Phosphodiesterase Inhibitors Flashcards
Medications
- 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)
Actions
-Block the enzyme phosphodiesterase, leads to an increase in myocardial cell cyclic adenosine monophosphate (cAMP), which increases calcium levels causing a stronger contraction and prolonged response to sympathetic stimulation; directly relaxes vascular smooth muscle
Indications
-Short-term treatment HF in patients unresponsive to digitalis, diuretics, or vasodilators
Contraindications
- Allergy
- Severe aortic or pulmonic disease, MI, fluid volume deficit, and ventricular arrthymias
Caution
- Pregnancy/lactation
- Elderly
Adverse effects
- Arrhythmias
- Hypotension
- N/V
- Thrombocytopenia
- Pericarditis
- Pleuritis
- Fever
- Chest pain
- Burning at injection site
Drug-Drug interactions
-Furosemide
Assessment
- History: check for any contraindications
- Physical: cardiac status and heart sounds, VS, certain labs
Nursing Diagnoses
- Decreased cardiac output r/t development of arrhythmias or hypotension
- Risk for injury r/t CNS or CV
- Ineffective tissue perfusion r/t hypotension, thrombocytopenia, or arrhythmias
- Deficient knowledge r/t drug therapy
Implementation
- Protect drug from light
- Monitor pulse and BP frequently
- Monitor I&O’s and weight
- Monitor platelet counts
- Provide life support equipment on standby
Evaluation
- Evaluation patient response to the drug (alleviation of signs and symptoms of heart failure)
- Monitor for adverse effects
- Evaluate the compliance with the regimen
- Evaluate the effectiveness of the teaching plan