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Cardiac > Cardiotonics: Heart Failure Treatments > Flashcards

Cardiotonics: Heart Failure Treatments Flashcards

1
Q

What is the definition of heart failure?

A

Condition in which the heart fails to effectively pump blood throughout the body

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2
Q

What does the primary treatment of heart failure do?

A

It allows the heart muscle to contract more efficiently in an effort to bring the system back into balance.

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3
Q

What are the 4 causes of congestive heart failure?

A

Dysfunction of the cardiac muscle caused by:

  • Coronary Artery Disease (CAD)
  • Cardiomyopathy
  • Hypertension
  • Valvular Heart Disease
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4
Q

Heart muscle damage is typically caused by what two things?

A
  • Atherosclerosis

- Cardiomyopathy

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5
Q

Increase in workload to maintain an efficient output can be caused by what two things?

A
  • Hypertension

- Valvular disease

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6
Q

A structural abnormality of the heart is typically caused by:

A

Congenital cardiac defects

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7
Q

What are the three underlying problems in heart failure involving muscle function?

A
  • Muscle damage
  • Increase in workload to maintain an efficient output
  • Structural Abnormality
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8
Q

What is the sarcomere composed of?

A

Protein fibers

  • Thin actin fibers
  • Thick myosin fibers
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9
Q

What are the two compensatory mechanisms?

A

Decreased cardiac output

Cellular changes

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10
Q

Decreased Cardiac Output is due because of these two things?

A

Sympathetic stimulation and release of renin

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11
Q

What are the three types of cardiotonic (inotropic) drugs?

A
  • Cardiac glycosides
  • Phosphodiesterase inhibitors
  • HCN Blockers
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12
Q

What do cardiac glycosides increase?

A

Increase the force of myocardial contraction, cardiac output, and renal perfusion.

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13
Q

What do cardiac glycosides decrease?

A

Decreases blood volume to slow heart rate and conduction velocity through the AV node.

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14
Q

What is the indications that a patient needs to be prescribed cardiac glycosides?

A

Treatment of:
Heart Failure
Atrial fibrillation

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15
Q

What are the adverse effects associated with cardiac glycosides?

A
  • Headache, weakness, drowsiness, and vision changes.
  • GI upset and anorexia
  • Arrhythmia development
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16
Q

What are the contraindications for prescribing a patient cardiac glycosides?

A
  • Ventricular tachycardia or fibrillation
  • Heart block
  • Sick sinus syndrome
  • Idiopathic hypertrophic sub aortic stenosis
  • Acute MI
  • Renal insufficiency
  • Electrolyte abnormalities
17
Q

What patients need to have caution used when prescribing cardiac glycosides?

A

Pediatric and geriatric patients

18
Q

What is the prototype for cardiac glycosides?

A

Digoxin

19
Q

True or False:

The primary treatment for congestive heart failure is to make the heart beat harder and faster?

A

False:

The primary treatment involves increasing muscle contractility, bringing the system back into balance.

20
Q

What is the prototype for phosphodiesterase inhibitors?

A

Milrinone

21
Q

What is the indication that a patient needs to be prescribed Milrinone?

A

They need a short-term treatment for heart failure and they didn’t respond to digitalis, diuretics, or vasodilators

22
Q

What are the adverse effects associated with Milrinone?

A

Arrhythmias, hypotension, nausea, vomiting, thrombocytopenia, pericarditis, pleuritis, fever, chest pain, burning at injection site.

23
Q

What drug interacts with phosphodiesterase inhibitors?

A

Furosemide

24
Q

What is a contraindication that a patient should not be prescribed a phosphodiesterase inhibitor?

A

Severe aortic or pulmonic disease
MI
Fluid volume deficit
Ventricular arrhythmias

25
Q

What age range should you use caution with if prescribing phosphodiesterase inhibitors?

A

Elderly

26
Q 
The nurse is caring for a patient who has presented to the emergency department with signs and symptoms of an acute MI. While making an initial assessment of this patient the nurse notes the patient has had adverse reactions to digoxin and a history of congestive heart failure. The physician writes admission orders. Which of the following drugs would be of concern?
A. Furosemide
B. Milrinone 
C Propranolol
D. Aspirin
A

Milrinone

Cardiac (13 decks)

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