Heart, Angina, MI, and Shock Flashcards
DIGOXIN
MOA
Keeps sodium in the cell, causing calcium to come out; when calcium is released it produces a more forceful contraction
DIGOXIN
theraputic ranged
0.5-2
over 2 you have digoxin toxicity
(check levels every 6-12hrs after administration)
DIGOXIN TOXICITY
>2
vomitting, dizziness, confusion, vision changes(yellow/green/white halos)*,
DIGOXIN
Administration
IV or PO
IV–> faster; digitalization
(when you increase dose enough until tissues become saturated it to DECREASE HF)
Take at same time each day(NO SKIP OR DOUBLE)
DIGOXIN
Adverse Effects/INTERVENTIONS
Gi symptoms
- monitor/report GI symptoms
- vomitting may cause Hypokalemia
- monitor K levels, low K >’s risk of toxicity; if levels are low give patient K
CNS symptoms (halos, HAs) - monitor/report;
Cardiac Dyrthmias (especially with toxicity) - take apical pulse full minute before giving medication; withhold if it's
DIGOXIN TOXICITY ANITDOTE
digibind
DIGOXIN
Contraindications
V-fib, tachycardia
-unless if caused by HF it is okay
digoxin toxicity
DIGOXIN INTERACTIONS
anti-dysrhythmics increase digoxin levels
Diuretics
Nesiritide (Natrecor)
MOA
reduce pre-load and after-load
VASODILATION
Nesiritide (Natrecor)
Adverse Effect
Severe Hypotension
Procainamide (pronestly)
[Sodium channel blocker]
MOA
increases duration of the action potential; BLOCKS SODIUM
Procainamide (pronestly)
AE/INTERVENTIONS
systemic lupus syndrome: butterfly rash, fever, swelling/enlargement
-If they have this syndrom stop the drugs, give them analgesics to help with pain and fever
Neutropenia and thrombocytopenia
- look for s/s and infections;
- teach them about bleeding and bruising
- monitor CBC weekly for 1st 12 weeks while on drug ; If patient gets this A.E stop drop
Cardiotoxicity
- IF this occurs stop drug;
- monitor ECG and vitals signs
Lidocaine (Xylocaine)
A.E
SAMS
Seizures
Altered CNS
Muscle twitching
Slurred/difficult speech
-Seizures (give Phenytoin)
Respiratory Arrest
-monitor EKG
Propafenone (Rythmol)
A.E/Interventions
bradycardia, HF, dizziness, and weakness
Monitor for HR, chest pain, and edema
Amiodarone (Cordarone, Pacerone)
A.E
Pulmonary toxicity
-dyspnea, decrease breath sounds
Hypotension
Bradycardia
BE CONCERNED ABOUT
visual disturbances, liver and thyroid function, CNS effects, phlebitis (inflammation of vein you put it in)
AV heart block!
Adenosine
MOA
terminates tachycardia
Adenosine
Administration
IV push as a bolus, flush afterwards!
(Can literally stop the heart)
warn patient they may as if they’re dying
Adenosine
A.E
dyspnea, vasoconstriction, vasodilation, and flushing in the face
Salicylic Acid (Aspirin) MOA
prevents clots; works as a blood thinner
Salicylic Acid (Aspirin) Administrations
orally (WITH food)*
(low does of aspirin (81mg) to prevent strokes,/MI)
Aspirin 325 mg should be taken during initial acute episode of MI
-CHEW IT AND SWALLOW iT! WANT This TO WORK FAST
Salicylic Acid (Aspirin) A.E/ Intervention
GI effects
-proton pump inhibitor; monitor/report
hemmorrhagic stroke
-monitor for s/s of weakness, dizziness, and HA
prolonged bleeding time/Gastric
-monitor bleeding and observe GI bleed (coffee emesis, and tarry stools)
bleed/thrombocytopenia
- monitor for bleeding gums, etc .
tinnitus, hearing loss*
Salicylic Acid (Aspirin) Interactions
NSAIDs, warfarin or any other med that enhance bleeding
Aspirin mixed with beta-blockers, reduces the beta-blocker effect
Corticosteriods decrease effects of asthma and increase risk for GI bleed
Caffeine increases absorption
Morphine
MOA
DRUG CHOICE WHEN PT HAS MI
Morphine
A.E
RESPIRATORY DEPRESSION*
- if less than 12bpm STOP
- NARCAN
- cough
contstipation(when longer periods of time)
- laxatives, stool softeners
- increase fiber and fluid
orthostatic hypotension
-assit with ambulation
urinary retention
- assess bladder for distention every 4-6 hours
- void every 4 hrs
