Exam 4 (Week 14) Flashcards
Pharmacological class of digoxin (lanoxin):
Cardiac glycoside/inotropic
Therapeutic class of digoxin (lanoxin):
heart failure/antidysrhythmic
What does digoxin (lanolin)’s positive inotropic action on the heart increase?
increases the force of ventricular contraction, increasing cardiac output
MOA of digoxin (lanoxin):
- inhibits the enzyme: sodium potassium ATPase, which promotes calcium accumulation in myocytes
- changes electrical activity of the heart
What benefits can digoxin (lanoxin) have at low doses?
can have neurohormonal benefits
Uses of digoxin (lanoxin):
- heart failure
2. manage dysrhythmias
ADE of digoxin (lanoxin) are induced by what?
high levels of the drug
ADE of digoxin (lanoxin):
- digoxin induced arrhythmias
- anorexia
- nausea
- vomiting
- fatigue
- visual disturbances
lab values for digoxin (lanoxin):
monitor potassium blood levels b/c potassium competes with digoxin for binding with sodium potassium ATPase
1 nursing implication of digoxin (lanoxin):
educate patients about early signs of toxicity.
Pharmacological class of dopamine (intropin):
Inotropic catecholamine
Therapeutic class of dopamine (intropin):
Heart failure/Antidysrhythmic
what is important about dopamine (intropin):
It is an inotropic catecholamine
Pharmacological class of Quinidine (Quinalan):
sodium channel blocker
Therapeutic class of Quinidine (Quinalan):
Class IA antidysrhythmic
MOA of Quinidine (Quinalan):
- blocks sodium channels –> slowing impulse conduction in the atria, ventricles, and HIS purkinje system
- delays repolarization at these sites by blocking potassium channels
What is Quinidine (Quinalan) specifically? Blocking what?
anticholinergic; blocks vagal input to the heart
What does Quinidine (Quinalan) do in terms of EKG:
- widens the QRS complex
2. prolongs QT interval
Uses of Quinidine (Quinalan):
- supra ventricular and ventricular dysrhythmias
2. malaria
ADE of Quinidine (Quinalan):
- diarrhea
- sintasism - ringing in the ears
- headache
- nausea
- vertigo
- visual disturbance
- cardio toxicity
- arterial embolism
- alpha adrenergic blockade, resulting in hypotension
1 nursing implication of Quinidine (Quinalan):
inform the patient to take the drug with meals
Pharmacological class of Lidocaine (xylocaine)
Sodium channel blocker
Therapeutic class of Lidocaine (xylocaine):
Class IB antidysrhythmic
MOA of Lidocaine (xylocaine):
Accelerates repolarization
Uses of Lidocaine (xylocaine):
ventricular dysrhythmias
Pharmacological class of Amiodarone (Cordarone)
Potassium channel blocker
Therapeutic class of Amiodarone (Cordarone):
Class III antidysrhythmic
MOA of Amiodarone (Cordarone):
- blocks potassium channels
2. delaying re-polarization
What does Amiodarone (Cordarone) do in terms of the heart:
- decreases automaticity of the SA node
- reduces contractility
- reduces contraction velocity
- widens QRS complex
- prolongs PR and QT intervals
Why is Amiodarone (Cordarone) limited?
due to potential for toxicity
Uses of Amiodarone (Cordarone):
life-threatening ventricular dysrhythmias like…
- re-current ventricular fibrillation
- re-current hemodynamically unstable ventricular tachycardia
ADE of Amiodarone (Cordarone) are due to…
due to toxic effects
ADE of Amiodarone (Cordarone):
pulmonary, cardiac, thyroid, liver, and dermatologic toxicity
How is Amiodarone (Cordarone) toxic during pregnancy and breastfeeding?
crosses the placental barrier and enters breast milk, so it can be toxic to pregnancy and breastfeeding
1 nursing implication of Amiodarone (Cordarone):
educate the patient on signs of toxicity
Pharmacological class of Adenosine (Adenocard):
Nucleotide: inhibits calcium influx
Therapeutic class of Adenosine (Adenocard):
Other (Class V) antidysrhythmic
What kind of life does Adenosine (Adenocard) have?
a short life
Uses of Adenosine (Adenocard):
paroxysmal Supra Ventricular Tachycardia
Pharmacological class of Nitroglycerin (Nitrostat):
Organic nitrate
Therapeutic class of Nitroglycerin (Nitrostat):
Antianginal
MOA of Nitroglycerin (Nitrostat):
acts directly on vascular smooth muscle to promote vasodilation of the veins
What does Nitroglycerin (Nitrostat) decrease? What does it relax or prevent?
- decreases cardiac oxygen demand, decreasing pain
2. relaxing or preventing spasm in the coronary arteries
Uses of Nitroglycerin (Nitrostat):
- acute anginal episodes in stable angina
2. sustained anginal episodes - variant angina
ADE of Nitroglycerin (Nitrostat):
- headache
- orthostatic hypotension
- reflex tachycardia
1 nursing implication of Nitroglycerin (Nitrostat):
avoid activities that may elicit anginal attack