CHF Flashcards
Digoxin/Lanoxin
P-Dyn
Increased inotropy with increased cellular Calcium
Decreased chronotropy (increased AV node sensitivity to vagal stimulation
Decreases dromotropy
Digoxin/Lanoxin
Class
Cardiac glycoside
Digoxin/Lanoxin
Indications
Control ventricular rates in A-Fib/A-Flutter
Alt. for reentry SVTs
Heart failure due to poor LV contractility
Digitalis Toxicity
Arrythmias
Anorexia, nausea, diarrhea
Drowsiness, fatigue
Visual disturbances
Digibind is antidote
Digoxin/Lanoxin
Contraindications
Allergy
Brady
Blocks
VT/VF
Digoxin/Lanoxin
Dose
Loading 4-6 mcg/kg over 5 min
2&3 2-3 mcg/kg 4-8 hr intervals
No peds
Dobutamine/Dobutrex
Class
Sympathomimetic
Synthetic catecholamine
Dobutamine/Dobutrex
P-Dyn
Synthetic catecholamine Primary beta 1 -inotropic -slight chronotropic Minimal alpha
Dobutamine/Dobutrex
Indications
Inotropic support in LV dysfunction
- pulmonary edema
- SBP 70-100
- no signs of shock
Dobutamine/Dobutrex
Contraindications
Allergy, hypovolemia, hypotension with signs of shock
Drug/toxin induced shock
Hypertrophic aortic stenosis tachydysrhythmias
Dobutamine/Dobutrex
Dose
2-20 mcg/kg/min
Dobutamine/Dobutrex
Peds Indications
Treatment of shock with high vascular systemic resistance
- heart failure
- cardiogenic shock
- MUST have adequate volume
Dobutamine/Dobutrex
Peds dose
2-20 mcg/kg/min
Furosemide/Lasix
Class
Loop diuretic
Furosemide/Lasix
P-Dyn
Inhibits reabsorption of sodium/chloride ions
Prompt diuresis
Increased venodilation (reduces preload)
Furosemide/Lasix
Indications
Acute pulmonary edema associated with heart failure (adjunctive therapy)
HTN emergency
Increased ICP
Hyperkalemia
Furosemide/Lasix
Contraindications
Allergy (lasix or sulfanomides) Hypovolemia Hypotension Severe electrolyte depletion Anuria
Furosemide/Lasix
Dose
0.5-1 mg/kg over 1-2 min
Double initial dose
Furosemide/Lasix
Peds Dose
1 mg/kg
Max 6 mg/kg
Bumetanide/Bumex
Class
Loop diuretic
Bumetanide/Bumex
P-Dyn
Inhibits reabsorption of sodium/chloride ions
Promotes prompt diuresis
Bumex vs. Lasix
Faster onset
Shorter duration
Increased potency 1 mg to 40 mg
Bumetanide/Bumex
Indications
Acute pulmonary edema/heart failure
Management of HTN
Bumetanide/Bumex
Contraindications
Allergy (bumex, sulfonamides) Hypovolemia Hypotension Electrolyte depletion Anuria
Bumetanide/Bumex
Dose
0.5-1 mg
Repeat prn q 2-3 hrs
No peds
Norepinephrine/Levophed
Class
Sympathomimetic
Catecholamine
Norepinephrine/Levophed
P-Dyn
Potent vasoconstrictor (primarily alpha, some beta 1, + inotropy)
Increased BP in cardiogenic shock/hypotensive emergencies
Constricts renal/mesenteric vessels
Norepinephrine/Levophed
Indications
Cardiogenic shock
SBP <70
Severe hypotension without hypovolemia
Norepinephrine/Levophed
Dose
0.1-0.5 mcg/min up to 35 mcg/min
Titrate to effect
Norepinephrine/Levophed
Peds Dose
0.1-2 mcg/kg/min
