardiac glycosides have a therapeutic outcome for?
Atrial dysrhythmias
Does digoxin have a high risk for toxicity?
YES YES YES
What are some adverse effects of cardiac glycosides?
Dysrhythmias
Bradycardia (can be a sign of toxicity)
What are some things that cause the dysrhythmias in people taking cardiac glycosides?
hypokalemia (this medication doesnt cause it)
High serum drug levels (major decrease in HR = other pacemakers kick in)
Heart disease (damaged tissue = dysrhythmias)
MONITOR HEART RATE!!!!!!
Patients with this specific disorder are contraindicated for the use of cardiac glycosides.
ventricular dysrhythmias
What can bradycardia associated with taking cardiac glycosides be a sign of?
toxicity
Because of the risk for bradycardia what should the nurse do before administering a cardiac glycoside?
assess the apical HR of the patient before administration and if it is less that 60 HOLD the medication and call the physician
RATE AND RHYTHM
How would you describe the therapeutic range for cardiac glycosides? Give a range in numbers as well.
Very narrow (0.5-2.0)
Toxicity has occurred from 1.5-1.7