Hyperpolarization-Activated CyclicNucleotide–Gated Channel Blockers Flashcards
IVABRADINE
treatment of patients with chronic HF
THERAPEUTIC ACTION AND INDICATION
How does this work in the body and why we are taking it
Blocking the HCNs slows the heart’s pacemaker, the sinus node, in the repolarizing phase of the action potential
CONTRANIDICATIONS
When NOT to give the drug
CAUTIONS
Known allergy
Active, decompensated HF;
hypotension; sick sinus syndrome of AV block; resting heart rate under 60 beats/min;
patients completely dependent on a pacemaker and severe hepatic impairment
Caution- atrial fibrillation or moderate heart block
ADVERSE EFFECTS
What we are monitoring for
Bradycardia
hypertension
atrial fibrillation
luminous phenomena (sudden changes in brightness in parts of the visual field, colored bright lights, image decompensation, multiple images)
DRUG -DRUG INTERACTIONS
CYP3A4 inhibitors or inducers
Negative chronotropic drugs
ASSESMENT
What we look at before administering the drug
History and physical Known allergy AV block decompensated HF, dependence on a pacemaker, resting heart rate under 60 beats/min hypotension Severe hepatic impairment or concurrent use of CYP3A4 inhibitors Cardiac status ECG appropriate lab values
NURSING D/X
Decreased cardiac output related to the development of arrhythmias or hypotension
Risk for injury related to visual or CV effect
Ineffective tissue perfusion related to hypotension or bradycardia
Deficient knowledge related to drug therapy
IMPLEMENTATION
Monitor heart rate and blood pressure regularly
Monitor input and output and record daily weight
Provide safety measures if visual disturbances occur
Provide thorough patient teaching
EVALUATION
Monitor patient response to the drug (alleviation of signs and symptoms of heart failure)
Monitor for adverse effects (hypotension, cardiac arrhythmias, visual disturbances)
Monitor the compliance with the regimen
Evaluate the effectiveness of the teaching plan
Prototype
IVABRADINE
