Phosphdiesterase Inhibitors Flashcards
Phosphodiesterase Inhibitors action
Cause a stronger muscle contraction of the heart (a + inotropic effect)
Block the enzyme phosphodiesterase leads to an increase in myocardial cell cyclic adenosine monophosphate (cAMP)
↑ calcium levels in the cell, causing a stronger contraction & prolonged response to sympathetic stimulation; directly relaxes vascular smooth muscle
Phosphodiesterase Inhibitors drug names
Inamrinone: Approved only for use in pts with HF that has not responded to digoxin, diuretics, or vasodilators
Milrinone: Short-term management of HF in patients who are receiving digoxin and diuretics
Phosphodiesterase Inhibitors contraindications
Allergy
severe aortic or pulmonic disease
MI, fluid volume deficit
ventricular arrhythmias
Phosphodiesterase Inhibitors Indications
Short-term tx of HF
In patients unresponsive to digitalis, diuretics, or vasodilators
Phosphodiesterase Inhibitors caution
pregnancy & lactation
Elderly
Phosphodiesterase Inhibitors drug-drug interactions
Furosemide
causes crystals to form; very painful
Can’t mix both meds in the same container
Phosphodiesterase Inhibitors adverse effects
Arrhythmias hypotension, N & V Thrombocytopenia (low platelet count) Pericarditis Pleuritis Fever, chest pain Burning at injection site
Phosphodiesterase Inhibitors nursing implications
Past HX and physical exam Known allergies pregnancy & lactation HR, BP, listen to heart sounds ECG of heart Lab: electrolyte; monitor for CBC Kidney/liver functions protect from light Monitor I/O Daily weight Platelet counts before & during therapy Life support equipment Be on cardiac monitor Compliant with regimen Teach to take own pulse
Phosphodiesterase Inhibitors prototype
Milrinone
Milrinone action
blocks the enzyme phosphodiesterase, which leads to an increase in myocardial cell cAMP, which increases calcium levels in the cell, causing a stronger contraction and prolonged response to sympathetic stimulation; directly relaxes vascular smooth muscle
Milrinone Indications
Short-term treatment of HF in patients who have not responded to digitalis, diuretics, or vasodilators
Milrinone adverse effects
Arrhythmias, hypotension, nausea, vomiting, thrombocytopenia, pericarditis, pleuritis, fever, chest pain, burning at injection site