HF Prototypes

Question 1

digoxin therapeutic class

Answer 1

drugs for heart failure

Question 2

digoxin pharm class

Answer 2

cardiac glycoside

Question 3

digoxin MOA

Answer 3

increase contractility, inhibits Na+K+ ATPase (this makes sodium accumulate and releases Ca2+ which=more force), increases CO, urine production, depresses SA node

Question 4

digoxin admin alerts

Answer 4

take apical pulse for 1 full min, if parameter is less than that set by HC provider (usually less than 60) don’t give, take serum digoxin levels before giving (narrow therapeutic range), decreases hepativ function so avoid peds and elderly

Question 5

digoxin adverse effects

Answer 5

digoxin and diuretics can lead to hypokalemia, which can lead to dysrhythmia

Question 6

digoxin contraindications

Answer 6

dont give with AV block or ventricular arrhythmias not related to HF

Question 7

digoxin drug reactions

Answer 7

ACE inhibitors (hyperkalemia)

Question 8

digoxin antidote

Answer 8

Digibind

Question 9

milrinone therapeutic class

Answer 9

drug for acute heart failure

Question 10

milrinone pharm class

Answer 10

phosphodiesterase (PDA) inhibitor

Question 11

milrinone MOA

Answer 11

blocks enzyme phosphodiesterase in cardiac and smooth muscle, increases force of cardiac contraction and increases CO (short half-life, given IV)
Heart – increases calcium availability to heart muscle – which increases contraction
Vessels - PDE inhibition prevents cGMP metabolism in the smooth musculature causing vasodilation

Question 12

milrinone adverse effects

Answer 12

ventricular dysrhythmia- which occurs in every 1 in 10, SO, you need ECG monitoring to prevent hypotension, can cause headache, nausea and vomitting (from vasodilation)

Question 13

milrinone overdose

Answer 13

causes hypotension, treat with vasopressor, administration of normal saline