Heart Failure Medications Flashcards
Positive Inotropic Medications:
increase the force of myocardial contractility
Positive Chronotropic Medications:
Increase HR
Positive Dromotropic Medications
Accelerate cardiac conduction
Ivabradine classification:
Sinoatrial Node Modulator
Ivabradine Indications:
treatment of chronic HF in stable clients at maximum beta-blocker doses with EF of <35
Ivabradine contraindications:
decompensated HF, hypotension, sick sinus syndrome, if HR is less that 60, pacemaker, hepatic impairment, increase risk for a fib, bradycardia, conduction disturbances
Ivabradine adv effects:
bradycardia, HTN, a fib, visual changes, AVOID GRAPEFRUIT JUICE
B-type Natriuretic peptides mech of action:
diuresis, natriuresis, vasodialating effects on arteries and veins, indriectly increases CO, indirectly suppresses RAAS
Nesiritide classification:
B-type Natriuretic peptides
Nesiritide adv effects:
HYPOtension, dysrhythmia, headache, abd pain, insomnia
Nesiritide use:
synthetic, used in ICU as last resort to treat severe HF
Phosphodiesterase Inhibitors mech of action:
work by inhibiting the enzyme phosphodiesterase, fort short term use VERY TOXIC
Milrinone adv effects:
dysrhythmias, HYPOtension, N/V, thrombocytopenia, pericarditis, pleuritis, fever, chest pain, burning at injection site
Milrinone classification:
Phosphodiesterase Inhibitors
Milrinone interactions:
diuretics, digoxin
Milrinone VS Furosemide:
separate lines, prevent precipitation (crystalling), hypotensive and inotropic effects, create abnormal labs
Cardiac Glycosides (inotropic) from what plant?
digitalis (foxglove)
Cardiac Glycosides (inotropic) mech of action:
increase myocardial contractility, change electrical conduction properties of the heart, positive inotropic effect, reduced HR, negative dromotropic effect
Medication effects of Cardiac Glycosides (inotropic):
reduction on heart size, decrease in venous BP and vein engorgment, improve quality of life
Diogxin classification:
Cardiac Glycosides (inotropic)
Diogxin correct levels:
0.5 to 2 ng/mL
what must you check before administering diogxin?
potassium levels, electrolytes, can cause toxicity
diogxin adv effects:
dysrhythmias including bradycardia or tachycardia, HA, fatigue, malaise, confusion, convulsions, very nausea and seeing green,yellow,purple/halo vision
will someone taking diogxin be on a tele monitor?
yes
nursing implications diogxin:
any adv effects, avooid with high fiber foods, slowly given, hold if HR less than 60, avoid IM
Nursing management for all HF meds:
adv effects, UOP, decreased edema, SOB, dyspnea, crackles, fatigue, improvements
nursing implications Milrinone:
IV only, protect from light, CBC count, renal hepatic tests, HR/BP monitoring, strict I&O
