heart failure continued Flashcards
How does digoxin work and what do you need to know about it’s therapeutic range?
What are Digoxin’s side effects?
What to know about Ivabradine?
Also known as digitek, digox, lanoxin. Inhibits the Na/K ATPase pump. positive inotropic effect and negative chronotropic effect. Therapeutic range needs to be 0.5-0.9(higher for AFib). Antidote is Digifab.
Monitor electrolytes and renal function, initial s/sx of toxicity are N/V, loss of appetite, and bradycardia, and halos. Hypokalemia, hypomagnesemia, and hypercalcemia increase risk of digoxin toxicity.
Need to be in sinus rhythm with a RHR >70. Target 50-60 BPM. Watch for bradycarida, hypertension, afib, and luminous phenomena. Can increase risk of QT prolongation and ventricular arrhythmias.
What to know about how to take potassium?
What drugs can prolong the QT interval?
What is the pnuemonic for remembering Antiarrythmics classification?
Micro-K can be sprinkled and opened, K-tab and Klor-Con can be swallowed whole, Klor-Con can be swallowed whole, or cut in half or dissolve in 4 oz water.
Class 1A and Class 3 antiarrythmics, Quinolones and Macrolides, Azole antifungals(not isavuconazole), Tricyclics, citalopram, escitalopram, Sertraline is preferred in cardiac patients, 5-HT3 receptor antagonists, droperidol, haloperidol, thioridazine, ziprasidone, Fingolimod, methadone.
Double quarter pounder, lettuce, mayo, fries please! Because dieting during stress is always very difficult. Disopyramide, Quinidine, Procainamide, Lidocaine, Mexiletine, Flecainide, Propafenone, Beta blockers, Dronedarone, Dofetilide, Sotalol, Ibutilide, Amiodarone, Verapamil, Diltiazem.
What drugs do people take for rate control?
What are Class 1 MOA?
What are class 2 MOA?
Beta blockers or non-DHP CCB’s(sometimes digoxin).
Na-Channel blockers, negative inotrope potential
Beta blockers to slow the rate
What are Class 3 MOA?
What are Class 4 MOA?
When is adenosine used?
K-channel blockers. Amio and Dron. Amio is useful for afib and preferentially used in HF. Sotalol blocks K-channels and is a beta blocker.
Ca-channel non DHP, slow the rate in ventricular tachyarrythmias. do not use with HF and HFrEF.
Adenosine receptors used in paroxysmal supraventricular tachyarrythmias.
What is amiodarone’s brand name and BBW?
What are amiodarones side effects?
What do we need to monitor with amiodarone and special notes?
Pacerone, Nexterone. Pulmonary and hepatotoxicity. Use only for life-threatening arrhythmias. Hospitalized when loading dose is given.
Hyper and hypo thyroidism(hypo more common), inhibits conversion of T4-T3. Optic neuropathy, photosensitivity, slate blue skin discoloration(grey ish). Brady cardia, hypotension, corneal microdepositis, dizziness, ataxia, N/V, constipation, tremor.
ECG, BP, electrolytes, pulmonary function, LFT and thyroid. Must be administered in a non PVC container. Premixed nexterone comes in GALAXY containers. Use a 0.22 micron, and heparin flush. Slow infusion rate or D/C if hypotension and bradycardia occurs, recommended in HF patients, contains iodine. half life is 40-60 days.
What are amiodarones drug interactions?
What special things to know about Disopyramide?
What to know about Quinidine?
increase levels of many drugs, CYP2C9 D6 and 3A4 inhibitor, and P-gp. Decrease dig by 50% and warfarin by 30-50% when starting. Watch for additive effects. Do not use with Sofosbuvir due to bradycaric effect.
Anticholinergic effects.
Take with food or milk, Watch for DILE, hemolysis risk(avoid in G6PD), coombs test positive(can cause). Diarrhea, stomach cramping, tinnitus, hearing loss, blurred vision, headache, delirium.
What to know about Procainamide?
What to know about Lidocaine(class 1B)?
Active metabolite(NAPA) is renally cleared. BBW of agranulocytosis. can cause ANA(antinuclear antibody) and DILE.
Used for ventricular arrhythmias only/cardiac arrest/refractory VT.
