NTG and Digoxin Flashcards
NTG is primarily used for what condition? what are other uses?
angina
HTN (crappy), CHF, AMI, pulmonary HTN
NTG decreases preload/afterload?
PRELOAD (end of diastole), from decreased VR
NTG –> NO = vasodilation in what vessels?
mainly venules, some arterioles
NTG causes direct coronary _________.
dilation and increased bloodflow
What limits the efficacy of NTG? what can be done about this?
tolerance.
10-12 hour nitrate-free interval for re-generation of SH groups
AEs of NTG include…
facial flushing, headahce, dizziness
Which NTG is DOC for relief from acute angina attacks?
sublingual (SL) –immediate release
NTG is available ER and IR. What would you use in an acute angina attack?
IR. NOT ER because those are slow on, slow off.
T or F. NTG is available IV and PO. How is the PO available?
True Extended release (IR gets destroyed by stomach)
IV NTG should be compounded in what?
GLASS
Why so we encourage refills of NTG?
Tabs are only potent for 6-12 months and we want everyone with angina to carry it around.
Other than IV and PO, what other ways is NTG available?
Aerosol spray, buccal tabs, ointment, transdermal
SL NTG should ______ when you place it under the tongue.
sting
Guidelines for NTG now is…
Tablet, tablet, ER.
CAUTION when combining NTG and…..what can happen?
PDE-5 inhibitors (erectile dysfunction drugs)
severe hypotension
Digoxin is derived from what?
fox glove plant
What is the MOA of digoxin?
positive inotrope (calcium): increased contractility negative chronotrope (vagal enhancement): decreased HR
Digoxin is the opposite of what drug?
Verapamil (negative inotrope)
Is Digoxin used in CHF?
used in patients with severe CHF that are not showing symptomatic improvement with other meds.
“not hot”
What are AEs of digoxin?
anorexia, N/V, bradycardia, visual changes (everything looks green/gold and halo vision), heart block
Toxicity: HYPOkalemia/mag, HYPERcalcemia
What is the treatment for OD on digoxin?
Digiband: antibodies that bind to Digoxin and inactivate them
