Heart Failure Flashcards
no limitation of ordinary activity (which NYHA class of HF)
Class I
slight limitation of activity- symptoms with normal activity (which NYHA class of HF)
Class II
marked limitation of physical activity- symptoms with mild activity (which NYHA class of HF)
Class III
symptoms occur at rest (which NYHA class of HF)
Class IV
steps for dig toxicity (4)
- Stop dig & potassium wasting diuretics
- Monitor potassium & give potassium
- May need to give antidysrhythmics (phenytoin or lidocaine)
- Severe cases give fab antibody fragments which bind to dig &prevent it from activating.
most common reason for digoxin-related dysrhythmias?
diuretic-induced hypokalemia
antidote for severe digoxin overdose
fab antibody fragments (digibind/digifab)
how is digoxin eliminated?
renal excretion
GI effects of digoxin (3)
anorexia, N/V
CNS effects of digoxin (2)
fatigue & visual disturbances
what provides advanced warning of serious digoxin toxicity?
GI & CNS effects
routine therapy for stage C HF should include 3 medications:
diuretic
ACE or an ARB
beta blocker
most serious adverse effect of digoxin
cardiotoxicity - dysrhythmias
medication classes that interact with digoxin (4)
- diuretics (thiazide & loop)
- ACEs & ARBs (elevate K+)
- sympathomimetics (increase risk for dysrhythmias)
- Quinidine (can elevate plasma levels of digoxin)
contraindications for digoxin (3)
V-fib
V-tach
dig toxicity
caution should be used when giving digoxin to patients with (4)
Hypokalemia
Partial AV block
Advanced HF
Renal impairment
what medications can be combined with digoxin? (4)
ACEs, ARBs, beta blockers, diuretics
drugs that should be avoided in Stage C HF (3)
antidysrhythmics
CCBs
NSAIDs
