Chapter 40 Antianginals Antidysrhythmics Flashcards
What is heart failure?
What are some common causes ?
When your heart isn’t able to pump enough blood to meet the bodies metabolic needs
Heart attack & valve deficiency
Coronary arty disease
Pulmonary hypertension
Diabetes
Heart failure heart becomes __
and loses its ability to pump ___
lungs and and periphery become ___
enlarges
Adequately
Congested
Right sided heart failure you have back up into ?
Left side heart failure you back up into ?
Veins
Lungs
How do you treat heart failure without medications?
Limit salt
Low fat diet
No alcohol
No smoking
Exercise
Lose weight
Fluids
What are two labs test for heart failure?
ANP & BNP
( BNP lab test, heart failure or not )
What are some cardiac glycosides medications?
Digitalis ( digoxin)
Is digoxin a first line medication?
No
What is the function of digoxin?
Positive inotropic (4)
Negative chronotropic (1)
Increase heart contractility
Increase stroke
Decrease preload
Increase coronary blood flow
Decrease heart rate improves cardiac output
What does cardiac glycosides do?
Reduction of the heart size
Increase urine production
What are the 6 side effects of digoxin?
Anorexia
Nausea
Vomitting
Diarrhea
Blurred/yellow vision
Halos around light
What causes digitalis toxicity ? (4)
Overdose or accumulation
Hypokalemia & hypercalcemia
Old age
What’s the antidote for digitalis toxicity?
Digoxin immune fab
What are the 5 digitals toxicity symptoms?
Blurred vision
Virtual illusions
Anorexia
Nausea
Vomitting
Digoxin immune fab helps us to get rid of that toxicity by?
Binding to the molecules and excrete it in urine
We want to avoid giving digoxin with what? (4) and example each
High fiber
- binds & proteins bound
Diuretics
- Hypokalemia
Cortisone
- sodium retention - hypokelamie
Antacids
- decrease absorptions
What is phosphodiesterace inhibitors function?
Inhibits enzyme phosphodiesterace to promote a stronger heart beat & vasodilations
What is an example of phosphodiesterace inhibitors?
Milrinone lactate
Should we be careful of giving it IV for more than 48-72 hours with phosphodiesterase inhibitors and why?
Yes because it causes bradycardia
Is ohosphodiesterase inhibitors a last choice medication?
Yes
What is antianginal drugs? Nitrates?
Prompts vasodailtion
Decrease preload and after load
We should be very cautions of giving nitrates to who and why?
People who take erectile dysfunction drug because it can cause severe hypotension
Nitrates usually become metabolize through the liver by first pass effect so we have other methods to admitted like?
Sublingual
IV
Aerosol spray
One thing that can happen with patients are on nitrates, they can have a tolerance to them. Why?
Because they get addicted to it, with the patch, so you take it off before going to bed
If they don’t, it won’t work
Should you chew and swallow nitroglycerin ?
No!!
Do we protect nitrates from light?
Yes!!
As soon as you have chest pain, should they stop what they are doing and take nitrate?
Yes
If they have a burning sensation under there tongue for there nitrates, is it working?
Yes
If you have to take a 2nd nitroglycerin to stop chest pain, what do you need to do?
Call 911
When do you start taking beta blockers when regarding the heart,
After a heart attack
Why do we take beta blockers after a heart attack?
Because we have so much epinephrine and norepinephrine circulating and irritating the heart causing imbalance supply and demand of oxygen
So beta blockers block the effects of cetachomines
What are the classes of antidysrthythmic drugs?
Sodium channel blockers
Beta adrenergic blockers
Prolong depolarization
Calcium channel blockers
What are the 3 things sodium channel blockers do?
Slow conduction prolongs repolarizing
Slow condition shortens repolarization
Prolonged conduction with little or no effect repoliarziaon
What does beta adrenergic blockers do?
Decrease conduction Velocity
What does calcium channel blockers do?
Slow the heart rate down & increase perfusion
