Heart Failure and Cardiac Glycosides

Question 1

What diuretic is used for heart failure usually? And what type of diuretic is it

Answer 1

Furosemide. Loop diuretic.

Question 2

What is the use of furosemide?

Answer 2

Reduces the symptoms of heart failure

Question 3

What is the main cardiac glycoside?

Answer 3

Digoxin

Question 4

Uses and action of Digoxin

Answer 4

Treatment of systolic heart failure and atrial fibrillation. Increases the heart contraction and blood flow. Decreases heart rate and blood pressure

Question 5

What patients should you not give Digoxin?

Answer 5

Acute myocardial infarction or V-fib.

Question 6

Side effects and complications of Digoxin

Answer 6

Bradycardia/tachycardia, hypotension, headache, fatigue, confusion, convulsions, worsening edema or rash

Question 7

Digoxin has a ____ _____ therapeutic window.

Answer 7

Very small

Question 8

What increases digoxin toxicity? (An electrolyte imbalance)

Answer 8

Hypokalemia

Question 9

What is the therapeutic range for Digoxin?

Answer 9

0.5-2.0 ng/mL (nanograms not milligrams)

Question 10

What are the main Digoxin toxicity effects and what do you need to do before you give it?

Answer 10

Take the apical pulse for 1 full minute. Nausea, vomiting, bradycardia, vision changes.

Question 11

What are the beta blockers?

Answer 11

Metoprolol, Esmolol, Atenolol (all end in -lol)

Question 12

What is the expected action of beta blockers?

Answer 12

Decrease HR, decrease contractility of the heart, decreased rate of conduction through the AV nodes.

Question 13

Complications of beta blockers

Answer 13

Bradycardia, decreased cardiac output, AV block, orthostatic hypotension

Question 14

Contraindications of beta blockers

Answer 14

Pregnancy, AV block, sinus bradycardia, diabetes, depression, older adults

Question 15

ACE inhbitors name and suffix

Answer 15

Captopril (all end in -pril)

Question 16

ACE inhibitors action

Answer 16

Inhibits angiotensive converting enzymes. Prevents sodium and water resorption by inhibiting aldosterone secretion

Question 17

Side effects of ACE inhibitors

Answer 17

Angioedema, Cough, Elevated Potassium (ACE)

Question 18

Calcium channel blocker names

Answer 18

Nifedipine, Verapamil and Diltiazem

Question 19

Calcium channel blocker action

Answer 19

Smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction. Decreases peripheral smooth muscle tone. Vasodilates peripheral arterioles and heart arteries

Question 20

Complications of calcium channel blockers

Answer 20

Tachycardia, toxicity, orthostatic hypotension, peripheral edema

Question 21

Important nursing administration

Answer 21

Give slowly (2-3mins)