Phosphodiesterase Inhibitors Flashcards
Phosphodiesterase Inhibitors:
INAMRINONE
MILRINONE
Second class of drugs that act as cardiotonic (inotropic) agents
INAMRINONE
Approved only for use in patients 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
THERAPEUTIC ACTION
What does this do our body?
Blocks the enzyme phosphodiesterase, leads to an increase in myocardial cell cyclic adenosine monophosphate (cAMP), which increases calcium levels in the cell, causing a stronger contraction and prolonged response to sympathetic stimulation; directly relaxes vascular smooth muscle
INDICATIONS
Short-term treatment of HF in patients unresponsive to digitalis, diuretics, or vasodilators
CONTRAINDICATIONS
Allergy Severe aortic or pulmonic disease MI fluid volume deficit, ventricular arrhythmias
CAUTION
Pregnancy or lactation
Elderly
ADVERSE EFFECTS
What to monitor for?
Arrhythmias Hypotension Nausea, Vomiting Thrombocytopenia Pericarditis Pleuritis Fever Chest Pain Burning at Injection Site
Drug-Drug Interactions
Furosemide
ASSESMENT
What we look for before administrating
History and physical exam Known allergies, acute aortic or pulmonic valvular disease, acute MI or fluid volume deficit, and ventricular arrhythmias Pregnancy and lactation Cardiac status and heart sounds Lab results
NURSING D/X
Decreased cardiac output related to the development of arrhythmias or hypotension
Risk for injury related to CNS or CV effects
Ineffective tissue perfusion related to hypotension, thrombocytopenia, or arrhythmias
Deficient knowledge related to drug therapy
IMPLEMENTATION
Protect the drug from light
Monitor pulse and blood pressure frequently during administration
Monitor input and output and record daily weight
Monitor platelet counts before and regularly during therapy
Provide life support equipment on standby
EVALUATION
Monitor patient response to the drug (alleviation of signs and symptoms of heart failure)
Monitor for adverse effects (hypotension, cardiac arrhythmias, GI upset, thrombocytopenia)
Monitor the compliance with the regimen
Evaluate the effectiveness of the teaching plan
Prototype
Milrinone
