Chapter 27 Flashcards
Digoxin (Lanoxin) for treatment of HF
Cardiac glycoside
Increase contractility of myocardium.
Inhibit Na+ K+ ATPase. Inhibition of sodium pump=more Ca+ ions released-> more forceful contraction.
Increased urine production
Reduction in blood volume (good)
Can suppress SA node/AV node to treat dysrhythmias.
- *Take apical pulse for 1 full minute, withhold admin if under 60bpm
- If serum digoxin level is above 1.8ng/mL withhold dose
- Use caution in children and elderly
AE:
- Can create dysrhythmias
- Diuretics
furosemide (Lasix) for treatment of HF
Diuretic
Prevents sodium and chloride reabsorption in kidneys
Beneficial when CO and renal flow are low
- *Check serum potassium- if low, notify provider before admin
- *Use with caution in premature infants
AE:
- Electrolyte imbalances
- Hypovolemia
-Black box: Can lead to profound diuresis with water and electrolyte depletion
Use caution with digoxin
metoprolol (Lopressor) for HF
Beta-adrenergic blocker
Sustained release for HF
Reduces sympathetic workload
- During IV, monitor vitals closely
- Oral: dont admin if BPM under 60 or hypotensive
Black box: abrupt withdrawal may exacerbate angina or cause MI. Dose should gradually be reduced over 1-2 weeks
